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Fazza A, Chemil S, Miladi S, Boussaa H, Makhlouf Y, Ben Abdelghani K, Laatar A. Les outils d’évaluation au cours de l’arthrite juvénile idiopathique :
Revuenarrative. LA TUNISIE MEDICALE 2023; 101:537-543. [PMID: 38372552 PMCID: PMC11217963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/29/2023] [Indexed: 07/05/2024]
Abstract
Juvenile idiopathic arthritis (JIA), as a chronic condition, is associated with significant disease- and treatment-related morbidity, thus impacting children's quality of life. In order to optimize JIA management and to ensure the best possible care and outcome for children with rheumatic diseases, dedicated disease activity and damage assessment tools are essential. In recent years, there has been a concerted and important international effort to develop and validate disease activity and outcome instruments specific to JIA. This update aims to describe the main outcome measures currently used in JIA patients. These outcome measures include composite disease activity score, measures of physical function, measures of health related quality of life, clinical measures of damage and the assessment of Parent and child reported outcomes (PCROs).
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Affiliation(s)
- Alia Fazza
- Rheumatology department, Mongi Slim hospital, La Marsa, Tunisia, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sakina Chemil
- Rheumatology department, independent consultant, Bordj Bou Arreridj, Algeria
| | - Sawssen Miladi
- Rheumatology department, Mongi Slim hospital, La Marsa, Tunisia, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Hiba Boussaa
- Rheumatology department, Mongi Slim hospital, La Marsa, Tunisia, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Yasmine Makhlouf
- Rheumatology department, Mongi Slim hospital, La Marsa, Tunisia, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Kaouther Ben Abdelghani
- Rheumatology department, Mongi Slim hospital, La Marsa, Tunisia, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ahmed Laatar
- Rheumatology department, Mongi Slim hospital, La Marsa, Tunisia, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Treemarcki EB, Hersh AO. Health-Related Quality of Life Measures in Childhood-Onset Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:593-607. [PMID: 33091261 DOI: 10.1002/acr.24374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/06/2020] [Indexed: 11/11/2022]
Affiliation(s)
| | - Aimee O Hersh
- University of Utah and Primary Children's Hospital, Salt Lake City
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Morgan EM, Carle AC. Measures of Health Status and Quality of Life in Juvenile Idiopathic Arthritis. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:565-576. [PMID: 33091241 DOI: 10.1002/acr.24372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 01/04/2023]
Affiliation(s)
- Esi M Morgan
- Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Adam C Carle
- University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio
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You L, Qiu A, Huang B, Qiu P. Early detection of high disease activity in juvenile idiopathic arthritis by sequential monitoring of patients' health-related quality of life scores. Biom J 2020; 62:1343-1356. [PMID: 32159871 DOI: 10.1002/bimj.201900127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 10/29/2019] [Accepted: 12/22/2019] [Indexed: 11/11/2022]
Abstract
Juvenile idiopathic arthritis (JIA) is a chronic disease. During its "high disease activity (HDA)" stage, JIA can cause severe pain, and thus could seriously affect patients' physical and psychological health. Early detection of the HDA stage of JIA can reduce the damage of the disease by treating it at an early stage and alleviating the painful experience of the patients. So far, no effective cure of JIA has been found, and one major goal of disease management is to improve patients' quality of life. To this end, patients' health-related quality of life (HRQOL) scores are routinely collected over time from JIA patients. In this paper, we demonstrate that a new statistical methodology called dynamic screening system (DySS) is effective for early detection of the HDA stage of JIA. By this approach, a patient's HRQOL scores are monitored sequentially, and a signal is given by DySS once the longitudinal pattern of the scores is found to be significantly different from the pattern of patients with low disease activity. Dimension reduction of the observed HRQOL scores and the corresponding impact on the performance of DySS are also discussed.
