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Cherepakhin OS, Ringold S, Ronis T, Kirkorian AY, Brandling-Bennett H. A survey assessment of combined pediatric dermatology-rheumatology clinics. Pediatr Dermatol 2024. [PMID: 38532613 DOI: 10.1111/pde.15588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/24/2024] [Indexed: 03/28/2024]
Abstract
The expertise of both dermatology and rheumatology may be beneficial when managing autoimmune conditions with cutaneous and systemic manifestations in children. This survey study was directed to pediatric dermatologists who participate in combined pediatric dermatology-rheumatology clinics; 13 sites in North America responded. The results provide information regarding clinic operations, benefits, and barriers to establishment. These findings have the potential to help institutions establish or modify combined pediatric dermatology-rheumatology clinics, although further research is needed to determine their impact.
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Affiliation(s)
| | - Sarah Ringold
- Department of Pediatrics, Division of Rheumatology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Tova Ronis
- Division of Rheumatology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - A Yasmine Kirkorian
- Department of Pediatrics and Department of Dermatology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Heather Brandling-Bennett
- Department of Pediatrics, Division of Dermatology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
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2
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Smitherman EA, Chahine RA, Beukelman T, Lewandowski LB, Rahman AKMF, Wenderfer SE, Curtis JR, Hersh AO, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar‐Smiley F, Barillas‐Arias L, Basiaga M, Baszis K, Becker M, Bell‐Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang‐Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel‐Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie‐Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui‐Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein‐Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PM, McGuire S, McHale I, McMonagle A, McMullen‐Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O'Brien B, O'Brien T, Okeke O, Oliver M, Olson J, O'Neil K, Onel K, Orandi A, Orlando M, Osei‐Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan‐Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas‐Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth‐Wojcicki E, Rouster – Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert‐Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner‐Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care. Arthritis Care Res (Hoboken) 2023; 75:1553-1562. [PMID: 36775844 PMCID: PMC10500561 DOI: 10.1002/acr.25002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/14/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis. METHODS We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded. RESULTS We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers. CONCLUSION In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.
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Beukelman T, Long MD, Rhee RL, Kappelman MD, Merkel PA, Nowell WB, Clinton C, Ringold S, Del Gaizo V, Price B, Shaw DG, Venkatachalam S, Cuthbertson D, Xie F, Zhang X, Curtis JR. Assessment of Real-World Patient-Reported Outcomes in Patients Initiating Biologic Agents for the Treatment of Autoimmune Diseases: An Observational Study in Four Patient-Powered Research Networks. Patient Relat Outcome Meas 2023; 14:171-180. [PMID: 37333063 PMCID: PMC10276583 DOI: 10.2147/prom.s392174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/23/2023] [Indexed: 06/20/2023] Open
Abstract
Background The most reliable and meaningful approach for inclusion of patient-reported outcomes (PROs) in the evaluation of real-world clinical effectiveness of biologics in the treatment of autoimmune diseases is u ncertain. This study aimed to assess and compare the proportions of patients who had abnormalities in PROs measuring important general health domains at the initiation of treatment with biologics, as well as the effects of baseline abnormalities on subsequent improvement. Methods PROs were collected for patient participants with inflammatory arthritis, inflammatory bowel disease, and vasculitis using Patient-Reported Outcomes Measurement Information System instruments. Scores were reported as T-scores normalized to the general population in the United States. Baseline PROs scores were collected near the time of biologic initiation, and follow-up scores were collected 3 to 8 months later. In addition to summary statistics, the proportion of patients with PROs abnormalities (scores ≥5 units worse than the population norm) was determined. Baseline and follow-up scores were compared, and an improvement of ≥5 units was considered significant. Results There was wide variation across autoimmune diseases in baseline PROs scores for all domains. For example, the proportion of participants with abnormal baseline pain interference scores ranged from 52% to 93%. When restricted to participants with baseline PROs abnormalities, the proportion of participants experiencing an improvement of ≥5 units was substantially higher. Conclusion As expected, many patients experienced improvement in PROs following initiation of treatment with biologics for autoimmune diseases. Nevertheless, a substantial proportion of participants did not exhibit abnormalities in all PROs domains at baseline, and these participants appear less likely to experience improvement. For PROs to be reliably and meaningfully included in the evaluation of real-world medication effectiveness, more knowledge and careful consideration are needed to select the most appropriate patient populations and subgroups for inclusion and evaluation in studies measuring change in PROs.
