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dc.contributor.authorBerntson, L
dc.contributor.authorFasth, A
dc.contributor.authorAndersson-Gäre, B
dc.contributor.authorKristinsson, J
dc.contributor.authorLahdenne, P
dc.contributor.authorMarhaug, G
dc.contributor.authorNielsen, S
dc.contributor.authorPelkonen, P
dc.contributor.authorSvensson, E
dc.date.accessioned2010-11-09T11:12:10Z
dc.date.available2010-11-09T11:12:10Z
dc.date.issued2001-12-01
dc.date.submitted2010-11-09
dc.identifier.citationJ. Rheumatol. 2001, 28(12):2737-43en
dc.identifier.issn0315-162X
dc.identifier.pmid11764226
dc.identifier.urihttp://hdl.handle.net/2336/115112
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractOBJECTIVE: New classification criteria (ILAR) have been proposed for juvenile idiopathic arthritis (JIA). They are more descriptive than those formerly used [American College of Rheumatology (ACR), European League Against Rheumatism (EULAR)], but require validation against classifications already in use. We validated the ILAR criteria in relation to the EULAR criteria in a prospective, incidence, and population based setting, and analyzed their feasibility. METHODS: Construct validity of ILAR and EULAR classification criteria refers to how closely the 2 instruments are related and how each of them operates in classifying subgroups/categories. Twenty doctors in 5 Nordic countries collected data from the incidence cases within their catchment areas during an 18 month period beginning July 1, 1997. Clinical and serological data from the first year of disease were collected. RESULTS: A total of 322 patients were included. Classification according to the ILAR criteria was possible in 321 patients; 290 patients had a disease duration > or = 3 months and were classified according to the EULAR criteria. One child could only be classified according to the EULAR criteria. Thus, 31/322 (9.6%) children were classified according to the ILAR criteria only. Forty-eight of 321 (15%) patients did not fit into any category and 6% (20/321) fulfilled criteria for2 categories. In the ILAR classification 5 out of 7 categories/subgroups have 2 to 5 specified exclusion criteria that highly discriminate the definition of each patient. In our study the exclusion criteria were fulfilled to only a small extent. CONCLUSION: The EULAR and ILAR criteria differ concerning the operational definitions of the subvariables involved, which complicates their comparison. By using ILAR rather than EULAR criteria the number of cases with juvenile arthritis increased by 10%, considering the first half-year after onset. The validity of the ILAR criteria is low since they often exclude patients from subgroup classification and the possibility of having more than one diagnosis is not negligible. The specified exclusion criteria for some of the subgroups are difficult to fulfill in clinical work and variables involved could be questioned with regard to their consistency.
dc.language.isoenen
dc.publisherJournal Of Rheumatology Publishing Coen
dc.relation.urlhttp://www.jrheum.org/content/28/12/2737.longen
dc.subject.meshAdolescenten
dc.subject.meshArthritis, Juvenile Rheumatoiden
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshFemaleen
dc.subject.meshFinlanden
dc.subject.meshHumansen
dc.subject.meshIcelanden
dc.subject.meshIncidenceen
dc.subject.meshInfanten
dc.subject.meshInternational Cooperationen
dc.subject.meshMaleen
dc.subject.meshProspective Studiesen
dc.subject.meshRheumatologyen
dc.subject.meshScandinaviaen
dc.subject.meshSocieties, Medicalen
dc.titleConstruct validity of ILAR and EULAR criteria in juvenile idiopathic arthritis: a population based incidence study from the Nordic countries. International League of Associations for Rheumatology. European League Against Rheumatismen
dc.typeArticleen
dc.contributor.departmentDepartment of Pediatrics, Hospital of Falun, Sweden. lillemor.berntson@falun.mail.telia.comen
dc.identifier.journalJournal of rheumatologyen
html.description.abstractOBJECTIVE: New classification criteria (ILAR) have been proposed for juvenile idiopathic arthritis (JIA). They are more descriptive than those formerly used [American College of Rheumatology (ACR), European League Against Rheumatism (EULAR)], but require validation against classifications already in use. We validated the ILAR criteria in relation to the EULAR criteria in a prospective, incidence, and population based setting, and analyzed their feasibility. METHODS: Construct validity of ILAR and EULAR classification criteria refers to how closely the 2 instruments are related and how each of them operates in classifying subgroups/categories. Twenty doctors in 5 Nordic countries collected data from the incidence cases within their catchment areas during an 18 month period beginning July 1, 1997. Clinical and serological data from the first year of disease were collected. RESULTS: A total of 322 patients were included. Classification according to the ILAR criteria was possible in 321 patients; 290 patients had a disease duration > or = 3 months and were classified according to the EULAR criteria. One child could only be classified according to the EULAR criteria. Thus, 31/322 (9.6%) children were classified according to the ILAR criteria only. Forty-eight of 321 (15%) patients did not fit into any category and 6% (20/321) fulfilled criteria for2 categories. In the ILAR classification 5 out of 7 categories/subgroups have 2 to 5 specified exclusion criteria that highly discriminate the definition of each patient. In our study the exclusion criteria were fulfilled to only a small extent. CONCLUSION: The EULAR and ILAR criteria differ concerning the operational definitions of the subvariables involved, which complicates their comparison. By using ILAR rather than EULAR criteria the number of cases with juvenile arthritis increased by 10%, considering the first half-year after onset. The validity of the ILAR criteria is low since they often exclude patients from subgroup classification and the possibility of having more than one diagnosis is not negligible. The specified exclusion criteria for some of the subgroups are difficult to fulfill in clinical work and variables involved could be questioned with regard to their consistency.


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