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Affiliation(s)
- Lu You
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Andrew Qiu
- Buchholz High School, Gainesville, FL, USA
| | - Bin Huang
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Peihua Qiu
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
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Hersh AO, Salimian PK, Weitzman ER. Using Patient-Reported Outcome Measures to Capture the Patient's Voice in Research and Care of Juvenile Idiopathic Arthritis. Rheum Dis Clin North Am 2016; 42:333-46. [PMID: 27133493 PMCID: PMC4853816 DOI: 10.1016/j.rdc.2016.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Patient-reported outcome (PRO) measures provide a valuable window into how patients with juvenile idiopathic arthritis and their parents perceive their functioning, quality of life, and medication side effects in the context of their disease and treatment. Momentum behind adoption of PRO measures is increasing as these patient-relevant tools capture information pertinent to taking a patient-centered approach to health care and research. This article reviews the clinical and research utility of obtaining PROs across domains applicable to the experience of juvenile idiopathic arthritis and summarizes available self-report and parent-proxy PRO measures. Current challenges and limitations of PRO usage are discussed.
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Affiliation(s)
- Aimee O Hersh
- Pediatric Rheumatology, University of Utah, 81 Mario Capecchi Way, 4th Floor, Salt Lake City, UT 84113, USA.
| | - Parissa K Salimian
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Avenue BCH3185, Boston, MA 02115, USA
| | - Elissa R Weitzman
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue BCH3187, Boston, MA 02115, USA; Department of Pediatrics, Harvard Medical School, 300 Longwood Avenue BCH3187, Boston, MA 02115, USA; Computational Health Informatics Program, Boston Children's Hospital, 300 Longwood Avenue BCH3187, Boston, MA 02115, USA
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Knight A, Vickery M, Fiks AG, Barg FK. The illness experience of youth with lupus/mixed connective tissue disease: a mixed methods analysis of patient and parent perspectives. Lupus 2016; 25:1028-39. [PMID: 27125290 DOI: 10.1177/0961203316646460] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 04/04/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We aimed to develop a model of the illness experience for youth with systemic lupus erythematosus (SLE)/mixed connective tissue disease (MCTD). METHODS We conducted 32 semi-structured interviews with 16 outpatient youth with SLE/MCTD, age 11 to 22 years, and their parents. We qualitatively defined key features of illness for families and distinguished profiles of youth adapting well vs poorly to SLE/MCTD. We then related these profiles to features of illness, patient-level attributes and outcomes. RESULTS Experiences with SLE/MCTD grouped into five themes: managing disease, limitations, stigma, illness uncertainty and psychological coping. Youth adapting well experienced minimal challenges in these areas. Youth adapting poorly (4/16) experienced significant challenges in >1 thematic area, and were older with lower socioeconomic status, quality of life and psychosocial functioning, and increased disease-related morbidity. They also described suboptimal treatment adherence, healthcare utilization and transition to adult care. These findings support a dynamic model in which illness adaptation and outcomes are shaped by patient characteristics and five central illness-related challenges. CONCLUSION Further testing of our model of illness experience may help guide comprehensive and personalized care of youth with SLE/MCTD, with targeted supports for youth at risk for negative adaptation to illness and poor outcomes.
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Affiliation(s)
- A Knight
- Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, USA Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, USA PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA
| | - M Vickery
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, USA PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA
| | - A G Fiks
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, USA PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA
| | - F K Barg
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, USA Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, USA
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Knight A, Weiss P, Morales K, Gerdes M, Rearson M, Vickery M, Keren R. Identifying Differences in Risk Factors for Depression and Anxiety in Pediatric Chronic Disease: A Matched Cross-Sectional Study of Youth with Lupus/Mixed Connective Tissue Disease and Their Peers with Diabetes. J Pediatr 2015; 167:1397-403.e1. [PMID: 26316371 PMCID: PMC5289225 DOI: 10.1016/j.jpeds.2015.07.048] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 06/09/2015] [Accepted: 07/27/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate differences in risk factors for depression and anxiety, such as central nervous system involvement in systemic lupus erythematosus (SLE)/mixed connective tissue disease (MCTD), by comparing youth with SLE/MCTD to peers with type 1 diabetes mellitus (T1D). STUDY DESIGN We conducted a cross-sectional study of 50 outpatient pairs, ages 8 years and above, matching subjects with SLE/MCTD and T1D by sex and age group. We screened for depression, suicidal ideation, and anxiety using the Patient Health Questionnaire-9 and the Screen for Childhood Anxiety Related Emotional Disorders, respectively. We collected parent-reported mental health treatment data. We compared prevalence and treatment rates between subjects with SLE/MCTD and T1D, and identified disease-specific risk factors using logistic regression. RESULTS Depression symptoms were present in 23%, suicidal ideation in 15%, and anxiety in 27% of participants. Compared with subjects with T1D, subjects with SLE/MCTD had lower adjusted rates of depression and suicidal ideation, yet poorer rates of mental health treatment (24% vs 53%). Non-White race/ethnicity and longer disease duration were independent risk factors for depression and suicidal ideation. Depression was associated with poor disease control in both groups, and anxiety with insulin pump use in subjects with T1D. CONCLUSION Depression and anxiety are high and undertreated in youth with SLE/MCTD and T1D. Focusing on risk factors such as race/ethnicity and disease duration may improve their mental health care. Further study of central nervous system and other disease-related factors may identify targets for intervention.
