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ALESSANDRO CONSOLARO, ROSA VITALE, ANGELA PISTORIO, BIANCA LATTANZI, NICOLINO RUPERTO, CLARA MALATTIA, GIOVANNI FILOCAMO, STEFANIA VIOLA, ALBERTO MARTINI, and ANGELO RAVELLI
ABSTRACT. Methods. Study data were obtained from the clinical database generated at the study unit. Each patient visit included a standardized assessment of JIA outcome measures. One visit for each patient was selected for analysis. Three definitions of inactive disease were applied to the data: a physician-based definition (physician global assessment = 0); a parent-based definition (parent global assessment = 0); and a formal definition, based on fulfillment of newly developed criteria for inactive disease in JIA. Results. Of 1237 visits made by 537 patients that included both physician and parent global assessments, 265 fulfilled the physician-based definition and/or the parent-based definition of inactive disease. Concordance between physicians and parents in rating the disease as inactive was seen in 40% of the visits, whereas in 60% of visits the 2 assessments were discordant. Parents tended to disagree with physicians in rating the disease as inactive if the child had pain or functional impairment, whereas physicians tended to disagree with parents in the presence of active joint symptoms. Only 2/3 of the 79 visits that fulfilled the formal definition of inactive disease also met the parent-based definition of inactive disease. Conclusion. We found frequent discordance between physicians' and parents' ratings of inactive disease in children with JIA, which suggests that the parent's rating of a child's disease activity should be considered for inclusion in the definition of clinical remission for JIA. (First Release July 1 2007; J Rheumatol 2007;34:1773-6) Key Indexing Terms:
JUVENILE IDIOPATHIC ARTHRITIS
From the Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini, Genova; and Università degli Studi di Genova, Genova, Italy. A. Consolaro, MD, Pediatric Resident; R. Vitale, MD, Pediatric Resident; B. Lattanzi, MD, Pediatric Resident; N. Ruperto, MD, Dirigente Medico; C. Malattia, MD, Research Fellow; G. Filocamo, MD, Research Fellow; S. Viola, MD, Dirigente Medico, Pediatria II, Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini; A. Pistorio, MD, PhD, Dirigente Medico, Servizio di Epidemiologia e Biostatistica, Direzione Scientifica, Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini; A. Martini, MD, Professor of Pediatrics; A. Ravelli, MD, Associate Professor of Pediatrics, Pediatria II, Istituto di Ricovero e Cura a Carattere Scientifico G. Gaslini, and Dipartimento di Pediatria, Università degli Studi di Genova. Address reprint requests to Dr. A. Ravelli, Pediatria II, Istituto G. Gaslini, Largo G. Gaslini 5, 16147 Genova, Italy. E-mail: angeloravelli@ospedale-gaslini.ge.it Accepted for publication April 17, 2007. |
