Development and External Validation of a Model Predicting New‐Onset Chronic Uveitis at Different Disease Durations in Juvenile Idiopathic Arthritis
Objective To develop and externally validate a prediction model for new‐onset chronic uveitis in children with juvenile idiopathic arthritis (JIA) for clinical application. Methods Data from the international Pharmachild registry were used to develop a multivariable Cox proportional hazards model. P...
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Published in | Arthritis & rheumatology (Hoboken, N.J.) Vol. 75; no. 2; pp. 318 - 327 |
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Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Boston, USA
Wiley Periodicals, Inc
01.02.2023
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Objective
To develop and externally validate a prediction model for new‐onset chronic uveitis in children with juvenile idiopathic arthritis (JIA) for clinical application.
Methods
Data from the international Pharmachild registry were used to develop a multivariable Cox proportional hazards model. Predictors were selected by backward selection, and missing values were handled by multiple imputation. The model was subsequently validated and recalibrated in 2 inception cohorts: the UK Childhood Arthritis Prospective Study (CAPS) study and the German Inception Cohort of Newly diagnosed patients with juvenile idiopathic arthritis (ICON) study. Model performance was evaluated by calibration plots and C statistics for the 2‐, 4‐, and 7‐year risk of uveitis. A diagram and digital risk calculator were created for use in clinical practice.
Results
A total of 5,393 patients were included for model development, and predictor variables were age at JIA onset (hazard ratio [HR] 0.83 [95% confidence interval (95% CI) 0.77–0.89]), ANA positivity (HR 1.59 [95% CI 1.06–2.38]), and International League of Associations for Rheumatology category of JIA (HR for oligoarthritis, psoriatic arthritis, and undifferentiated arthritis versus rheumatoid factor–negative polyarthritis 1.40 [95% CI 0.91–2.16]). Performance of the recalibrated prediction model in the validation cohorts was acceptable; calibration plots indicated good calibration and C statistics for the 7‐year risk of uveitis (0.75 [95% CI 0.72–0.79] for the ICON cohort and 0.70 [95% CI 0.64–0.76] for the CAPS cohort).
Conclusion
We present for the first time a validated prognostic tool for easily predicting chronic uveitis risk for individual JIA patients using common clinical parameters. This model could be used by clinicians to inform patients/parents and provide guidance in choice of uveitis screening frequency and arthritis drug therapy. |
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Bibliography: | Supported by FOREUM Foundation for Research in Rheumatology. Pharmachild was supported by the European Union (grant 260353) and by funding from the Italian public hospital IRCCS Istituto Giannina Gaslini. CAPS was supported by Versus Arthritis (UK grant 20542). The research team at The University of Manchester were supported by the Centre for Epidemiology Versus Arthritis (UK grant 21755), the Centre for Genetics and Genomics Versus Arthritis (UK grant 21754), and the NIHR Manchester Biomedical Research Centre. The ICON study was supported by the German Federal Ministry of Education and Research (awards BMBF, FKZ 01ER0812, 01ER0813, 01ER0828, FKZ‐01‐ER1504A, 01‐ER‐1504B, and 01‐ER‐1504C). . Author disclosures are available at https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Fart.42329&file=art42329‐sup‐0001‐Disclosureform.pdf ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Author disclosures are available at https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Fart.42329&file=art42329‐sup‐0001‐Disclosureform.pdf. |
ISSN: | 2326-5191 2326-5205 |
DOI: | 10.1002/art.42329 |