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Affiliation(s)
- Andrea Knight
- Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA; Children's Hospital of Philadelphia PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA.
| | - Pamela Weiss
- Division of Rheumatology, Children's Hospital of Philadelphia, 3405 Civic Center Blvd, Philadelphia, PA 19104, Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, 3535 Market St. 15th Flr, Philadelphia, PA 19104, Center for Clinical Epidemiology & Biostatistics. University of Pennsylvania, 8th Flr Blockley Hall, 423 Guardian Drive, Philadelphia PA
| | - Knashawn Morales
- Center for Clinical Epidemiology & Biostatistics. University of Pennsylvania, 8th Flr Blockley Hall, 423 Guardian Drive, Philadelphia PA
| | - Marsha Gerdes
- Center for Clinical Epidemiology & Biostatistics. University of Pennsylvania, 8th Flr Blockley Hall, 423 Guardian Drive, Philadelphia PA, Division of General Pediatrics, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104
| | - Melissa Rearson
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104
| | - Michelle Vickery
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, 3535 Market St. 15th Flr, Philadelphia, PA 19104, Children's Hospital of Philadelphia PolicyLab, Children's Hospital of Philadelphia, 3535 Market St. 15th Flr, Philadelphia, PA 19104
| | - Ron Keren
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, 3535 Market St. 15th Flr, Philadelphia, PA 19104, Center for Clinical Epidemiology & Biostatistics. University of Pennsylvania, 8th Flr Blockley Hall, 423 Guardian Drive, Philadelphia PA
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Taxter AJ, Wileyto EP, Behrens EM, Weiss PF. Patient-reported Outcomes across Categories of Juvenile Idiopathic Arthritis. J Rheumatol 2015; 42:1914-21. [PMID: 26329337 DOI: 10.3899/jrheum.150092] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Although there is increasing reliance on patient-reported outcomes (PRO) for disease management, there is little known about the differences in PRO across juvenile idiopathic arthritis (JIA) categories. The purpose of our study was to assess PRO across JIA categories, including pain, quality of life, and physical function, and to determine clinical factors associated with differences in these measures across categories. METHODS This was a longitudinal cohort study of patients with JIA at a tertiary care pediatric rheumatology clinic. Subjects, PRO, and clinical variables were identified by querying the electronic medical record. Mixed-effects regression assessed pain, quality of life, and function. RESULTS Subjects with enthesitis-related arthritis (ERA) and undifferentiated JIA had significantly more pain, poorer quality of life, and poorer physical function. The ERA and undifferentiated JIA categories, physician's global disease activity assessment, female sex, and nonsteroidal antiinflammatory drug use were significantly associated with more pain, poorer quality of life, and poorer function. In models limited to ERA, female sex and tender enthesis count were significant predictors of decreased function. CONCLUSION ERA and undifferentiated JIA categories had poorer PRO than other JIA categories. Further work is needed to address ways to improve PRO in children with JIA, with a special focus on children with ERA and undifferentiated JIA.
