Measurement of health status in children with juvenile rheumatoid arthritis

Abstract

Objective. To develop and validate a self-or parent-administered instrument for measuring functional status in children with juvenile rheumatoid arthritis (JRA).Methods. We adapted the Stanford Health Assessment Questionnaire (HAQ) for use in children ages 1-19 years, by adding several new questions, such that for each functional area, there was at least 1 question relevant to children of all ages. The face validity of the instrument was evaluated by a group of 20 health professionals and parents of 22 healthy children. reliability, studied at a 2-week interval, revealed virtually identical Disability Index scores measured on the 2 occasions (0.96 versus 0.96; P > 0.9 by paired t-test; Spearman's correlation coefficient = 0.8, P < 0.002).Conclusion. The Childhood HAQ, which takes less than 10 minutes to complete, is a valid, reliable, and sensitive instrument for measuring functional status in children with JRA.

A randomized, placebo‐controlled trial of infliximab plus methotrexate for the treatment of polyarticular‐course juvenile rheumatoid arthritis

“…Serum infliximab concentrations were determined with an enzyme-linked immunoassay (18) Definitions of response to therapy. Response to therapy was defined based on the combination of the following 6 JRA core set parameters (19,20): 1) physician global assessment of disease activity, on a 10-cm visual analog scale (VAS); 2) parent/patient global assessment of overall well-being, on a 10-cm VAS; 3) a measure of physical function, which for this trial was the cross-culturally adapted and validated version of a measure of functional ability in children with JRA, i.e., the Childhood Health Assessment Questionnaire (21,22); 4) the number of joints with active arthritis, defined by the presence of swelling or, if no swelling was present, limitation of motion accompanied by pain, tenderness, or both (16); 5) the number of joints with limited range of motion; and 6) a laboratory measure of inflammation, which for this trial was the erythrocyte sedimentation rate. Whenever possible, each patient's joints were evaluated by the same assessor at each visit.…”

Early outcomes and improvement of patients with juvenile idiopathic arthritis enrolled in a Canadian multicenter inception cohort

“…The outcomes reported in this study are based on the core criteria set measures collected at the enrollment and 6-month study visits, including: active joint count (AJC); number of joints with limited range of motion; erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) level; a 10-cm visual analog scale of physician global assessment of disease activity, in which higher scores indicate greater disease activity; a 10-cm visual analog scale of patient or parent global assessment of overall well-being, in which higher scores indicate worse well-being; and a measure of physical function, the Childhood Health Assessment Questionnaire (C-HAQ), in which 0 indicates the best function and 3 indicates the worst function (25).…”

A randomized trial of parenteral methotrexate comparing an intermediate dose with a higher dose in children with juvenile idiopathic arthritis who failed to respond to standard doses of methotrexate

“…As secondary outcomes measures, we used the individual validated JIA core set variables (11,12), which include the number of joints with active arthritis (defined as a joint with swelling or a joint with pain and limitation on movement) (range 0-71) (17), the number of joints with limited range of motion (range 0-67) (18), the physician's global evaluation of disease activity on a double-anchored 10-cm visual analog scale (VAS) (anchoring words 0 ϭ inactive, 10 ϭ very severe), the parent's global assessment of the child's overall well-being on a double-anchored 10-cm VAS (anchoring words 0 ϭ very well, 10 ϭ very poor) as reported on the Childhood Health Assessment Questionnaire (CHAQ) (19,20), the disability index of the CHAQ, and the Westergren ESR. All measures related to assessment of the joints are reported as a joint count only, to avoid redundancy with the scoring method for joint evaluation (18,21).…”

“…All measures related to assessment of the joints are reported as a joint count only, to avoid redundancy with the scoring method for joint evaluation (18,21). The CHAQ (19,20) is a validated diseasespecific instrument for JIA adapted from the adult Health Assessment Questionnaire. It measures functional ability in 8 activities of daily living: dressing and grooming, arising, eating, walking, hygiene, reach, grip, and activities.…”