Development and validation of a preliminary definition of minimal disease activity in patients with juvenile idiopathic arthritis

Silvia Magni-Manzoni, Nicolino Ruperto, Angela Pistorio, Elena Sala, Nicoletta Solari, Elena Palmisani, Chiara Cugno, Elena Bozzola, Alberto Martini, Angelo Ravelli

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Objective. To develop and validate a definition of minimal disease activity (MDA) in patients with juvenile idiopathic arthritis (JIA). Methods. The clinical charts of JIA patients followed over a 16-year period were reviewed to identify visits with high disease activity and MDA, defined on the basis of therapeutic decisions made by the attending physician. For each JIA activity measure recorded at the time of the visit, the cutoff value that best identified states of MDA was calculated by means of the area under the receiver operating characteristic curve analysis. A definition of MDA for oligoarthritis and polyarthritis was set up after testing the relative power of each variable in a multivariate analysis. Validation procedures included assessment of discriminant and construct validity. Results. The definition that resulted from the analyses led to establish that a state of MDA could be defined as the presence of a physician global assessment ≤2.5 cm and a swollen joint count of 0 in patients with oligoarthritis; and as the presence of a physician global assessment ≤3.4 cm, a parent global assessment ≤2.1 cm, and a swollen joint count ≤1 in patients with polyarthritis. Validation procedures demonstrated that the MDA definition had good discriminant and construct validity in the context of both observational studies and controlled trials. Conclusion. We developed a preliminary definition of MDA in patients with JIA that represents a useful treatment target state and is proposed for inclusion as an outcome measure in future observational studies and clinical trials in patients with JIA.

Original languageEnglish
Pages (from-to)1120-1127
Number of pages8
JournalArthritis Care and Research
Volume59
Issue number8
DOIs
Publication statusPublished - 15 Aug 2008
Externally publishedYes

Fingerprint

Juvenile Arthritis
Physicians
Arthritis
Observational Studies
Joints
ROC Curve
Multivariate Analysis
Outcome Assessment (Health Care)
Clinical Trials
Therapeutics

ASJC Scopus subject areas

  • Rheumatology

Cite this

Magni-Manzoni, S., Ruperto, N., Pistorio, A., Sala, E., Solari, N., Palmisani, E., ... Ravelli, A. (2008). Development and validation of a preliminary definition of minimal disease activity in patients with juvenile idiopathic arthritis. Arthritis Care and Research, 59(8), 1120-1127. https://doi.org/10.1002/art.23916

Development and validation of a preliminary definition of minimal disease activity in patients with juvenile idiopathic arthritis. / Magni-Manzoni, Silvia; Ruperto, Nicolino; Pistorio, Angela; Sala, Elena; Solari, Nicoletta; Palmisani, Elena; Cugno, Chiara; Bozzola, Elena; Martini, Alberto; Ravelli, Angelo.

In: Arthritis Care and Research, Vol. 59, No. 8, 15.08.2008, p. 1120-1127.

Research output: Contribution to journalArticle

Magni-Manzoni, S, Ruperto, N, Pistorio, A, Sala, E, Solari, N, Palmisani, E, Cugno, C, Bozzola, E, Martini, A & Ravelli, A 2008, 'Development and validation of a preliminary definition of minimal disease activity in patients with juvenile idiopathic arthritis', Arthritis Care and Research, vol. 59, no. 8, pp. 1120-1127. https://doi.org/10.1002/art.23916
Magni-Manzoni, Silvia ; Ruperto, Nicolino ; Pistorio, Angela ; Sala, Elena ; Solari, Nicoletta ; Palmisani, Elena ; Cugno, Chiara ; Bozzola, Elena ; Martini, Alberto ; Ravelli, Angelo. / Development and validation of a preliminary definition of minimal disease activity in patients with juvenile idiopathic arthritis. In: Arthritis Care and Research. 2008 ; Vol. 59, No. 8. pp. 1120-1127.
@article{09d0a78b3eb84f759f8232ae287035c1,
title = "Development and validation of a preliminary definition of minimal disease activity in patients with juvenile idiopathic arthritis",
abstract = "Objective. To develop and validate a definition of minimal disease activity (MDA) in patients with juvenile idiopathic arthritis (JIA). Methods. The clinical charts of JIA patients followed over a 16-year period were reviewed to identify visits with high disease activity and MDA, defined on the basis of therapeutic decisions made by the attending physician. For each JIA activity measure recorded at the time of the visit, the cutoff value that best identified states of MDA was calculated by means of the area under the receiver operating characteristic curve analysis. A definition of MDA for oligoarthritis and polyarthritis was set up after testing the relative power of each variable in a multivariate analysis. Validation procedures included assessment of discriminant and construct validity. Results. The definition that resulted from the analyses led to establish that a state of MDA could be defined as the presence of a physician global assessment ≤2.5 cm and a swollen joint count of 0 in patients with oligoarthritis; and as the presence of a physician global assessment ≤3.4 cm, a parent global assessment ≤2.1 cm, and a swollen joint count ≤1 in patients with polyarthritis. Validation procedures demonstrated that the MDA definition had good discriminant and construct validity in the context of both observational studies and controlled trials. Conclusion. We developed a preliminary definition of MDA in patients with JIA that represents a useful treatment target state and is proposed for inclusion as an outcome measure in future observational studies and clinical trials in patients with JIA.",
author = "Silvia Magni-Manzoni and Nicolino Ruperto and Angela Pistorio and Elena Sala and Nicoletta Solari and Elena Palmisani and Chiara Cugno and Elena Bozzola and Alberto Martini and Angelo Ravelli",
year = "2008",
month = "8",
day = "15",
doi = "10.1002/art.23916",
language = "English",
volume = "59",
pages = "1120--1127",
journal = "Arthritis and Rheumatology",
issn = "2326-5191",
publisher = "John Wiley and Sons Ltd",
number = "8",