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Affiliation(s)
- Alysha J Taxter
- From the Department of Pediatric Rheumatology, and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia; Center for Epidemiology and Biostatistics, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.A.J. Taxter, MD, Fellow, Department of Pediatric Rheumatology, The Children's Hospital of Philadelphia; E.P. Wileyto, PhD, Associate Professor, Center for Epidemiology and Biostatistics, The University of Pennsylvania; E.M. Behrens, MD, Associate Professor, Department of Pediatric Rheumatology, The Children's Hospital of Philadelphia; P.F. Weiss, MD, MSCE, Associate Professor, Department of Pediatric Rheumatology, and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia
| | - E Paul Wileyto
- From the Department of Pediatric Rheumatology, and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia; Center for Epidemiology and Biostatistics, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.A.J. Taxter, MD, Fellow, Department of Pediatric Rheumatology, The Children's Hospital of Philadelphia; E.P. Wileyto, PhD, Associate Professor, Center for Epidemiology and Biostatistics, The University of Pennsylvania; E.M. Behrens, MD, Associate Professor, Department of Pediatric Rheumatology, The Children's Hospital of Philadelphia; P.F. Weiss, MD, MSCE, Associate Professor, Department of Pediatric Rheumatology, and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia
| | - Edward M Behrens
- From the Department of Pediatric Rheumatology, and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia; Center for Epidemiology and Biostatistics, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.A.J. Taxter, MD, Fellow, Department of Pediatric Rheumatology, The Children's Hospital of Philadelphia; E.P. Wileyto, PhD, Associate Professor, Center for Epidemiology and Biostatistics, The University of Pennsylvania; E.M. Behrens, MD, Associate Professor, Department of Pediatric Rheumatology, The Children's Hospital of Philadelphia; P.F. Weiss, MD, MSCE, Associate Professor, Department of Pediatric Rheumatology, and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia
| | - Pamela F Weiss
- From the Department of Pediatric Rheumatology, and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia; Center for Epidemiology and Biostatistics, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.A.J. Taxter, MD, Fellow, Department of Pediatric Rheumatology, The Children's Hospital of Philadelphia; E.P. Wileyto, PhD, Associate Professor, Center for Epidemiology and Biostatistics, The University of Pennsylvania; E.M. Behrens, MD, Associate Professor, Department of Pediatric Rheumatology, The Children's Hospital of Philadelphia; P.F. Weiss, MD, MSCE, Associate Professor, Department of Pediatric Rheumatology, and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia.
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Knight A, Weiss P, Morales K, Gerdes M, Gutstein A, Vickery M, Keren R. Depression and anxiety and their association with healthcare utilization in pediatric lupus and mixed connective tissue disease patients: a cross-sectional study. Pediatr Rheumatol Online J 2014; 12:42. [PMID: 25242900 PMCID: PMC4169806 DOI: 10.1186/1546-0096-12-42] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 09/05/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression and anxiety adversely affects outcomes in systemic lupus erythematosus (SLE) and healthcare utilization is high for pediatric SLE. We aimed to characterize the prevalence of depression and anxiety in pediatric SLE, and their association with healthcare utilization. METHODS We conducted a cross-sectional analysis of pediatric SLE and mixed connective tissue disease (MCTD) subjects and healthy controls aged 8 years and above. We used the Patient Health Questionnaire 9 (PHQ-9) and the Screen for Childhood Anxiety Related Disorders (SCARED) to identify depression, suicidal ideation and anxiety symptoms, respectively. We compared symptom prevalence in SLE/MCTD and healthy subjects using logistic regression. For SLE/MCTD subjects, we calculated the rate of annual outpatient visits [rheumatology/nephrology, primary care provider (PCP) and emergency department], hospitalizations and rheumatology/nephrology telephone consultations in the preceding year. We compared these outcomes in those with and without depression and anxiety using negative binomial regression. RESULTS We identified depression symptoms in 10 (20%) SLE/MCTD and 4 (8%) healthy subjects, representing a trend towards increased prevalence in unadjusted analysis (OR = 2.9, 95% CI 0.8-9.9, p = 0.09). Adjusted analysis did not show a significant difference; however, non-white race was a statistically significant independent risk factor for depression symptoms compared to white race (OR = 5.4, 95% CI 1.1-27.2, p = 0.04). We identified anxiety symptoms in 11 (22%) SLE/MCTD and 13 (26%) healthy subjects, which was not statistically different. Suicidal ideation was present in 7 (14%) SLE/MCTD and 2 (4%) healthy subjects, which was a statistically significant difference (OR = 5.4, 95% CI 1.02-28.3, p = 0.047). Of the 34% of SLE/MCTD subjects with any symptoms, only 24% had previous mental health care. Those with depression symptoms had a statistically significant lower rate of visits to the PCP (IRR = 0.38, 95% CI 0.19-0.76, p < 0.001). Anxiety symptoms were not associated with the healthcare utilization outcomes. CONCLUSIONS Depression and anxiety symptoms were prevalent, and suicidal ideation significantly more common in SLE/MCTD than in healthy subjects. Non-white race was an independent risk factor for depression. Despite prevalent symptoms, there were poor rates of prior mental health treatment, and less frequent PCP visits among those with depression symptoms. Further investigation of barriers to mental health care and interventional strategies for symptomatic youth with SLE/MCTD is needed.
