{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T14:21:22Z","timestamp":1788531682357,"version":"build-2803163510"},"reference-count":23,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"unspecified","delay-in-days":65,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,8,5]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To comparatively evaluate recent adult-onset Still\u2019s disease (AOSD) activity measures\u2014Development and Validation of Disease Activity in AOSD (DAVID), Still\u2019s Disease Activity Score (SDAS), Still Activity Score (SAS) with Pouchot\u2019s Systemic Score (PSS) in an independent multicentre cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>DAVID and SDAS were modified (m) by omitting global assessments due to availability and to circumvent incorporation bias. Criterion validity was assessed by receiver operating characteristic (ROC) analysis against the treating physician\u2019s determination of disease activity (active vs inactive). Responsiveness was evaluated by comparing mean change in scores between remission and active disease, and Cohen\u2019s d. Longitudinal sensitivity to change was assessed using linear mixed-effects models with z-standardised scores and marginal R\u00b2. Primary analysis uses imputed data, with complete-case sensitivity analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort comprised 86 patients with initially active AOSD (64% female; mean age 39.4\u00b115.0 years). In ROC analyses, mSDAS, mDAVID and SAS showed comparable area under the curves (0.69, 0.68 and 0.68, respectively), whereas PSS had a lower AUC (0.60). Responsiveness was greatest for mDAVID (Cohen\u2019s d 0.76 (95% CI 0.30 to 1.20)), followed by mSDAS (0.61 (0.13 to 1.1)), SAS (0.46 (\u22120.01 to 0.90)) and PSS (0.22 (\u22120.30 to 0.68)). Longitudinal sensitivity to change, quantified by marginal R\u00b2, was highest for mDAVID (0.65 (95% CI 0.59 to 0.70)), followed by mSDAS (0.61 (0.55 to 0.67)), PSS (0.61 (0.54 to 0.67)) and SAS (0.55 (0.45 to 0.64)). Sensitivity analyses using complete cases yielded similar results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>mDAVID and mSDAS demonstrated the most favourable and largely comparable performance profiles across the evaluated metrics, with mDAVID showing greater responsiveness and mSDAS demonstrating a stronger correlation with the articular disease domain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN86135778\">ISRCTN86135778<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2026-007112","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T13:41:25Z","timestamp":1788529285000},"page":"e007112","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative evaluation of disease activity measures for adult-onset Still\u2019s disease: a multicentre, retrospective, cohort study"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"isrctn86135778","registry":"10.18810\/isrctn"},{"clinical-trial-number":"isrctn86135778","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5725-5483","authenticated-orcid":false,"given":"Stefan","family":"Vordenb\u00e4umen","sequence":"first","affiliation":[{"name":"Department of Rheumatology & Hiller Research Center, University Hospital of D\u00fcsseldorf, D\u00fcsseldorf, Germany"},{"name":"Department of Rheumatology, St Elisabeth-Hospital Meerbusch-Lank, Meerbusch, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5628-8398","authenticated-orcid":false,"given":"Tim","family":"Filla","sequence":"additional","affiliation":[{"name":"Department of Rheumatology & Hiller Research Center, University Hospital of D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhea","family":"Friedrich","sequence":"additional","affiliation":[{"name":"Justus Liebig University Giessen, Giessen, Germany"},{"name":"Department of Rheumatology and Immunology, Helios Clinic Vogelsang-Gommern, Gommern, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Blank","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Rheumatology, Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Ernst","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8385-6861","authenticated-orcid":false,"given":"J\u00f6rg","family":"Henes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology, and Rheumatology, University Hospital T\u00fcbingen, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gernot","family":"Key\u00dfer","sequence":"additional","affiliation":[{"name":"Clinic for Internal Medicine II, Department of Internal Medicine, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle (Saale), Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Klemm","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-Universitat Giessen, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Krusche","sequence":"additional","affiliation":[{"name":"Department Internal Medicine III, Division of Rheumatology and Inflammatory Systemic Autoimmune Diseases, University Hospital Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8517-616X","authenticated-orcid":false,"given":"Anna","family":"Meinecke","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2569-2029","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Rech","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3 - Rheumatology and Immunology, Deutsches Zentrum Immuntherapie and Center for Rare Diseases Erlangen (ZSEER), Friedrich-Alexander-Universit\u00e4t (FAU) Erlangen-N\u00fcrnberg and Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0378-3766","authenticated-orcid":false,"given":"Nils","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-Universitat Giessen, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4686-1143","authenticated-orcid":false,"given":"Simon Michael","family":"Petzinna","sequence":"additional","affiliation":[{"name":"Clinic of Internal Medicine