Evidence map›Paper›PMID 30111380›Full record

ArticleArthritis research & therapy2018

Clinical signs and symptoms in a joint model of four disease activity parameters in juvenile dermatomyositis: a prospective, longitudinal, multicenter cohort study.

E H Pieter van Dijkhuizen, Maria De Iorio, Lucy R Wedderburn, Claire T Deakin, JDRG

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Arthritis research & therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 11 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 4 countries.

E H Pieter van DijkhuizenPediatric Rheumatology, University Medical Center Utrecht Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Maria De IorioDepartment of Statistical Science, University College London, London, UK.
Lucy R WedderburnPaediatric Rheumatology, University College London GOS Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
Claire T DeakinPaediatric Rheumatology, University College London GOS Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK. c.deakin@ucl.ac.uk.
JDRG
Great Ormond Street Hospital · GBInstitute of Child Health · GRIstituto Giannina Gaslini · ITUniversity Medical Center Utrecht · NL

Funding

Arthritis Research UK 14518Arthritis Research UK 20164Wellcome TrustWellcome Trust 085860
6 · The paper itself

Abstract

backgroundIt is currently impossible to predict the prognosis of patients with juvenile dermatomyositis (JDM). The aim of this study was to find clinical features most strongly associated with outcome variables in JDM as a first step towards tailor-made treatment.

methodsIn a large, prospectively followed, multicenter cohort study of 340 patients with JDM, each contributing multiple visits, a Bayesian model of disease activity was developed, using the four continuous outcome variables creatine kinase (CK), childhood myositis assessment score (CMAS), manual muscle testing of 8 muscle groups (MMT8) and the physician's global assessment of disease activity (PGA). Covariates were clinical signs and symptoms. Correlations among visits of the same patient were resolved by introducing subject-specific random effects.

resultsMyalgia and dysphonia were associated with worse disease activity according to all outcome variables. Periorbital rash, rash on the trunk, rash over large joints, nail fold changes and facial swelling were associated with higher PGA. Notably, periorbital rash was also associated with higher CK and lower CMAS and nail fold changes with lower CMAS. Contractures were associated with lower CMAS and MMT8 and higher PGA. Patients with higher CMAS exhibited a higher MMT8 as well. PGA had the highest probability among the four outcome variables of being abnormal even if the other three outcome variables were normal.

conclusionsThe signs and symptoms associated with disease activity could be used to stratify patients and adapt treatment plans to disease activity. The correlation between CMAS and MMT8 and the unique information captured by PGA implied that PGA should be maintained as an outcome variable, whereas CMAS and MMT8 might be simplified.

Indexed as

Severity of Illness IndexBayes TheoremChildChild, PreschoolDermatomyositisFemaleHumansLongitudinal StudiesMalePrognosisProspective StudiesBayesian modelClinical associationsDisease activityJuvenile dermatomyositisLongitudinal data

Identifiers

PMID30111380
PMCPMC6094880
OpenAlexW2886984877

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.