Analysis of ceiling effect and score distribution of outcome measures in juvenile idiopathic arthritis (JIA)
© Lattanzi et al; licensee BioMed Central Ltd. 2008
Published: 15 September 2008
The ceiling effect and skewness of score distribution (i.e. tendency for scores to cluster at or towards the normal end of the scale) are potential limitations of outcome measures used in JIA.
To characterize ceiling effect and score distribution of the main JIA outcome measures.
A total of 1818 visits made from 1989 to 2006 were examined. Percentage of patients with score = 0 and score distribution were assessed for physician and parent global assessments, CHAQ, joint counts, and ESR.
No. swollen joints
No. tender joints
No. restricted joints
No. active joints
% score = 0
Ceiling effect was greater for ESR, CHAQ and tender and restricted joint counts. In only 1/5 of the visits made in a wide time frame JIA patients receiving routine care in a tertiary center met inclusion criteria (i.e. active joint count ≥ 5) for recent clinical trials of second-line or biologic agents.
This article is published under license to BioMed Central Ltd.