Assessment of disease activity by patients with juvenile idiopathic arthritis and the parents compared to the assessment by pediatric rheumatologists.
Assessment of disease activity by patients with juvenile idiopathic arthritis and the parents compared to the assessment by pediatric rheumatologists.
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DOI：
10.1186/1546-0096-11-48
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发表时间：
2013-12-24
期刊：
影响因子：
--
通讯作者：
van Sonderen E
中科院分区：
文献类型：
--
作者：
Armbrust W;Kaak JG;Bouma J;Lelieveld OT;Wulffraat NM;Sauer PJ;van Sonderen E
关节炎的自我评估对于识别疾病活动性和早期开始治疗很重要。因此，对身体症状的正确解释是必要的。本研究旨在调查幼年特发性关节炎（JIA）患者和父母对疾病活动性的评估，并将其评估与风湿病学家的评估进行比较。患者和父母评估了69个关节上的纸小人，并根据疾病的假定存在用不同的颜色标记每个关节：活动性疾病（AD），怀疑和非活动性疾病（NAD）。他们的评估与流变学家的评估进行了比较。如果患者和/或父母标记了发炎的关节，则算作AD。对疼痛、功能损害和疾病持续时间进行了分析，以更准确地区分真阳性和假阳性以及真阴性和假阴性评估。我们收集了113名患者和/或父母的评估。AD评估了54次，其中33次为真阳性。NAD评估了23次，其中22次为真阴性。怀疑36次，其中9次被风湿病学家评估为AD。AD的敏感性为0.77，特异性为0.31。疼痛和功能障碍评分最高的AD，中间的怀疑，最低的NAD。患者和/或父母很少错过关节炎，但经常高估疾病活动。疼痛、功能障碍、病程、性别和年龄不能区分真阳性和假阳性。患者认为JIA活跃，如果他们经历了疼痛和功能障碍。为了减少对AD存在的高估，我们需要通过教他们区分JIA的主要症状和疼痛和功能障碍等症状来提高他们对疾病活动的理解。
Self assessment of arthritis is important for recognition of disease activity and early initiation of therapy. Proper interpretation of physical symptoms is necessary for this. The purpose was to investigate the assessment by patients and parents of disease activity in juvenile idiopathic arthritis (JIA) and to compare their assessments to rheumatologists’ assessments. Patients and parents assessed 69 joints on a paper homunculus and marked each joint with a different color according to presumed presence of disease: active disease (AD), doubt, and non-active disease (NAD). Their assessments were compared to the rheumatologists’ assessments. If patients and/or parents marked an inflamed joint, it counted as AD. Pain, functional impairment, and disease duration were analyzed to differentiate more precise between true and false positive and true and false negative assessments. We collected assessments of 113 patients and/or parents. AD was assessed 54 times, 33 of which were true positives. NAD was assessed 23 times, 22 of which were true negatives. Doubt was expressed 36 times, 9 of which were assessed by the rheumatologist as AD. Sensitivity and specificity of AD was 0.77 and 0.31. Pain and functional impairment scored highest in AD, intermediate in doubt, and lowest in NAD. Patients and/or parents seldom missed arthritis but frequently overestimated disease activity. Pain, functional impairment, disease duration, gender, and age did not differentiate between true and false positives for. Patients perceived JIA as active if they experienced pain and functional impairment. To reduce overestimation of the presence of AD we need to improve their understanding of disease activity by teaching them to distinguish between primary symptoms of JIA and symptoms like pain and functional impairment.
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影响因子：
--
作者：
Consolaro, Alessandro;Bracciolini, Giulia;Ravelli, Angelo
通讯作者：
Ravelli, Angelo
影响因子：
2.5
作者：
Lawson, Erica F.;Hersh, Aimee O.;von Scheven, Emily
通讯作者：
von Scheven, Emily
影响因子：
5.5
作者：
Haslam, Kirsty E.;McCann, Liza J.;Wakefield, Richard J.
通讯作者：
Wakefield, Richard J.
影响因子：
5.2
作者：
Kuis, W;Heijnen, CJ;Helders, PJM
通讯作者：
Helders, PJM
DOI：
10.1002/art.22897
发表时间：
2007-08-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Lelieveld, Otto T. H. M.;van Brussel, Marco;Armbrust, Wineke
通讯作者：
Armbrust, Wineke