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Affiliation(s)
- Timothy Beukelman
- Department of Pediatrics, Division of Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Millie D Long
- Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rennie L Rhee
- Department of Medicine, Division of Rheumatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael D Kappelman
- Department of Pediatrics, Division of Pediatric Gastroenterology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Peter A Merkel
- Department of Medicine, Division of Rheumatology, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology, and Informatics; Division of Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Cassie Clinton
- Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sarah Ringold
- Department of Pediatrics, Division of Rheumatology, Seattle Children’s Hospital, Seattle, WA, USA
| | - Vincent Del Gaizo
- Childhood Arthritis and Rheumatology Research Alliance (CARRA) and PARTNERS PPRN, Milwaukee, WI, USA
| | - Brian Price
- Crohn’s and Colitis Foundation and IBD-Partners, New York, NY, USA
| | - Dianne G Shaw
- Vasculitis Patient Powered Research Network, Kansas City, MO, USA
| | | | - David Cuthbertson
- Health Informatics Institute, University of South Florida, Tampa, FL, USA
| | - Fenglong Xie
- Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Xian Zhang
- Department of Pediatrics, Division of Pediatric Gastroenterology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jeffrey R Curtis
- Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
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Ringold S, Dennos AC, Kimura Y, Beukelman T, Shrader P, Phillips TA, Kohlheim M, Schanberg LE, Yeung RSM, Horton DB. Disease Recapture Rates After Medication Discontinuation and Flare in Juvenile Idiopathic Arthritis: An Observational Study Within the Childhood Arthritis and Rheumatology Research Alliance Registry. Arthritis Care Res (Hoboken) 2023; 75:715-723. [PMID: 35921198 DOI: 10.1002/acr.24994] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/19/2022] [Accepted: 07/26/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Children with well-controlled juvenile idiopathic arthritis (JIA) frequently experience flares after medication discontinuation, but the outcomes of these flares have not been well described. The objective of this study was to characterize the rates and predictors of disease recapture among children with JIA who restarted medication to treat disease flare. METHODS Children with JIA who discontinued conventional synthetic or biologic disease-modifying antirheumatic drugs for well-controlled disease but subsequently experienced a flare and restarted medication were identified from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry. The primary outcome was inactive disease (ID) (physician global assessment <1 and active joint count = 0) 6 months after flare. RESULTS A total of 333 patients had complete data for ID at 6 months after flare. The recapture rate for the cohort was 55%, ranging from 47% (persistent oligoarthritis) to 69% (systemic arthritis) (P = 0.4). Approximately 67% of children achieved ID by 12 months. In the multivariable model, history and reinitiation of biologic drugs were associated with increased odds of successful recapture (odds ratio [OR] 4.79 [95% confidence interval (95% CI) 1.22-18.78] and OR 2.74 [95% CI 1.62-4.63], respectively). Number of joints with limited range of motion was associated with decreased odds (OR 0.83 per 1 joint increase [95% CI 0.72-0.95]). CONCLUSION Approximately half of JIA flares post-discontinuation were recaptured within 6 months, but rates of recapture varied across JIA categories. These findings inform shared decision-making for patients, families, and clinicians regarding the risks and benefits of medication discontinuation. Better understanding of biologic predictors of successful recapture in JIA are needed.
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Affiliation(s)
| | | | - Yukiko Kimura
- Joseph M. Sanzari Children's Hospital, Hackensack, New Jersey
| | | | | | | | - Melanie Kohlheim
- Childhood Arthritis and Rheumatology Research Alliance Parent/Patient Partner
| | | | - Rae S M Yeung
- Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
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Weitzman ER, Gaultney A, von Scheven E, Ringold S, Mann CM, Magane KM, Lin L, Leverty R, Dennos A, Hernandez A, Lippmann SJ, Dedeoglu F, Marin AC, Cox R, Reeve BB, Schanberg LE. Construct validity of Patient-Reported Outcomes Measurement Information System Paediatric measures in juvenile idiopathic arthritis and systemic lupus erythematosus: cross-sectional evaluation. BMJ Open 2023; 13:e063675. [PMID: 36707118 PMCID: PMC9884859 DOI: 10.1136/bmjopen-2022-063675] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Evaluate construct validity of Patient-Reported Outcomes Measurement Information System (PROMIS) Paediatric measures of symptoms and functioning against measures of disease activity among youth with juvenile idiopathic arthritis (JIA) or systemic lupus erythematosus (SLE). DESIGN Cross-sectional associations among PROMIS measures and clinical metrics of disease activity were estimated. SETTING Seven clinical sites of the Childhood Arthritis and Rheumatology Alliance (CARRA) in the USA. PARTICIPANTS Youth aged 8-17 years enrolled in the CARRA Registry. INTERVENTION PROMIS measures were collected and associations with clinical measures of disease activity estimated, by condition, in bivariate and multivariable analyses with adjustment for sociodemographics, insurance status, medications and disease duration. MAIN OUTCOME MEASURES PROMIS Paediatric measures of mobility, physical activity, fatigue, pain interference, family relationships, peer relationships, depressive symptoms, psychological stress, anxiety, and meaning and purpose, and clinical metrics of disease. RESULTS Among 451 youth (average age 13.8 years, 71% female), most (n=393, 87%) had a JIA diagnosis and the remainder (n=58, 13%) had SLE. Among participants with JIA, those with moderate/high compared with low/inactive disease had, on average, worse mobility (multivariable regression coefficient and 95% CIs) (-7.40; -9.30 to -5.50), fatigue (3.22; 1.02 to 5.42), pain interference (4.76; 3.04 to 6.48), peer relationships (-2.58; -4.52 to -1.64), depressive symptoms (3.00; 0.96 to 5.04), anxiety (2.48; 0.40 to 4.56) and psychological stress (2.52; 0.68 to 4.36). For SLE, youth with active versus inactive disease had on average worse mobility (-5.07; -10.15 to 0.01) but PROMIS Paediatric measures did not discriminate participants with active and inactive disease in adjusted analyses. CONCLUSIONS Seven PROMIS Paediatric measures discriminated between active and inactive disease in youth with JIA. Results advance the usefulness of PROMIS for understanding well-being and improving interventions for youth with JIA, but larger studies are needed to determine utility in SLE cohorts. TRIAL REGISTRATION NUMBER National Institute of Arthritis and Musculoskeletal and Skin Diseases (U19AR069522).