}

TY - JOUR

T1 - Development and validation of a preliminary definition of minimal disease activity in patients with juvenile idiopathic arthritis

AU - Magni-Manzoni, Silvia

AU - Ruperto, Nicolino

AU - Pistorio, Angela

AU - Sala, Elena

AU - Solari, Nicoletta

AU - Palmisani, Elena

AU - Cugno, Chiara

AU - Bozzola, Elena

AU - Martini, Alberto

AU - Ravelli, Angelo

PY - 2008/8/15

Y1 - 2008/8/15

N2 - Objective. To develop and validate a definition of minimal disease activity (MDA) in patients with juvenile idiopathic arthritis (JIA). Methods. The clinical charts of JIA patients followed over a 16-year period were reviewed to identify visits with high disease activity and MDA, defined on the basis of therapeutic decisions made by the attending physician. For each JIA activity measure recorded at the time of the visit, the cutoff value that best identified states of MDA was calculated by means of the area under the receiver operating characteristic curve analysis. A definition of MDA for oligoarthritis and polyarthritis was set up after testing the relative power of each variable in a multivariate analysis. Validation procedures included assessment of discriminant and construct validity. Results. The definition that resulted from the analyses led to establish that a state of MDA could be defined as the presence of a physician global assessment ≤2.5 cm and a swollen joint count of 0 in patients with oligoarthritis; and as the presence of a physician global assessment ≤3.4 cm, a parent global assessment ≤2.1 cm, and a swollen joint count ≤1 in patients with polyarthritis. Validation procedures demonstrated that the MDA definition had good discriminant and construct validity in the context of both observational studies and controlled trials. Conclusion. We developed a preliminary definition of MDA in patients with JIA that represents a useful treatment target state and is proposed for inclusion as an outcome measure in future observational studies and clinical trials in patients with JIA.

AB - Objective. To develop and validate a definition of minimal disease activity (MDA) in patients with juvenile idiopathic arthritis (JIA). Methods. The clinical charts of JIA patients followed over a 16-year period were reviewed to identify visits with high disease activity and MDA, defined on the basis of therapeutic decisions made by the attending physician. For each JIA activity measure recorded at the time of the visit, the cutoff value that best identified states of MDA was calculated by means of the area under the receiver operating characteristic curve analysis. A definition of MDA for oligoarthritis and polyarthritis was set up after testing the relative power of each variable in a multivariate analysis. Validation procedures included assessment of discriminant and construct validity. Results. The definition that resulted from the analyses led to establish that a state of MDA could be defined as the presence of a physician global assessment ≤2.5 cm and a swollen joint count of 0 in patients with oligoarthritis; and as the presence of a physician global assessment ≤3.4 cm, a parent global assessment ≤2.1 cm, and a swollen joint count ≤1 in patients with polyarthritis. Validation procedures demonstrated that the MDA definition had good discriminant and construct validity in the context of both observational studies and controlled trials. Conclusion. We developed a preliminary definition of MDA in patients with JIA that represents a useful treatment target state and is proposed for inclusion as an outcome measure in future observational studies and clinical trials in patients with JIA.

UR - http://www.scopus.com/inward/record.url?scp=49549118435&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=49549118435&partnerID=8YFLogxK

U2 - 10.1002/art.23916

DO - 10.1002/art.23916

M3 - Article

VL - 59

SP - 1120

EP - 1127

JO - Arthritis and Rheumatology

JF - Arthritis and Rheumatology

SN - 2326-5191

IS - 8

ER -