A1 Refereed original research article in a scientific journal
Validating 10-joint juvenile arthritis disease activity score cut-offs for disease activity levels in non-systemic juvenile idiopathic arthritis
Authors: Maria Backström, Pirjo Tynjälä, Kristiina Aalto, Minna-Maija Grönlund, Heikki Ylijoki, Anne Putto-Laurila, Johanna Kärki, Paula Keskitalo, Sirja Sard, Heini Pohjankoski, Maiju Hietanen, Silke Witter, Helena Lehto, Eliisa Löyttyniemi, Paula Vähäsalo
Publisher: BMJ Publishing Group
Publication year: 2019
Journal:RMD Open
Journal name in sourceRMD Open
Volume: 5
Issue: 1
Number of pages: 9
ISSN: 2056-5933
eISSN: 2056-5933
DOI: https://doi.org/10.1136/rmdopen-2018-000888
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/40802112
Objectives
 To validate cut-offs of the Juvenile Arthritis Disease Activity Score 
10 (JADAS10) and clinical JADAS10 (cJADAS10) and to compare them with 
other patient cohorts.
Methods
 In a national multicentre study, cross-sectional data on recent visits 
of 337 non-systemic patients with juvenile idiopathic arthritis (JIA) 
were collected from nine paediatric outpatient units. The cut-offs were 
tested with receiver operating characteristic curve-based methods, and 
too high, too low and correct classification rates (CCRs) were 
calculated.
Results
 Our earlier presented JADAS10 cut-offs seemed feasible based on the 
CCRs, but the cut-off values between low disease activity (LDA) and 
moderate disease activity (MDA) were adjusted. When JADAS10 cut-offs for
 clinically inactive disease (CID) were increased to 1.5 for patients 
with oligoarticular disease and 2.7 for patients with polyarticular 
disease, as recently suggested in a large multinational register study, 
altogether 11 patients classified as CID by the cut-off had one active 
joint. We suggest JADAS10 cut-off values for 
oligoarticular/polyarticular disease to be in CID: 0.0–0.5/0.0–0.7, LDA:
 0.6–3.8/0.8–5.1 and MDA: >3.8/5.1. Suitable cJADAS10 cut-offs are 
the same as JADAS10 cut-offs in oligoarticular disease. In polyarticular
 disease, cJADAS10 cut-offs are 0–0.7 for CID, 0.8–5.0 for LDA and 
>5.0 for MDA.
Conclusion
 International consensus on JADAS cut-off values is needed, and such a 
cut-off for CID should preferably exclude patients with active joints in
 the CID group.
| Downloadable publication  This is an electronic reprint of the original article. | 