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Affiliation(s)
- Elissa R Weitzman
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Amy Gaultney
- Pediatric Rheumatology, Children's Hospital of Orange County, Orange, California, USA
| | - Emily von Scheven
- Pediatric Rheumatology, University of California San Francisco, San Francisco, California, USA
| | - Sarah Ringold
- Pediatrics, Seattle Children's Hospital, Seattle, Washington, USA
| | - Courtney M Mann
- Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kara M Magane
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Li Lin
- Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Renee Leverty
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Anne Dennos
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Alexy Hernandez
- Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Steven J Lippmann
- Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Fatma Dedeoglu
- Division of Immunology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Alexandra C Marin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Rachele Cox
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Bryce B Reeve
- Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Laura E Schanberg
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
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Stoustrup P, Resnick CM, Abramowicz S, Pedersen TK, Michelotti A, Küseler A, Koos B, Verna C, Nordal EB, Granquist EJ, Halbig JM, Kristensen KD, Kaban LB, Arvidsson LZ, Spiegel L, Stoll ML, Lerman MA, Glerup M, Defabianis P, Frid P, Alstergren P, Cron RQ, Ringold S, Nørholt SE, Peltomaki T, Larheim TA, Herlin T, Peacock ZS, Kellenberger CJ, Twilt M. Management of Orofacial Manifestations of Juvenile Idiopathic Arthritis: Interdisciplinary Consensus-Based Recommendations. Arthritis Rheumatol 2023; 75:4-14. [PMID: 36041065 PMCID: PMC10100353 DOI: 10.1002/art.42338] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 08/08/2022] [Accepted: 08/19/2022] [Indexed: 02/04/2023]
Abstract
Involvement of the temporomandibular joint (TMJ) is common in juvenile idiopathic arthritis (JIA). TMJ arthritis can lead to orofacial symptoms, orofacial dysfunction, and dentofacial deformity with negative impact on quality of life. Management involves interdisciplinary collaboration. No current recommendations exist to guide clinical management. We undertook this study to develop consensus-based interdisciplinary recommendations for management of orofacial manifestations of JIA, and to create a future research agenda related to management of TMJ arthritis in children with JIA. Recommendations were developed using online surveying of relevant stakeholders, systematic literature review, evidence-informed generation of recommendations during 2 consensus meetings, and Delphi study iterations involving external experts. The process included disciplines involved in the care of orofacial manifestations of JIA: pediatric rheumatology, radiology, orthodontics, oral and maxillofacial surgery, orofacial pain specialists, and pediatric dentistry. Recommendations were accepted if agreement was >80% during a final Delphi study. Three overarching management principles and 12 recommendations for interdisciplinary management of orofacial manifestations of JIA were outlined. The 12 recommendations pertained to diagnosis (n = 4), treatment of TMJ arthritis (active TMJ inflammation) (n = 2), treatment of TMJ dysfunction and symptoms (n = 3), treatment of arthritis-related dentofacial deformity (n = 2), and other aspects related to JIA (n = 1). Additionally, a future interdisciplinary research agenda was developed. These are the first interdisciplinary recommendations to guide clinical management of TMJ JIA. The 3 overarching principles and 12 recommendations fill an important gap in current clinical practice. They emphasize the importance of an interdisciplinary approach to diagnosis and management of orofacial manifestations of JIA.
