Physician global assessments of juvenile IIM disease activity and damage demonstrated excellent interrater reliability (97.7% and 94.7% agreement, respectively) and responsiveness over 8 months.
Observational (n=117)
Physician and parent global assessments of juvenile IIM disease activity demonstrate high reliability and responsiveness, supporting their use as quantitative measures for evaluating therapeutic responses.
OBJECTIVE: To determine the reliability, content validity, and responsiveness of physician global assessments of disease activity and damage in the juvenile idiopathic inflammatory myopathies (IIM), and to investigate concordance among physician, parent, and patient global ratings. METHODS: Sixteen pediatric rheumatologists rated 10 juvenile IIM paper patient cases for global disease activity and damage, and assessed the importance of 51 clinical and laboratory parameters in formulating their global assessments. Then, 117 juvenile IIM patients were enrolled in a protocol to examine the relationship between Likert and visual analog scale global assessments, their sensitivity to change, and the comparability of physician, parent, and patient global ratings. RESULTS: Pediatric rheumatologists demonstrated excellent interrater reliability in their global assessments of juvenile IIM disease activity and damage (97.7% and 94.7% agreement among raters, respectively), and agreed on a core set of clinical parameters in formulating their judgments. Likert scale ratings correlated with those on a visual analog scale, and both were comparable in responsiveness (standardized response means -0.56 for disease activity, 0.02 Likert and 0.14 visual analog for damage, measured over 8 months). Parent global ratings of disease activity correlated with physician assessments, but were not colinear (Spearman's correlation r = 0.41-0.45). Patient global disease activity assessments correlated with those done by parents (r = 0.57-0.84) and physicians (r = 0.37-0.63), but demonstrated less responsiveness (standardized response means -0.21 and -0.12, respectively, over 8 months). CONCLUSION: Physician global assessments of juvenile IIM disease activity and damage demonstrated high interrater reliability and were shown to be comprehensive measures. Both physician and parent disease activity assessments should be considered valuable as quantitative measures for evaluating therapeutic responses in juvenile IIM patients.
Rider et al. (Sat,) conducted a observational in Juvenile idiopathic inflammatory myopathies (IIM) (n=117). Physician, parent, and patient global assessments was evaluated on Interrater reliability, responsiveness, and concordance of global assessments of disease activity and damage. Physician global assessments of juvenile IIM disease activity and damage demonstrated excellent interrater reliability (97.7% and 94.7% agreement, respectively) and responsiveness over 8 months.