{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T18:42:35Z","timestamp":1770230555856,"version":"3.49.0"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The physician global assessment of disease activity (PhGA) is a tool used nearly ubiquitously by pediatric rheumatologists for the assessment of patient disease activity status. However, this tool lacks standardization in its scoring. This survey aimed to identify score influencing factors, along with inclusion or exclusion of extra\u2010articular manifestations and imaging, when scoring the PhGA in juvenile idiopathic arthritis (JIA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic surveys were sent to Paediatric Rheumatology International Trials Organisation and Pediatric Rheumatology Care and Outcomes Improvement Network members who completed a previous survey on scoring of the PhGA. Respondents were asked to rank their top seven factors for inclusion in the PhGA for nonsystemic JIA (nsJIA) and systemic JIA (sJIA), along with ranking extra\u2010articular manifestations and imaging for inclusion. Frequency and percentage of rank and Likert responses were analyzed, and geographic regions as well as level of experience were compared using the chi\u2010square test and Fisher's test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 276 respondents from 54 countries and six continents participated. For nsJIA, factors selected by &gt;50% included number of swollen joints, active uveitis, duration of morning stiffness, and number of tender joints. For sJIA, factors selected by &gt;50% were presence and duration of fever, laboratory tests, number of swollen joints, serositis, rash, hepatomegaly, lung disease, and lymphadenopathy. Agreement on the inclusion of extra\u2010articular factors, such as uveitis, macrophage activation syndrome, and sJIA\u2010associated lung disease, had &gt;70% moderate or strong agreement for inclusion, whereas psoriasis had only 50.5% agreement for inclusion and imaging had 64.7% agreement for inclusion. Variations in rank between different geographic regions or level of experience were minor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This survey identifies factors that pediatric rheumatology providers find important for PhGA scoring of disease activity, documents varying agreement on inclusion of extra\u2010articular manifestations of disease, and lays the framework for further consensus work.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25447","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T09:03:01Z","timestamp":1728550981000},"page":"528-533","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors for Consideration by Pediatric Rheumatologists When Scoring the Physician Global Assessment of Disease Activity in Juvenile Idiopathic Arthritis: First Step Toward an Internal Consensus"],"prefix":"10.1002","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1569-5349","authenticated-orcid":false,"given":"Maarit","family":"Tarkiainen","sequence":"first","affiliation":[{"name":"Helsinki University Hospital and University of Helsinki, New Children's Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6235-1947","authenticated-orcid":false,"given":"Erin","family":"Balay\u2010Dustrude","sequence":"additional","affiliation":[{"name":"University of Washington and Seattle Children's Hospital  Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0065-7614","authenticated-orcid":false,"given":"Alessandro","family":"Consolaro","sequence":"additional","affiliation":[{"name":"Istituto Giannina Gaslini and University of Genova and Universit\u00e0 degli Studi di Genova  Genova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-1781","authenticated-orcid":false,"given":"Esi M.","family":"Morgan","sequence":"additional","affiliation":[{"name":"University of Washington and Seattle Children's Hospital  Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8407-7782","authenticated-orcid":false,"given":"Nicolino","family":"Ruperto","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Milano Bicocca and IRCCS Fondazione San Gerardo dei Tintori\/PRINTO  Monza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronika","family":"Rypdal","sequence":"additional","affiliation":[{"name":"University Hospital of North Norway and UIT the Arctic University of Norway  Troms\u00f8 Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8632-8634","authenticated-orcid":false,"given":"Maria","family":"Backstr\u00f6m","sequence":"additional","affiliation":[{"name":"University of Oulu, Oulu, Finland, and The Wellbeing Services County of Ostrobothnia, Vaasa, Finland. University of Oulu  Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"V\u00e4h\u00e4salo","sequence":"additional","affiliation":[{"name":"University of Oulu, Oulu, Finland, and Oulu University Hospital  Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth S.","family":"Gottlieb","sequence":"additional","affiliation":[{"name":"Northwell Health, Cohen Children's Medical Center  Queens New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Paediatric Rheumatology International Trials Organisation, the Pediatric Rheumatology Care & Outcomes Improvement Network and the Physician Global Assessment of Disease Activity (PhGA) Consensus Task Force, and for the Pediatric Rheumatology European Society (PRES) Juvenile Idiopathic Arthritis Working Party","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400703"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20497"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24516"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-018-1571-6"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.160197"},{"issue":"1","key":"e_1_2_7_7_1","first-page":"113","article-title":"Inter\u2010observer agreement of the physician's global assessment of disease activity in children with juvenile idiopathic arthritis","volume":"23","author":"Falcone A","year":"2005","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23203"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead151"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1546-0096-9-9"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2005.03.057"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.031237"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2021-002042"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2023.152340"},{"key":"e_1_2_7_15_1","unstructured":"BieberRD GottliebBS.Exploring Determinants of Parent\/Patient Global Assessment (PGA) of Overall Well\u2010Being Among Parents and Patients with Juvenile Idiopathic Arthritis (JIA). Conference Abstract Pediatric Academic Societies (PAS) 2016 Annual Meeting.2016."},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-008-0025-6"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.25447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T16:58:56Z","timestamp":1759424336000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.25447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,30]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/acr.25447"],"URL":"https:\/\/doi.org\/10.1002\/acr.25447","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,30]]},"assertion":[{"value":"2024-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}