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Affiliation(s)
| | - Cory M. Resnick
- Department of Plastic and Oral SurgeryBoston Children's HospitalBostonMassachusetts
| | - Shelly Abramowicz
- Division of Oral and Maxillofacial Surgery, Departments of Surgery and PediatricsEmory University School of MedicineAtlantaGeorgia
| | - Thomas K. Pedersen
- Section of Orthodontics and Department of Oral and Maxillofacial SurgeryAarhus University HospitalAarhusDenmark
| | | | - Annelise Küseler
- Section of Orthodontics and Department of Oral and Maxillofacial SurgeryAarhus University HospitalAarhusDenmark
| | - Bernd Koos
- Department of OrthodonticsUniversity Hospital TübingenTübingenGermany
| | - Carlalberta Verna
- Department of Pediatric Oral Health and OrthodonticsUZB University Center for Dentistry Basel, University of BaselBaselSwitzerland
| | - Ellen B. Nordal
- Department of Pediatrics, University Hospital of North Norway and the Pediatric Research Group, Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Eric J. Granquist
- Department of Oral and Maxillofacial Surgery, School of Dental MedicineUniversity of PennsylvaniaPhiladelphia
| | - Josefine Mareile Halbig
- The Public Dental Health Competence Centre of North Norway, and the Department of Clinical Medicine, Faculty of Health SciencesUiT The Arctic University of NorwayTromsøNorway
| | | | - Leonard B. Kaban
- Massachusetts General Hospital, Harvard School of Dental MedicineBostonMassachusetts
| | - Linda Z. Arvidsson
- Department of Maxillofacial RadiologyInstitute of Clinical Dentistry, University of OsloOsloNorway
| | - Lynn Spiegel
- The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada
| | | | - Melissa A. Lerman
- Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvania
| | - Mia Glerup
- Department of Pediatrics and Adolescent MedicineAarhus University HospitalAarhusDenmark
| | | | - Paula Frid
- Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital of North Norway, Public Dental Service Competence Centre of North Norway, and Department of Clinical DentistryUiT The Arctic University of NorwayTromsøNorway
| | - Per Alstergren
- Faculty of Odontology, Orofacial Pain UnitMalmö UniversityMalmöSweden
| | | | | | - Sven Erik Nørholt
- Section of Orthodontics and Department of Oral and Maxillofacial SurgeryAarhus University HospitalAarhusDenmark
| | - Timo Peltomaki
- Faculty of Medicine and Health Technology, and Department of Ear and Oral Diseases, Tampere University, Tampere, Finland, and Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland and Department of Oral and Maxillofacial Diseases, Kuopio University HospitalKuopioFinland
| | - Tore A. Larheim
- Department of Maxillofacial RadiologyInstitute of Clinical Dentistry, University of OsloOsloNorway
| | - Troels Herlin
- Department of Pediatrics and Adolescent MedicineAarhus University HospitalAarhusDenmark
| | - Zachary S. Peacock
- Massachusetts General Hospital, Harvard School of Dental MedicineBostonMassachusetts
| | | | - Marinka Twilt
- Alberta Children's Hospital and University of CalgaryCalgaryAlbertaCanada
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Hahn T, Daymont C, Beukelman T, Groh B, Hays K, Bingham CA, Scalzi L, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J 2022; 20:107. [PMID: 36434731 PMCID: PMC9701017 DOI: 10.1186/s12969-022-00770-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months. METHODS We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed. RESULTS We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05). CONCLUSION While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.
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Affiliation(s)
- Timothy Hahn
- Department of Pediatrics, Penn State Children's Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA, 17033-0855, USA.
| | - Carrie Daymont
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Timothy Beukelman
- grid.265892.20000000106344187Department of Pediatrics, University of Alabama at Birmingham, CPPN G10, 1600 7th Ave South, Birmingham, AL 35233 USA
| | - Brandt Groh
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | | | - Catherine April Bingham
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Lisabeth Scalzi
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
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Lim LSH, Lokku A, Pullenayegum E, Ringold S. Probability of Response in the First Sixteen Weeks After Starting Biologics: An Analysis of Juvenile Idiopathic Arthritis Biologics Trials. Arthritis Care Res (Hoboken) 2022; 75:1238-1249. [PMID: 36651601 DOI: 10.1002/acr.25003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 07/07/2022] [Accepted: 08/16/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Most juvenile idiopathic arthritis (JIA) biologic disease-modifying antirheumatic drugs (bDMARDs) trials used an open-label run-in period followed by randomized medication withdrawal. We used data from the run-in period of 4 bDMARD trials to 1) delineate early response trajectory to bDMARDs and 2) identify predictors of early response. METHODS Data from the first 16 weeks of 4 bDMARD trials were used. The primary outcome was the American College of Rheumatology (ACR) Pediatric 50 (Pedi 50) response criteria: clinically significant response defined as ACR Pedi 50 or greater. The secondary outcome was the clinical Juvenile Arthritis Disease Activity Score in 10 joints (cJADAS10) minimal disease activity state. Response transition rates and predictors were modeled using an inhomogeneous Markov multistate model. RESULTS Five hundred thirty-two participants (70% receiving methotrexate, 41% prednisone) were included. By month 4, the probability of attaining ACR Pedi 50 or greater was 0.698. If ACR Pedi 50 or more was not achieved by month 1, the probability of achieving it by month 4 was 0.60. If ACR Pedi 50 or more was not achieved by month 3, the probability of achieving this by month 4 was 0.31. Age at diagnosis, disease duration, baseline rheumatoid factor, and active joint counts predicted ACR and cJADAS state transitions, adjusted for concomitant treatment. CONCLUSIONS No response ACR Pedi 50 or more by month 1 after treatment was associated with a 0.60 probability of responding by month 4, but not responding by month 3 was associated with a 0.31 probability of response by month 4. Baseline disease duration, rheumatoid factor, and active joint counts predicted early treatment response (ACR and cJADAS10 states).
