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Does incorporation of aids/devices and help, make a difference in the childhood health assessment questionnaire disability index? Analysis from the printo juvenile idiopathic arthritis database


To assess whether Childhood Health Assessment Questionnaire Disability Index (C-HAQ-DI) score and responsiveness to change, calculated with and without aids/devices or help from another person, are different in juvenile idiopathic arthritis (JIA) patients.


A cross-sectional sample of 2,727 and 530 active JIA patients from the PRINTO methotrexate (MTX) trial, including those with at least 6/8 CHAQ functional areas, was analysed.


MTX trial patients had higher disease activity compared to the cross-sectional sample (p < 0.0001). The frequency of aids/devices was similar between the 2 samples, while help was more frequently used in the MTX trial (p < 0.0001 for all areas). Correlation between disease activity variables and the C-HAQ DI different scoring methods did not change substantially, but were higher for the MTX trial sample. Responsiveness in the MTX responders did not change with the different C-HAQ DI scoring methods (range 0.86–0.82). There was a statistically significant change in the C-HAQ DI scoring methods for the cross-sectional sample (mean range 0.65–0.55, p <0.0001) and MTX trial (mean range 1.23–1.07, p <0.0001). When the baseline C-HAQ DI for all patients were categorised according to different disability level, 32% had a category shift from severe (>1.5) to either moderate (0.5–1.5), mild (0.1–0.5) or no disability (0).


The removal of aids/devices and/or help lead to a significant shift from severe to lower disability categories especially for patients in the active phase of disease.

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Correspondence to C Saad-Magalhães.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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About this article


  • Methotrexate
  • Juvenile Idiopathic Arthritis
  • Activity Variable
  • Functional Area
  • Juvenile Idiopathic Arthritis Patient