{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:32:19Z","timestamp":1780471939214,"version":"3.54.1"},"reference-count":87,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2008,10,30]],"date-time":"2008-10-30T00:00:00Z","timestamp":1225324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2008,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify the optimal initial treatment strategy for knee monarthritis in juvenile idiopathic arthritis (JIA) using a decision model and parents' preferences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We utilized a decision analysis model with Markov states and a 6\u2010month multi\u2010attribute outcome with 7 dimensions pertinent to the treatment decision. The 3 most common treatment strategies for knee monarthritis were compared: nonsteroidal antiinflammatory drugs (NSAIDs) only, NSAID trial followed by intraarticular corticosteroid injection (IACI) if arthritis was not resolved after 2 months, and initial IACI. Probability estimates for the efficacy and adverse effects of NSAIDs and IACIs were derived from a systematic review of the literature. Parents' preferences for the 7 dimensions of the multi\u2010attribute outcome were elicited by a unique hybrid of the time tradeoff and magnitude estimation techniques. These preferences were then combined with the outcomes of the decision analysis to determine an individual's preferred treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The NSAID trial strategy may avert IACIs in some patients, but at a cost of continued active arthritis. The number of patients that need to be treated with the NSAID trial strategy to avoid a single IACI compared with the initial IACI strategy is 3.8 with an expected additional cost of 6.7 months of active arthritis. Of the 12 parent subjects, 11 (92%) preferred the initial IACI strategy and 1 preferred the NSAID\u2010only strategy. These preferences were not sensitive to model assumptions or probability estimates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Initial IACI appears to be the optimal treatment strategy for knee monarthritis in JIA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.24190","type":"journal-article","created":{"date-parts":[[2008,10,30]],"date-time":"2008-10-30T11:08:48Z","timestamp":1225364928000},"page":"1580-1588","source":"Crossref","is-referenced-by-count":25,"title":["Optimal treatment of knee monarthritis in juvenile idiopathic arthritis: A decision analysis"],"prefix":"10.1002","volume":"59","author":[{"given":"Timothy","family":"Beukelman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James P.","family":"Guevara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel 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