Giannini et al developed criteria for determining if a pediatric patient with juvenile arthritis has shown improvement. The authors are members of the Pediatric Rheumatology International Trials Organization (PRINTO).
Parameters - 6 core set of outcome variables:
(1) physician's global assessment of overall disease activity, using a 10 cm VAS scale ranging from 0 (no activity) to 10 (extreme activity)
(2) parent's or patient's global assessment of overall well-being, using a 10 cm VAS scale ranging from 0 (no activity) to 10 (extreme activity)
(3) functional ability (measured using the Children's Health Activity Questionnaire Disability Index, CHAQ; values from 0 to 3)
(4) number of joints with active arthritis
(5) number of joints with limited range of motion
(6) erythrocyte sedimentation rate by Westergren method in mm in first hour
where:
• It is important that the same joints be examined on each occasion.
• The joint counting for item 5 could represent all joints with a limited range of motion or those joints with a limited range of motion without active arthritis. The former interpretation will be used in the implementation.
• In theory none of the measures should be 0 at the initial assessment. A 0 score at the initial reading makes a percent change difficult to calculate.
ratio of current measure to previous as percent =
= (current value) / (previous value) * 100%
Criteria for improvement:
(1) 3 or more of the measures show an improvement of >= 30% (ratio of measures <= 70%)
(2) no more than 1 measure has worsened by > 30% (ratio of measures > 130%)