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Lim LSH, Shobhan S, Lokku A, Ringold S, Pullenayegum E. Latent classes of early response trajectories to biologics initiation in juvenile idiopathic arthritis: an analysis of four trials. Pediatr Rheumatol Online J 2022; 20:57. [PMID: 35907978 PMCID: PMC9338501 DOI: 10.1186/s12969-022-00719-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
AIMS 1) To delineate latent classes of treatment response to biologics in juvenile idiopathic arthritis (JIA) patients in the first 16 weeks after initiation. 2) To identify predictors of early disease response. METHODS The study population was drawn from four biologics trials in polyarticular course JIA: Etanercept 2000, Abatacept 2008, TRial of Early Aggressive Therapy (TREAT) 2012 and Tocilizumab 2014. The outcome was active joint counts (AJC). Semiparametric latent class trajectory analysis was applied to identify latent classes of response to treatment; AJC was transformed for this modelling. We tested baseline disease and treatment characteristics for their abilities to predict class membership of response. RESULTS There were 480 participants, 74% females. At baseline, 26% were rheumatoid factor positive. 67% were on methotrexate at enrollment. Three latent class solution provided the best fit. Baseline AJC was the sole best predictor of class membership. Participants classified by their highest membership probabilities into high baseline AJC (> 30) and slow response (26.5%), low baseline AJC (< 10), early and sustained response (29.7%), and moderate baseline AJC progressive response (43.8%). Participants were classified into the latent classes with a mean class membership posterior probability of 0.97. Those on methotrexate at baseline were less likely to belong to high baseline AJC class. CONCLUSIONS Three latent classes of responses were detectable in the first 16 weeks of biologics therapy. Those with the highest baseline AJC demonstrated very slow response in this window and were less likely to be on concomitant methotrexate. TRIALS REGISTRATION TREAT 2012 (NCT NCT00443430 ) (Wallace et. al, Arthritis Rheum 64:2012-21, 2012), tocilizumab trial 2014 ( NCT00988221 ), abatacept trial 2008 ( NCT00095173 ). Etanercept 2000 from Amgen does not have a trial registration number.
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Affiliation(s)
- Lily Siok Hoon Lim
- Department of Pediatrics, Children's Hospital Research Institute of Manitoba, University of Manitoba, 501F-715 McDermot Ave, Winnipeg, Manitoba, R3E 0V9, Canada.
| | - Shamsia Shobhan
- grid.21613.370000 0004 1936 9609Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Armend Lokku
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sarah Ringold
- grid.240741.40000 0000 9026 4165Seattle Children’s Hospital, Seattle, USA
| | - Eleanor Pullenayegum
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, Canada ,grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, SickKids, Toronto, Canada
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Soulsby WD, Balmuri N, Cooley V, Gerber LM, Lawson E, Goodman S, Onel K, Mehta B, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis. Pediatr Rheumatol Online J 2022; 20:18. [PMID: 35255941 PMCID: PMC8903717 DOI: 10.1186/s12969-022-00676-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry. METHODS In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months. RESULTS One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability. CONCLUSION High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.
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Affiliation(s)
- William Daniel Soulsby
- University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA, 94158, USA.
| | - Nayimisha Balmuri
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Victoria Cooley
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Linda M. Gerber
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Erica Lawson
- grid.266102.10000 0001 2297 6811University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA 94158 USA
| | - Susan Goodman
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Karen Onel
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Bella Mehta
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
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11
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Kimura Y, Ong MS, Tomlinson G, Ringold S, Schanberg LE, Feldman BM, Dennos A, Del Gaizo V, Murphy KL, Riordan ME, Natter M. Response to Editorial Accompanying STOP-JIA Articles by Ruperto, et al. Arthritis Rheumatol 2021; 74:912-913. [PMID: 34905294 DOI: 10.1002/art.42047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/27/2021] [Accepted: 10/12/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Yukiko Kimura
- Joseph M Sanzari Children's Hospital, Hackensack Meridian School of Medicine, Hackensack, NJ
| | - Mei-Sing Ong
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | | | | | - Laura E Schanberg
- Duke University Medical Center Medical Center, Durham, NC; CARRA, Inc
| | | | - Anne Dennos
- Duke Clinical Research Institute, Durham, NC
| | | | - Katherine L Murphy
- Louisiana State Department of Health, Office of Public Health, New Orleans, LA
| | - Mary Ellen Riordan
- Joseph M Sanzari Children's Hospital, Hackensack Meridian School of Medicine, Hackensack, NJ
| | - Marc Natter
- Boston Children's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Ringold S, Consolaro A, Ardoin SP. Outcome Measures in Pediatric Rheumatic Disease. Rheum Dis Clin North Am 2021; 47:655-668. [PMID: 34635297 DOI: 10.1016/j.rdc.2021.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Reliable and responsive outcome measures that accurately detect changes in disease state, activity, and damage are crucial to conducting observational and interventional trials that can directly transform care for children with rheumatic disease. A combination of consensus-based and direct measurement approaches has led to the development of several validated, composite outcome measures in juvenile idiopathic arthritis, juvenile dermatomyositis, childhood-onset systemic lupus erythematosus, and pediatric vasculitis. This review outlines clinician-reported, disease-specific outcome measures developed for these conditions.