III, Oncology, Hematology, Rheumatology and Clinical Immunology, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Pankow","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Campus Charit\u00e9 Mitte, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin S","family":"Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Clinic of Internal Medicine III, Oncology, Hematology, Rheumatology and Clinical Immunology, University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2709-6685","authenticated-orcid":false,"given":"Alexander","family":"Pfeil","sequence":"additional","affiliation":[{"name":"Center of Rheumatology and Section Rheumatology and Osteology, Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0012-0163","authenticated-orcid":false,"given":"Sebastian","family":"Klapa","sequence":"additional","affiliation":[{"name":"Institute of Experimental Medicine, Christian-Albrecht University Kiel, Kiel, Germany"},{"name":"Department of Rheumatology and Clinical Immunology, University of L\u00fcbeck, L\u00fcbeck, Germany and Institute of Experimental Medicine, Christian-Albrecht University Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Pongratz","sequence":"additional","affiliation":[{"name":"Medical Faculty, University of Regensburg, Regensburg, Germany"},{"name":"Department of Rheumatology and Clinica Immunology, Barmherzige Br\u00fcder Hospital, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9872-5282","authenticated-orcid":false,"given":"Eugen","family":"Feist","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Helios Clinic Vogelsang-Gommern, Gommern, Germany"},{"name":"Experimental Rheumatology, Otto von Guericke University Magdeburg, Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kernder","sequence":"additional","affiliation":[{"name":"Department of Rheumatology & Hiller Research Center, University Hospital of D\u00fcsseldorf, D\u00fcsseldorf, Germany"},{"name":"Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"2026090405501917000_12.3.e007112.1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s00393-022-01294-2","article-title":"Diagnosis and treatment of adult-onset Still\u2019s disease: a concise summary of the German society of rheumatology S2 guideline","volume":"82","author":"Vordenb\u00e4umen","year":"2023","journal-title":"Z 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The urgent need of a specific disease activity score to adult-onset Still\u2019s disease","volume":"81","author":"Ruscitti","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"2026090405501917000_12.3.e007112.13","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199103000-00004"},{"key":"2026090405501917000_12.3.e007112.14","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1002\/art.42845","article-title":"The systemic score may identify life-threatening evolution in Still disease: data from the GIRRCS AOSD-Study Group and the AIDA Network Still Disease Registry","volume":"76","author":"Ruscitti","year":"2024","journal-title":"Arthritis Rheumatol"},{"key":"2026090405501917000_12.3.e007112.15","doi-asserted-by":"crossref","first-page":"501814","DOI":"10.1016\/j.reuma.2024.501814","article-title":"Evaluation of performance of the Still Activity Score for assessment of adult-onset Still\u2019s disease: comparative study with Systemic Feature Score and Modified Pouchot-Activity Score","volume":"21","author":"Uslu","year":"2025","journal-title":"Reumatol Clin (Engl Ed)"},{"key":"2026090405501917000_12.3.e007112.16","doi-asserted-by":"crossref","first-page":"105499","DOI":"10.1016\/j.jbspin.2022.105499","article-title":"Derivation and validation of adult Still Activity Score (SAS)","volume":"90","author":"Kalyoncu","year":"2023","journal-title":"Joint Bone Spine"},{"key":"2026090405501917000_12.3.e007112.17","doi-asserted-by":"crossref","first-page":"3273","DOI":"10.1007\/s10067-024-07127-8","article-title":"Disease activity score for Still\u2019s disease","volume":"43","author":"Daghor-Abbaci","year":"2024","journal-title":"Clin Rheumatol"},{"key":"2026090405501917000_12.3.e007112.18","doi-asserted-by":"crossref","first-page":"e451","DOI":"10.1016\/S2665-9913(25)00377-7","article-title":"Development and validation of clinical criteria for the definition of disease activity in adult-onset Still\u2019s disease: a cohort study","volume":"8","author":"Ruscitti","year":"2026","journal-title":"Lancet Rheumatol"},{"key":"2026090405501917000_12.3.e007112.19","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.01134.x"},{"key":"2026090405501917000_12.3.e007112.20","doi-asserted-by":"publisher","DOI":"10.1111\/j.2041-210x.2012.00261.x"},{"key":"2026090405501917000_12.3.e007112.21","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.042143"},{"key":"2026090405501917000_12.3.e007112.22","doi-asserted-by":"crossref","DOI":"10.1093\/rap\/rkaf139","article-title":"Physician global assessment in rheumatoid arthritis-is there any logic?","volume":"9","author":"J\u00e4ppinen","year":"2025","journal-title":"Rheumatol Adv Pract"},{"key":"2026090405501917000_12.3.e007112.23","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1002\/art.43058","article-title":"Do we need distinct pediatric classification criteria for rheumatic diseases that affect both children and adults?","volume":"77","author":"Ciurtin","year":"2025","journal-title":"Arthritis Rheumatol"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2026-007112","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T13:41:27Z","timestamp":1788529287000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2026-007112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9,4]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/rmdopen-2026-007112"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2026-007112","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}