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Does removal of AIDS/devices and help make a difference in the Childhood Health Assessment Questionnaire Disability Index?
  1. Claudia Saad-Magalhães (claudi{at}
  1. Hospital das Clínicas - Faculdade de Medicina de Botucatu, UNESP, Brazil
    1. Angela Pistorio (angelapistorio{at}
    1. IRCCS Istituto G. Gaslini, Servizio di Epidemiologia e Biostatistica, Italy
      1. Angelo Ravelli (angeloravelli{at}
      1. IRCCS Istituto G. Gaslini, Divisione di Pediatria II, Italy
        1. Giovanni Filocamo (giovannifilocamo{at}
        1. IRCCS Istituto G. Gaslini, Divisione di Pediatria II, Italy
          1. Stefania Viola (stefaniaviola{at}
          1. IRCCS Istituto G. Gaslini, Divisione di Pediatria II, Italy
            1. Riva Brik (r_brik{at}
            1. Rambam Medical Center, Department of Pediatrics B, Israel
              1. Dimitrina Mihaylova (drdmm{at}
              1. University Children Hospital, Department of Paediatric Rheumatology, Bulgaria
                1. Rebecca Ten Cate (r.ten_cate{at}
                1. Academisch Ziekenhuis Leiden, Department of Pediatrics, J6-S, Netherlands
                  1. Boel Andersson Gare (boel.andersson-gare{at}
                  1. Ryhov's County Hospital, Department of Child Public Health, Qulturum, Sweden
                    1. Virginia P L Ferriani (printo{at}
                    1. Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo, Brazil
                      1. Kirsten Minden (kirsten.minden{at}
                      1. Charite University Hospital Berlin, Kinderklinik, Rheumatologie, Germany
                        1. Philip J Hashkes (hashkep{at}
                        1. Cleveland Clinic Foundation, Dept. of Rheumatic Diseases A50, United States
                          1. Marite Rygg (marite.rygg{at}
                          1. St. Olavs University Hospital of Trondheim, Department of Pediatrics, Norway
                            1. Marie-Josephe Sauvain ({at}
                            1. Policlinique de pediatrie Hopital Universitaire, Switzerland
                              1. Helen Venning (helen.venning{at}
                              1. Nottingham University Hospital, Paediatric & Adolescent Rheumatology, United Kingdom
                                1. Alberto Martini (albertomartini{at}
                                1. IRCCS Istituto G. Gaslini, Divisione di Pediatria II, Italy
                                  1. Nicolino Ruperto (nicolaruperto{at}
                                  1. IRCCS Istituto G. Gaslini, Divisione di Pediatria II, Italy


                                    Objective: To assess whether the removal of aids/devices and/or help from another person in the Childhood Health Assessment Questionnaire (C-HAQ) leads to a significant change in the Disability Index (DI) score and responsiveness in juvenile idiopathic arthritis (JIA).

                                    Methods: We compared the C-HAQ DI score changes in a cross-sectional sample of 2,663 children with JIA and in 530 active JIA patients from a methotrexate (MTX) trial.

                                    Results: MTX trial patients had higher disease activity and disability compared to the cross-sectional sample. The frequency of aids/devices (range 1.2-10.2%) was similar between the 2 samples, while help (range 5.3-38.1%) was more frequently used in the MTX group. Correlation between disease severity variables and the two different C-HAQ DI scoring methods did not change substantially. There was a decrease in the C-HAQ DI score for both the cross-sectional (mean score from 0.64 with the original method to 0.54 without aids/devices and help, p <0.0001) and the MTX sample (mean score from 1.23 to 1.07, p <0.0001). A linear regression analysis of the original C-HAQ DI score versus the score without aids/devices and help demonstrated the substantial overlapping of the different scoring methods. Responsiveness in the responders to MTX treatment did not change with the different C-HAQ DI scoring methods (range 0.86-0.82).

                                    Conclusion: The removal of aids/devices and help from the C-HAQ does not alter the interpretation of disability at a group level. The simplified C-HAQ is a more feasible and valid alternative for the evaluation of disability in JIA patients.

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