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Houghton K, McPherson M, Surjanovic N, Loughin T, Berard R, Proulx-Gauthier JP, Chédeville G, Rumsey D, Schmeling H, Luca N, Johnson N, Gerschman T, Miettunen P, Tam H, Lim L, Morishita K, Scuccimarri R, Roth J, Duffy C, Tucker L, Feldman BM, Guzman J. Development and validation of the Kids Disability Screen for children with juvenile idiopathic arthritis: results from the CAPRI Registry. Rheumatology (Oxford) 2022; 61:4835-4844. [PMID: 35438140 DOI: 10.1093/rheumatology/keac146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/01/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE The aim of this study was to develop and validate a brief disability screen for children with JIA, the Kids Disability Screen (KDS). METHODS A total of 216 children enrolled in the Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI) Registry in 2017-2018 formed a development cohort, and 220 children enrolled in 2019-2020 formed a validation cohort. At every clinic visit, parents answered two questions derived from the Childhood Health Assessment Questionnaire (CHAQ): 'Is it hard for your child to run and play BECAUSE OF ARTHRITIS?' ('Hard' 0-10), and 'Does your child usually need help from you or another person BECAUSE OF ARTHRITIS?' ('Help', 0-10). We used 36-fold cross-validation and tested nine different mathematical methods to combine the answers and optimize psychometric properties. The results were confirmed in the validation cohort. RESULTS Expressed as the mean of the two answers, KDS best balanced ease of use and psychometric properties, while a LASSO regression model combining the two answers with other patient characteristics [estimated CHAQ [eCHAQ]) had the highest responsiveness. In the validation cohort, 22.7%, 25.9% and 28.6% of patients had a score of 0 at enrolment for the KDS, eCHAQ and CHAQ, respectively. Responsiveness was 0.67, 0.74 and 0.62, respectively. Sensitivity to detect a CHAQ > 0 was 0.90 and specificity 0.56, KDS detecting some disability in 44% of children with a CHAQ = 0. CONCLUSION This simple KDS has psychometric properties comparable with those of a full CHAQ and may be used at every clinic visit to identify those children who need a full disability assessment.
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Affiliation(s)
- Kristin Houghton
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
| | - Meghan McPherson
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
| | | | | | - Roberta Berard
- London Health Sciences Centre and Western University, London
| | | | | | - Dax Rumsey
- The Stollery Children's Hospital and University of Alberta, Edmonton
| | | | - Nadia Luca
- The Alberta Children's Hospital and University of Calgary, Calgary
| | - Nicole Johnson
- The Alberta Children's Hospital and University of Calgary, Calgary
| | - Tommy Gerschman
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
| | - Paivi Miettunen
- The Alberta Children's Hospital and University of Calgary, Calgary
| | - Herman Tam
- The Stollery Children's Hospital and University of Alberta, Edmonton
| | - Lillian Lim
- The Stollery Children's Hospital and University of Alberta, Edmonton
| | - Kimberly Morishita
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
| | | | - Johannes Roth
- Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa
| | - Ciaran Duffy
- Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa
| | - Lori Tucker
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
| | - Brian M Feldman
- Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Jaime Guzman
- British Columbia Children's Hospital and the University of British Columbia, Vancouver, Canada
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