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Affiliation(s)
- Sarah Ringold
- Seattle Children's, 4800 Sand Point Way Northeast, Seattle, WA 98115, USA.
| | - Alessandro Consolaro
- Rheumatology Unit, Istituto Giannina Gaslini, University of Genoa, Via Gerolamo Gaslini 5, 16147 Genoa, Italy
| | - Stacy P Ardoin
- Department of Pediatrics, Nationwide Children's Hospital, Ohio State University, 700 Children's Drive, Columbus, OH 43205, USA
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Trincianti C, Van Dijkhuizen EHP, Alongi A, Mazzoni M, Swart JF, Nikishina I, Lahdenne P, Rutkowska-Sak L, Avcin T, Quartier P, Panaviene V, Uziel Y, Pruunsild C, Vargova V, Vilaiyuk S, Dolezalova P, Ringold S, Garrone M, Ruperto N, Ravelli A, Consolaro A. Definition and Validation of the American College of Rheumatology 2021 Juvenile Arthritis Disease Activity Score Cutoffs for Disease Activity States in Juvenile Idiopathic Arthritis. Arthritis Rheumatol 2021; 73:1966-1975. [PMID: 34582120 PMCID: PMC8597164 DOI: 10.1002/art.41879] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/18/2021] [Indexed: 11/12/2022]
Abstract
Objective To develop and validate new Juvenile Arthritis Disease Activity Score 10 (JADAS10) and clinical JADAS10 (cJADAS10) cutoffs to separate the states of inactive disease (ID), minimal disease activity (MiDA), moderate disease activity (MoDA), and high disease activity (HDA) in children with oligoarthritis and with rheumatoid factor–negative polyarthritis, based on subjective disease assessment by the treating pediatric rheumatologist. Methods The cutoffs definition cohort was composed of 1,936 patients included in the multinational Epidemiology, Treatment and Outcome of Childhood Arthritis (EPOCA) study. Using the subjective physician rating as an external criterion, 4 methods were applied to identify the cutoffs: mapping, Youden index, 90% specificity, and maximum agreement. The validation cohort included 4,014 EPOCA patients, patients from 2 randomized trials, and 88 patients from the PharmaChild registry. Cutoff validation was conducted by assessing discriminative and predictive ability. Results The JADAS10 cutoffs were 1.4, 4, and 13, respectively, for oligoarthritis and 2.7, 6, and 17, respectively, for polyarthritis. The cJADAS10 cutoffs were 1.1, 4, and 12, respectively, for oligoarthritis and 2.5, 5, and 16, respectively, for polyarthritis. The cutoffs discriminated strongly among different levels of pain and morning stiffness, between patients who were and those who were not prescribed a new medication, and between different levels of improvement in clinical trials. Achievement of ID and MiDA according to the new JADAS cutoffs at least twice in the first year of disease predicted better outcome at 2 years. Conclusion The 2021 JADAS and cJADAS cutoffs revealed good metrologic properties in both definition and validation samples, and are therefore suitable for use in clinical trials and routine practice.
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Affiliation(s)
| | - Evert Hendrik Pieter Van Dijkhuizen
- Wilhelmina Children's Hospital, Utrecht, The Netherlands, and Istituto Giannina Gaslini, IRCCS and Clinica Pediatrica e Reumatologia, Genoa, Italy
| | - Alessandra Alongi
- Istituto Giannina Gaslini, IRCCS and Clinica Pediatrica e Reumatologia, Genoa, Italy
| | - Marta Mazzoni
- Istituto Giannina Gaslini, IRCCS and Clinica Pediatrica e Reumatologia, Genoa, Italy
| | - Joost F Swart
- Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Irina Nikishina
- V. A. Nasonova Research Institute of Rheumatology, Moscow, Russia
| | - Pekka Lahdenne
- New Children's Hospital and Helsinki University Hospital, Helsinki, Finland
| | - Lidia Rutkowska-Sak
- National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland
| | - Tadej Avcin
- University Children's Hospital and University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Pierre Quartier
- Université Paris-Descartes, Institut IMAGINE, Centre de Référence National pour les Rhumatismes Inflammatoires et les Maladies Auto-Immunes Systémiques Rares de l'Enfant (RAISE), Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Violeta Panaviene
- Children's Hospital, Affiliate of Vilnius University Hospital Santaros Clinic and Clinic of Children's Diseases, Vilnius University, Vilnius, Lithuania
| | - Yosef Uziel
- Meir Medical Centre and Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Chris Pruunsild
- Tartu University Hospital Children's Clinic, and University of Tartu Institute of Clinical Medicine, Tartu, Estonia
| | | | | | - Pavla Dolezalova
- Charles University in Prague and General University Hospital, Prague, Czech Republic
| | | | - Marco Garrone
- Istituto Giannina Gaslini, IRCCS and Clinica Pediatrica e Reumatologia, Genoa, Italy
| | - Nicolino Ruperto
- Istituto Giannina Gaslini, IRCCS and Clinica Pediatrica e Reumatologia, Genoa, Italy
| | - Angelo Ravelli
- Università degli Studi di Genova, Istituto Giannina Gaslini, IRCCS and Clinica Pediatrica e Reumatologia, Genoa, Italy, and Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alessandro Consolaro
- Università degli Studi di Genova, Istituto Giannina Gaslini, IRCCS and Clinica Pediatrica e Reumatologia, Genoa, Italy
