Development and retrospective validation of the juvenile spondyloarthritis disease activity index.

TitleDevelopment and retrospective validation of the juvenile spondyloarthritis disease activity index.
Publication TypeJournal Article
Year of Publication2014
AuthorsWeiss PF, Colbert RA, Xiao R, Feudtner C, Beukelman T, DeWitt EM, Pagnini I, Wright TB, Wallace CA
JournalArthritis Care Res (Hoboken)
Date Published2014 Dec
KeywordsAdolescent, Child, Delphi Technique, Female, Health Status, Humans, Male, Pain Measurement, Questionnaires, Retrospective Studies, Rheumatology, Severity of Illness Index, Spondylarthritis

OBJECTIVE: To develop and validate the Juvenile Spondyloarthritis Disease Activity Index (JSpADA) for use in clinical practice and research.

METHODS: Using modified Delphi consensus techniques, 10 items were selected by participants in the international pediatric rheumatology listserv, the Childhood Arthritis and Rheumatology Research Alliance, and the listserv for the pediatric section of the American College of Rheumatology. Validation was performed in a retrospective multicenter cohort of 244 children.

RESULTS: In total, 106 physicians representing 14 countries completed the initial questionnaire. Completion rates for the subsequent questionnaires were 84%, 75%, and 77% of the original respondents. Ten items exceeded 80% consensus: arthritis, enthesitis, patient pain assessment, inflammatory markers, morning stiffness, clinical sacroiliitis, uveitis, back mobility, and patient and physician assessments of disease activity. After item analysis, 2 items were eliminated (patient and physician assessments of disease activity). Factor analysis identified 3 primary domains that explained 58% of the variance: peripheral disease, axial disease, and uveitis. The Cronbach's α coefficient was 0.66. The JSpADA had high or moderate correlations with the Juvenile Arthritis Disease Activity Score (r = 0.81), patient and physician assessments of disease activity (r = 0.70 and r = 0.66, respectively), and the Childhood Health Assessment Questionnaire (r = 0.56). The JSpADA discriminated well between subjects with active versus inactive disease (P < 0.001) and was responsive to improvement or worsening in disease activity over time (P < 0.001).

CONCLUSION: Using international input and consensus formation techniques, we developed and validated the first disease activity assessment for juvenile spondyloarthritis. Future studies should validate the JSpADA in a prospective multicenter cohort.

Alternate JournalArthritis Care Res (Hoboken)
PubMed ID25047959
PubMed Central IDPMC4245319
Grant List1-K23-AR-059749-01A1 / AR / NIAMS NIH HHS / United States
K23 AR059749 / AR / NIAMS NIH HHS / United States
Z01-AR-041184 / AR / NIAMS NIH HHS / United States
/ / Intramural NIH HHS / United States