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  • Poster presentation
  • Open Access

Development and initial validation of the parent acceptable symptom state in juvenile idiopathic arthritis (JIA)

  • 1,
  • 1,
  • 2,
  • 2,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Pediatric Rheumatology20086 (Suppl 1) :P117

https://doi.org/10.1186/1546-0096-6-S1-P117

  • Published:

Keywords

  • Public Health
  • Arthritis
  • Logistic Regression
  • Health Status
  • Disease Management

Background

The parent acceptable symptom state (PASS) constitutes the symptom threshold beyond which parents consider their child' health status as satisfactory. The PASS represents an ambitious target for disease management.

Objective

To devise and validate the PASS in patients with JIA.

Methods

369 parents completed a multidimensional questionnaire (the JAMAR), including Juvenile Arthritis Functionality Scale (JAFS) (score 0–30), Pediatric Rheumatology Quality of Life (PRQL) questionnaire (score 0–30) and traditional JIA outcome measures, and stated whether they considered their children's status satisfactory or not. PASS thresholds were estimated based on parent opinion and targeting the 75th percentile of cumulative distribution. Stepwise logistic regression was used to assess contributors to PASS. PASS was validated by analyzing proportions of patients who were judged by parent or physician in remission, flare or continued activity.

Results

72.9% of parents reported their children being in PASS (table 1).
Table 1

The PASS threshold

 

Parent global

Parent pain

JAFS

PRQL

MD global

Active joints

Limited joints

75° centile

2

1.5

1

4

1.5

1

1

Parent global (OR 4.6), PRQL (3.9), JAFS (4.0), MD global (2.6) and CRP (3.9) were the strongest contributors of PASS in logistic regression analysis (AUC: 0.92). Among patients judged in remission, flare or continued activity by the parent and physician, the percentage of those in PASS was 98, 46 and 49 (p < 0.0001), and 93, 57 and 27 (p < 0.0001), respectively.

Conclusion

We devised the PASS for JIA. The PASS demonstrated good validity by discriminating strongly between patients in remission or active disease.

Authors’ Affiliations

(1)
IRCCS G Gaslini, Genova, Italy
(2)
IRCCS Pol San Matteo, Pavia, Italy

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