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Wahezi DM, Lo MS, Rubinstein TB, Ringold S, Ardoin SP, Downes KJ, Jones KB, Laxer RM, Pellet Madan R, Mudano AS, Turner AS, Karp DR, Mehta JJ. American College of Rheumatology Guidance for the Management of Pediatric Rheumatic Disease During the COVID-19 Pandemic: Version 2. Arthritis Rheumatol 2021; 73:e46-e59. [PMID: 34114365 DOI: 10.1002/art.41772] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/08/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To provide clinical guidance to rheumatology providers who treat children with pediatric rheumatic disease (PRD) in the context of the coronavirus disease 2019 (COVID-19) pandemic. METHODS The task force, consisting of 7 pediatric rheumatologists, 2 pediatric infectious disease physicians, 1 adult rheumatologist, and 1 pediatric nurse practitioner, was convened on May 21, 2020. Clinical questions and subsequent guidance statements were drafted based on a review of the queries posed by the patients as well as the families and healthcare providers of children with PRD. An evidence report was generated and disseminated to task force members to assist with 3 rounds of asynchronous, anonymous voting by email using a modified Delphi approach. Voting was completed using a 9-point numeric scoring system with predefined levels of agreement (categorized as disagreement, uncertainty, or agreement, with median scores of 1-3, 4-6, and 7-9, respectively) and consensus (categorized as low, moderate, or high). To be approved as a guidance statement, median vote ratings were required to fall into the highest tertile for agreement, with either moderate or high levels of consensus. RESULTS To date, 39 guidance statements have been approved by the task force. Those with similar recommendations were combined to form a total of 33 final guidance statements, all of which received median vote ratings within the highest tertile of agreement and were associated with either moderate consensus (n = 5) or high consensus (n = 28). CONCLUSION These guidance statements have been generated based on review of the available literature, indicating that children with PRD do not appear to be at increased risk for susceptibility to SARS-CoV-2 infection. This guidance is presented as a "living document," recognizing that the literature on COVID-19 is rapidly evolving, with future updates anticipated.
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Affiliation(s)
- Dawn M Wahezi
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, New York, New York, United States
| | - Mindy S Lo
- Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Tamar B Rubinstein
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, New York, New York, United States
| | - Sarah Ringold
- Seattle Children's Hospital, Seattle, Washington, United States
| | - Stacy P Ardoin
- Nationwide Children's Hospital and Ohio State University, Columbus, Ohio, United States
| | - Kevin J Downes
- Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Karla B Jones
- Nationwide Children's Hospital and Ohio State University, Columbus, Ohio, United States
| | - Ronald M Laxer
- University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rebecca Pellet Madan
- New York University Grossman School of Medicine and Hassenfeld Children's Hospital, New York, New York, United States
| | | | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia, United States
| | - David R Karp
- University of Texas Southwestern Medical Center, Dallas
| | - Jay J Mehta
- Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
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15
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Kimura Y, Schanberg LE, Tomlinson GA, Riordan ME, Dennos AC, Del Gaizo V, Murphy KL, Weiss PF, Natter MD, Feldman BM, Ringold S. Optimizing the Start Time of Biologics in Polyarticular Juvenile Idiopathic Arthritis: A Comparative Effectiveness Study of Childhood Arthritis and Rheumatology Research Alliance Consensus Treatment Plans. Arthritis Rheumatol 2021; 73:1898-1909. [PMID: 34105312 PMCID: PMC8518909 DOI: 10.1002/art.41888] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 06/01/2021] [Indexed: 01/17/2023]
Abstract
Objective The optimal time to start biologics in polyarticular juvenile idiopathic arthritis (JIA) remains uncertain. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed 3 consensus treatment plans (CTPs) for untreated polyarticular JIA to compare strategies for starting biologics. Methods Start Time Optimization of Biologics in Polyarticular JIA (STOP‐JIA) was a prospective, observational, CARRA Registry study comparing the effectiveness of 3 CTPs: 1) the step‐up plan (initial nonbiologic disease‐modifying antirheumatic drug [DMARD] monotherapy, adding a biologic if needed, 2) the early combination plan (DMARD and biologic started together), and 3) the biologic first plan (biologic monotherapy). The primary outcome measure was clinically inactive disease according to the provisional American College of Rheumatology (ACR) criteria, without glucocorticoids, at 12 months. Secondary outcome measures included Patient‐Reported Outcomes Measurement Information System (PROMIS) pain interference and mobility scores, inactive disease as defined by the clinical Juvenile Arthritis Disease Activity Score in 10 joints (JADAS‐10), and the ACR Pediatric 70 criteria (Pedi 70). Results Of 400 patients enrolled, 257 (64%) began the step‐up plan, 100 (25%) the early combination plan, and 43 (11%) the biologic first plan. After propensity score weighting and multiple imputation, clinically inactive disease according to the ACR criteria was achieved in 37% of those on the early combination plan, 32% on the step‐up plan, and 24% on the biologic first plan (P = 0.17). Inactive disease according to the clinical JADAS‐10 (score ≤2.5) was also achieved in more patients on the early combination plan than the step‐up plan (59% versus 43%; P = 0.03), as was ACR Pedi 70 (81% versus 62%; P = 0.008), but generalizability was limited by missing data. PROMIS measures improved in all groups, but without significant differences. Twenty serious adverse events were reported (mostly infections). Conclusion Achievement of clinically inactive disease without glucocorticoids did not significantly differ between groups at 12 months. While there was a significantly higher likelihood of early combination therapy achieving inactive disease according to the clinical JADAS‐10 and ACR Pedi 70, these results require further exploration.
