{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:18:35Z","timestamp":1793089115615,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,1,27]],"date-time":"2014-01-27T00:00:00Z","timestamp":1390780800000},"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; Rheumatology"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To use electronic diaries (e\u2010diaries) to determine whether pain, stiffness, and fatigue continue to be common, disabling symptoms in children with juvenile idiopathic arthritis (JIA) despite the use of aggressive treatments in contemporary medical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty\u2010nine children with JIA (ages 8\u201318 years) provided ratings of pain, stiffness, and fatigue intensity and functional limitations using a smartphone e\u2010diary 3 times each day for 1 month. Medication information was collected via parent report and checked for accuracy by chart review. Descriptive analyses were conducted to determine typical symptom intensity, frequency, and variability. Multilevel modeling was used to analyze associations between symptoms and functional outcomes and between medication use and symptom intensity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Children reported moments of pain in 66% of e\u2010diary entries. No children were entirely pain\u2010free across the reporting period. In 31% of all e\u2010diary entries the visual analog scale score for pain was &gt;40 (high pain intensity), with 86% of children reporting a high level of pain at least once during the study period. The mean ratings of pain, stiffness, and fatigue intensity were in the mild\u2010to\u2010moderate range. Medication class was not a reliable predictor of differences in symptom intensity, even though 79% of children were prescribed a disease\u2010modifying antirheumatic drug and 47% were prescribed a biologic agent. Moments of higher pain intensity and higher stiffness intensity were each uniquely predictive of higher concurrent functional limitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Self\u2010reported pain, stiffness, and fatigue continue to be common in children with JIA, despite contemporary advances in treatment strategies, including use of biologic agents. These findings are surprisingly consistent with previous results from research using daily paper diaries in the pre\u2010biologics era. There remains a pressing and ongoing need to optimize pain and symptom management in JIA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.38223","type":"journal-article","created":{"date-parts":[[2013,12,18]],"date-time":"2013-12-18T14:20:48Z","timestamp":1387376448000},"page":"462-469","source":"Crossref","is-referenced-by-count":114,"title":["Self\u2010Reported Pain and Disease Symptoms Persist in Juvenile Idiopathic Arthritis Despite Treatment Advances: An Electronic Diary Study"],"prefix":"10.1002","volume":"66","author":[{"given":"Maggie H.","family":"Bromberg","sequence":"first","affiliation":[{"name":"University of North Carolina Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Connelly","sequence":"additional","affiliation":[{"name":"Children's Mercy Hospitals and Clinics Kansas City Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly K.","family":"Anthony","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M.","family":"Gil","sequence":"additional","affiliation":[{"name":"University of North Carolina Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura E.","family":"Schanberg","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,1,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(97)00110-3"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(16)36734-7"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)80652-3"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/12.2.241"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21852"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kel218"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22473"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10986"},{"key":"e_1_2_6_10_1","first-page":"196","article-title":"School attendance and patterns, special services and special needs in pediatric patients with rheumatic diseases: results of a multicenter study","volume":"3","author":"Lovell DJ","year":"1990","journal-title":"Arthritis Care Res"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.59.4.276"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/28.1.17"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21850"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20460"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34343"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21625"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.51.3.343"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1790080109"},{"key":"e_1_2_6_19_1","first-page":"561","article-title":"Psychosocial outcome in juvenile chronic arthritis: a nine\u2010year follow\u2010up","volume":"15","author":"Aasland A","year":"1997","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20238"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20348"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/abm\/16.3.199"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.54.101601.145030"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2003.12.017"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ajp.0000173371.54579.31"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.07.002"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.07.013"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsr088"},{"key":"e_1_2_6_29_1","unstructured":"BoskerRJ SnijdersTA GuldemondH. 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