Clinical responsiveness of self-report functional assessment measures for children with juvenile idiopathic arthritis undergoing intraarticular corticosteroid injections
| Autor: | F. Virginia Wright, Joan McComas, G. Ted Brown, Derek Stephens, Nina Birdi, Bianca A. Lang, Kim Oen, Brian M. Feldman |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Parents medicine.medical_specialty Adolescent Health Status Immunology Arthritis Severity of Illness Index Injections Intra-Articular Rheumatology Surveys and Questionnaires Internal medicine Severity of illness medicine Humans Immunology and Allergy Pharmacology (medical) Prospective Studies Child Prospective cohort study Glucocorticoids Hip surgery business.industry Reproducibility of Results medicine.disease Arthritis Juvenile Confidence interval Clinical trial Methotrexate Antirheumatic Agents Physical therapy Self-Examination Drug Therapy Combination Female business Juvenile rheumatoid arthritis |
| Zdroj: | Arthritis & Rheumatism. 53:897-904 |
| ISSN: | 1529-0131 0004-3591 |
| DOI: | 10.1002/art.21599 |
| Popis: | Objective The Childhood Health Assessment Questionnaire (CHAQ), Juvenile Arthritis Functional Assessment Report (JAFAR), and Juvenile Arthritis Functional Status Index (JASI) are widely used functional measures for juvenile idiopathic arthritis (JIA) that differ in content, format, and completion time. We compared the responsiveness and child-parent agreement of the JAFAR, CHAQ, and JASI in a prospective, multicenter study. Methods Children and adolescents from 5 rheumatology centers were enrolled. Subjects were about to undergo therapy (intraarticular corticosteroid injections [IAS] and methotrexate or hip surgery (MTX/hip]) expected to produce a functional improvement. All subjects were studied before the intervention and at 6 weeks and 6 months posttreatment. At each study visit, the 3 measures were administered in randomized, balanced order to both parents and children. Results A total of 92 subjects (mean age 12.8 years) were enrolled in the study, 74 of which were in the IAS group. The responsiveness of all 3 measures was moderate to strong. The standardized response mean at 6 weeks for the IAS group on the JAFAR, CHAQ, and JASI was 0.41 (95% confidence interval [95% CI] 0.18, 0.64), 0.70 (95% CI 0.47, 0.93), and 0.36 (95% CI 0.13, 0.59), respectively. The CHAQ was somewhat more responsive to change at 6 weeks (IAS group: relative efficiency 0.34 [JAFAR], 0.27 [JASI]), but less responsive at 6 months (MTX/hip group: relative efficiency 5.1 [JAFAR], 3.9 [JASI]). All 3 questionnaires showed acceptable parent-child agreement, and overall, there were few differences between the 3 questionnaires. Conclusion The functional outcome measures currently used for JIA are all adequately responsive for use in trials or in the clinic setting. The choice of which measure to use should therefore be based on the time available for completion, the intended clinical/research use, and the depth of content required. |
| Databáze: | OpenAIRE |
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