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The correlation between the Childhood Health Assessment Questionnaire and disease activity in juvenile idiopathic
Watchareewan Sontichai1,2, Soamarat Vilaiyuk1
1Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
The Childhood Health Assessment Questionnaire (CHAQ) effectively assesses functional ability in children with active juvenile idiopathic arthritis (JIA). However, its correlation with disease activity diminishes significantly when JIA is inactive.
Area of Science:
- Pediatric Rheumatology
- Clinical Assessment Tools
- Childhood Arthritis
Background:
- The Childhood Health Assessment Questionnaire (CHAQ) is an adaptation of the Stanford Health Assessment Questionnaire.
- It is utilized for evaluating functional ability in pediatric populations.
Purpose of the Study:
- To investigate the correlation between the CHAQ disability index (DI) and disease activity markers in juvenile idiopathic arthritis (JIA).
- To assess this correlation during both active and inactive phases of JIA.
Main Methods:
- Retrospective analysis of 139 JIA patients from Ramathibodi Hospital (January 2011-December 2013).
- Collected CHAQ-DI and disease activity variables (joint counts, ESR, global assessments, JADAS27) over six visits.
- Correlations analyzed using Spearman's correlation, classifying disease as active or inactive at each visit.
Main Results:
- RF-negative polyarthritis showed the highest CHAQ-DI, while oligoarthritis had the lowest.
- A significant positive correlation was observed between CHAQ-DI and JADAS27, PGA, and PtGA during active JIA (p < 0.05).
- A poor correlation was found between CHAQ-DI and disease activity variables when JIA was inactive.
Conclusions:
- CHAQ-DI demonstrates good correlation with disease activity markers in active JIA.
- The correlation is poor during inactive JIA, suggesting limited utility in this phase.
- CHAQ is primarily useful for assessing functional ability in children with active JIA.
Background:
The Childhood Health Assessment Questionnaire (CHAQ) has been adapted from the Stanford Health Assessment Questionnaire for assessing functional ability in children. The present study aimed to determine the correlation between CHAQ and disease activity in juvenile idiopathic arthritis (JIA) during active and inactive disease.
Methods:
JIA patients in the Pediatric Department, Ramathibodi Hospital, between January 2011 and December 2013, were included in the study. The CHAQ disability index (DI) and disease activity variables, including active and limited joint count, erythrocyte sedimentation rate, patient's global assessment (PtGA), physician's global assessment (PGA) and 27-joint Juvenile Arthritis Disease Activity Score (JADAS27), were collected from medical records for each patient over six visits. At each visit, each patient was classified as having either active or inactive disease. The correlations between CHAQ-DI and disease activity variables were analysed using Spearman's correlation.
Results:
The classification of 139 JIA patients consisted of enthesitis-related arthritis (30.9%), systemic JIA (28.1%), oligoarthritis (16.5%), rheumatoid factor (RF)-negative polyarthritis (15.1%), RF-positive polyarthritis (6.5%) and undifferentiated arthritis (2.9%). Out of 812 patient visits, 606 were in active disease and 206 were in inactive disease. RF-negative polyarthritis had the highest CHAQ-DI (0.39 ± 0.66), while oligoarthritis had the lowest (0.20 ± 0.32). There was a good correlation between CHAQ-DI and JADAS27, PGA and PtGA in all JIA subtypes (p < 0.05) during active disease, but a poor correlation between CHAQ-DI and disease activity variables during inactive disease.
Conclusions:
CHAQ-DI had a good correlation with disease activity during active disease but a poor correlation during inactive disease. Therefore, CHAQ is only useful for assessing functional ability during active disease.
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