Physician's global assessment of disease activity in juvenile idiopathic arthritis: consensus-based recommendations from an international task force.
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Rypdal Veronika, Brunner Hermine I, Feldman Brian M, Ruperto Nicolino, Aggarwal Amita, Angeles-Han Sheila T, Backström Maria, Balay-Dustrude Erin, Bracaglia Claudia, De Benedetti Fabrizio, Doležalová Pavla, Garrone Marco, Guzman Jaime, Horton Daniel B, Laxer Ronald M, Lovell Daniel J, Løvli Tonje, Magni-Manzoni Silvia, Minoia Francesca, Morgan Esi M, Munro Jane, Nordal Ellen B, Normand Christophe, Pan Nancy, Patrone Elisa, Ravelli Angelo, Magalhães Claudia Saad, Sinha Rashmi, Swart Joost F, Tarkiainen Maarit, Twilt Marinka, Vähäsalo Paula, Vastert Sebastiaan, Vojinovic Jelena, Weiss Pamela F, Gottlieb Beth, Consolaro Alessandro, Pediatric Rheumatology European Society, the Paediatric Rheumatology International Trials Organisation, the Pediatric Rheumatology Care & Outcome Improvement Network, and the Pediatric Rheumatology Collaborative Study Group
Аннотация
METHODS: An international task force of 34 members was assembled, and recommendations were developed in 3 phases: (1) 2 preliminary surveys of paediatric rheumatologists and a literature review; (2) 14 videoconference meetings, informed by multicriteria decision analysis and formal anonymous voting; and (3) a 2-day in-person consensus conference using structured nominal group technique discussions and formal voting. The threshold for achieving consensus was ≥78% of voting task force members. Agreement with the final statements was rated using a numerical rating scale from 0, strongly disagree, to 10, strongly agree.
RESULTS: Eighteen points to consider were agreed upon. All statements achieved consensus (≥78%), with a level of agreement ≥9.2. Points included the definition of disease activity in juvenile idiopathic arthritis (JIA), factors to assess in nonsystemic JIA and systemic JIA, consideration of available imaging and laboratory tests, the role of extra-articular manifestations, the evaluation of treatment, and the timing of PhGA scoring.
CONCLUSIONS: The task force developed consensus-based recommendations when scoring the PhGA in nonsystemic and systemic JIA. These recommendations will lead to more reliable scoring of disease activity in patients with JIA.