Development of validated disease activity and damage indices for the juvenile idiopathic inflammatory myopathies. I. Physician, parent, and patient global assessments

Abstract

in cooperation with the JUVENILE DERMATOMYOSITIS DISEASE ACTIVITY COLLABORATIVE STUDY GROUP Objective. To determine the reliability, content validity, and responsiveness of physician global assessments of disease activity and damage in the juvenile idiopathic inflammatory myopathies (IIM), and to investigate concordance among physician, parent, and patient global ratings.Methods. Sixteen pediatric rheumatologists rated 10 juvenile IIM paper patient cases for global disease activity and damage, and assessed the importance of 51 clinical and laboratory parameters in formulating their global assessments. Then, 117 juvenile IIM patients were enrolled in a protocol to examine the relationship between Likert and visual analog scale global assessments, their sensitivity to change, and the comparability of physician, parent, and patient global ratings.Results. Pediatric rheumatologists demonstrated excellent interrater reliability in their global assessments of juvenile IIM disease activity and damage (97.7% and 94.7% agreement among raters, respectively), and agreed on a core set of clinical parameters in formulating their judgments. Likert scale ratings correlated with those on a visual analog scale, and both were comparable in responsiveness (standardized response means -0.56 for disease activity, 0. Conclusion. Physician global assessments of juvenile IIM disease activity and damage demonstrated high interrater reliability and were shown to be comprehensive measures. Both physician and parent disease activity assessments should be considered valuable as

Glucocorticoid‐related changes in body mass index among children and adolescents with rheumatic diseases

“…ment were included in the graphical trajectories after their second birthday, but were excluded from the mixed-effects models and were not analyzed for return to baseline BMI Z scores. The Habitual Activity Estimation Scale (HAES) was used to measure physical activity (27,28), and rheumatic disease activity was assessed with a 10-cm visual analog scale (VAS) by the treating rheumatologist (29). Puberty was assessed by physical examination according to the Marshall and Tanner method (30,31) at baseline and at 12 months, except for one study center where it was recorded by self-report (32).…”

“…Disease activity was scored on a 10-cm VAS by a pediatric rheumatologist (29), where 0 cm ϭ inactive disease and 10 cm ϭ very active disease. The scale refers to the particular disease being scored.…”

Muscle metabolites, detected in urine by proton spectroscopy, correlate with disease damage in juvenile idiopathic inflammatory myopathies

“…Physician and parent global assessments of disease activity and damage, using both Likert and VAS scales, were obtained (2,5). The Physician Global Disease Activity and Damage VAS score is an accepted standardized scoring system for assessing disease activity and damage (2,5).…”

“…Physician and parent global assessments of disease activity and damage, using both Likert and VAS scales, were obtained (2,5). The Physician Global Disease Activity and Damage VAS score is an accepted standardized scoring system for assessing disease activity and damage (2,5). Twenty-two patients (at one center) Ͼ4 years of age underwent manual muscle testing, which was performed by a pediatric physical therapist; this could not be performed in younger patients, as previously explained by Rider (6).…”

“…There are a limited number of validated clinical measures to assess activity and damage in the juvenile IIMs, including global muscle strength and physical function measures (2)(3)(4)(5)(6). Such clinical assessments are used with laboratory investigations to assess the inflammatory activity of juvenile IIM (7)(8)(9).…”