title: American College of Rheumatology provisional criteria for defining clinical inactive disease in select categories of juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To prospectively validate the preliminary criteria for clinical inactive disease (CID) in patients with select categories of juvenile idiopathic arthritis (JIA).
  
  
  METHODS
  We used the process for development of classification and response criteria recommended by the American College of Rheumatology Quality of Care Committee. Patient-visit profiles were extracted from the phase III randomized controlled trial of infliximab in polyarticular-course JIA (i.e., patients considered to resemble those with select categories of JIA) and sent to an international group of expert physician raters. Using the physician ratings as the gold standard, the sensitivity and specificity were calculated using the preliminary criteria. Modifications to the criteria were made, and these were sent to a larger group of pediatric rheumatologists to determine quantitative, face, and content validity.
  
  
  RESULTS
  Variables weighted heaviest by physicians when making their judgment were the number of joints with active arthritis, erythrocyte sedimentation rate (ESR), physician's global assessment, and duration of morning stiffness. Three modifications were made: the definition of uveitis, the definition of abnormal ESR, and the addition of morning stiffness. These changes did not alter the accuracy of the preliminary set.
  
  
  CONCLUSIONS
  The modified criteria, termed the "criteria for CID in select categories of JIA," have excellent feasibility and face, content, criterion, and discriminant validity to detect CID in select categories of JIA. The small changes made to the preliminary criteria set did not alter the area under the receiver operating characteristic curve (0.954) or accuracy (91%), but have increased face and content validity.
authors: Seattle Children's Hospital and University of Washington School of Medicine, Seattle. cwallace@u.washington.edu.
authors: Carol A
authors: CA
authors: Wallace
authors: Edward H
authors: EH
authors: Giannini
authors: Bin
authors: B
authors: Huang
authors: Lukasz
authors: L
authors: Itert
authors: Nicolino
authors: N
authors: Ruperto
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D012219:Rheumatology / Q000592:standards*; D012680:Sensitivity and Specificity; D012955:Societies, Medical / Q000592:standards