Responsiveness of clinical measures in children with oligoarticular juvenile chronic arthritis

Objective. To compare the relative responsiveness of outcome measures in ch ildren with oligoarticular course juvenile chronic arthritis (JCA). Methods, Twenty-six consecutive children with JCA and less than or equal to 4 joints involved were assessed at admission and after 3 months of followu p. Outcome measures included physician and parent global assessments, funct ional ability as measured by the Childhood Health Assessment Questionnaire (CHAQ), articular variables, and laboratory indicators of systemic inflamma tion, Responsiveness was calculated with the standardized response median, the effect size, and the Guyatt method. Results. The physician global assessment of disease activity, the active jo int count, the global articular severity score, and the number and score of swollen joints proved consistently more responsive with either responsiven ess measure used. The parent global assessment of the child's well being, t he scores of joints with pain/tenderness and limited range of motion, and t he number of joints with limited range of motion showed intermediate respon siveness. The CHAQ, morning stiffness, and laboratory indicators of systemi c inflammation were the least responsive measures. Conclusion. The subjective estimation of disease activity by the physician and the articular variables were the more responsive outcome measures in ch ildren with oligoarticular JCA. The assessment of functional ability as mea sured by the CHAQ showed a poor sensitivity to clinical change in this subs et of patients with JCA.