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Affiliation(s)
- Andrea Knight
- Division of Rheumatology, Children’s Hospital of Philadelphia, 3405 Civic Center Blvd, Philadelphia, PA 19104 USA ,Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, 3535 Market St, 15th Flr, Philadelphia, PA 19104 USA ,Children’s Hospital of Philadelphia PolicyLab, Children’s Hospital of Philadelphia, 3535 Market St, 15th Flr, Philadelphia, PA 19104 USA ,Children’s Hospital of Philadelphia, 3535 Market St, Ste 1527, Philadelphia, PA 19104 USA
| | - Pamela Weiss
- Division of Rheumatology, Children’s Hospital of Philadelphia, 3405 Civic Center Blvd, Philadelphia, PA 19104 USA ,Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, 3535 Market St, 15th Flr, Philadelphia, PA 19104 USA ,Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, 8th Flr Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104 USA
| | - Knashawn Morales
- Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, 8th Flr Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104 USA
| | - Marsha Gerdes
- Children’s Hospital of Philadelphia PolicyLab, Children’s Hospital of Philadelphia, 3535 Market St, 15th Flr, Philadelphia, PA 19104 USA ,Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Allyson Gutstein
- Florida International University, Herbert Wertheim College of Medicine, 11200 SW 8th Street, AHC2, Miami, FL 33199 USA
| | - Michelle Vickery
- Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, 3535 Market St, 15th Flr, Philadelphia, PA 19104 USA ,Children’s Hospital of Philadelphia PolicyLab, Children’s Hospital of Philadelphia, 3535 Market St, 15th Flr, Philadelphia, PA 19104 USA
| | - Ron Keren
- Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, 3535 Market St, 15th Flr, Philadelphia, PA 19104 USA ,Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, 8th Flr Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104 USA ,Division of General Pediatrics, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104 USA
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Abstract
Measurement of health outcomes in pediatric rheumatic diseases is a critical component of clinical practice and research studies. Measures should include the biological, physical, and psychosocial dimensions of health. Health outcome measures are developed systematically, often using consensus methods. Prior to implementation into practice, health outcome measures must undergo evaluation of measurement properties such as reliability, validity, and responsiveness. There are several health outcome measures available for juvenile idiopathic arthritis, juvenile systemic lupus erythematosus, and juvenile dermatomyositis, many of which are composite measures of disease activity. In addition, tools exist for measuring physical functioning and health-related quality of life. There is increasing focus on the incorporation of patient-reported or parent-reported outcomes when measuring the health state of patients with pediatric rheumatic diseases. Further work is required to determine the optimal health outcome measures and approach for eliciting the patient's perception of their health state in pediatric rheumatology.
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Affiliation(s)
- Nadia J C Luca
- Section of Rheumatology, Department of Paediatrics, University of Calgary and Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada.
| | - Brian M Feldman
- Division of Rheumatology, Department of Paediatrics, University of Toronto and The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada; Department of Medicine and Institute of Health Policy Management and Evaluation, University of Toronto, 155 College St, Toronto, ON M5T 3M7, Canada.
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