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Affiliation(s)
- Yukiko Kimura
- Joseph M. Sanzari Children's Hospital and Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | - Laura E Schanberg
- Duke Clinical Research Institute and Duke University Medical Center, Durham, North Carolina
| | | | - Mary Ellen Riordan
- Joseph M. Sanzari Children's Hospital and Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | - Anne C Dennos
- Duke Clinical Research Institute and Duke University School of Medicine, Durham, North Carolina
| | - Vincent Del Gaizo
- Childhood Arthritis and Rheumatology Research Alliance (CARRA), Milwaukee, Wisconsin
| | | | - Pamela F Weiss
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Marc D Natter
- Boston Children's Hospital, Massachusetts General Hospital, and Harvard Medical School, Boston
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16
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Ong MS, Ringold S, Kimura Y, Schanberg LE, Tomlinson GA, Natter MD. Improved Disease Course Associated With Early Initiation of Biologics in Polyarticular Juvenile Idiopathic Arthritis: Trajectory Analysis of a Childhood Arthritis and Rheumatology Research Alliance Consensus Treatment Plans Study. Arthritis Rheumatol 2021; 73:1910-1920. [PMID: 34105303 DOI: 10.1002/art.41892] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 06/01/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the effects of early introduction of biologic disease-modifying antirheumatic drugs (bDMARDs) on the disease course in untreated polyarticular juvenile idiopathic arthritis (JIA). METHODS We analyzed data on patients with polyarticular JIA participating in the Start Time Optimization of Biologics in Polyarticular JIA (STOP-JIA) study (n = 400) and a comparator cohort (n = 248) from the Childhood Arthritis and Rheumatology Research Alliance Registry. Latent class trajectory modeling (LCTM) was applied to identify subgroups of patients with distinct disease courses based on disease activity (clinical Juvenile Arthritis Disease Activity Score in 10 joints) over 12 months from baseline. RESULTS In the STOP-JIA study, 198 subjects (49.5%) received bDMARDs within 3 months of baseline assessment. LCTM analyses generated 3 latent classes representing 3 distinct disease trajectories, characterized by slow, moderate, or rapid disease activity improvement over time. Subjects in the rapid improvement trajectory attained inactive disease within 6 months from baseline. Odds of being in the rapid improvement trajectory versus the slow improvement trajectory were 3.6 times as high (95% confidence interval 1.32-10.0; P = 0.013) for those treated with bDMARDs ≤3 months from baseline compared with subjects who started bDMARDs >3 months after baseline, after adjusting for demographic characteristics, clinical attributes, and baseline disease activity. Shorter disease duration at first rheumatology visit approached statistical significance as a predictor of favorable trajectory without bDMARD treatment. CONCLUSION Starting bDMARDs within 3 months of baseline assessment is associated with more rapid achievement of inactive disease in subjects with untreated polyarticular JIA. These results demonstrate the utility of trajectory analysis of disease course as a method for determining treatment efficacy.
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Affiliation(s)
- Mei Sing Ong
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | | | - Yukiko Kimura
- Joseph M. Sanzari Children's Hospital and Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | | | | | - Marc D Natter
- Boston Children's Hospital, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
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Zhai S, Ward T, Palermo T, Ringold S. 578 Sleep Attitudes and Beliefs in Children with Juvenile Idiopathic Arthritis and Their Caregivers. Sleep 2021. [DOI: 10.1093/sleep/zsab072.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Sleep deficiency is highly comorbid in children with juvenile idiopathic arthritis (JIA), affecting approximately 40% of children. In this study, we examined children’s and parents’ beliefs and attitudes about sleep, their self-efficacy, and self-regulation in sleep-related behaviors and managing JIA, and if these factors were associated with their self-report and actigraphic sleep patterns.
Methods
The sample included 44 children with JIA (22 girls; mean age 10.5±1.8) and their parents. Dyads completed the Dysfunctional Beliefs and Attitudes about Sleep Scale and Self-Efficacy Scale. Children completed the Index of self-regulation. Parents completed the Pittsburgh Sleep Quality Index and PROMIS sleep-disturbance. Children wore an actiwatch and completed electronic sleep diaries for ten days. Scored actigraphy variables included children’s total sleep time (TST), wake time after sleep onset (WASO), sleep efficiency (SE, %); sleep diaries included the variables of children’s time in bed (TIB). Parents’ self-reported variables included sleep-disturbances and sleep quality (SQ).
Results
Children’s mean TST was 7.7 hours (±0.7), mean SE of 77%, and mean WASO of 1.1 hours (±0.4). After adjusting for child sex and age, children’s beliefs and attitudes towards sleep (BAS) were positively correlated with their self-efficacy in carrying out sleep-related behaviors (r=.6, p<.0001). Parents’ BAS were positively correlated with child self-efficacy in sleep (r=.4, p<.05) and TIB (r=.4, p<.001). Children’s self-regulation was positively correlated with parents’ SQ (r=.4, p<.05). In the first regression model, parents’ self-efficacy in managing their child’s JIA and parents’ sleep disturbances explained 25% of the variance of children’s TST, (F(4,35)=2.8, p=.039). Both parents’ self-efficacy and sleep disturbances were significant predictors of children’s TST. In the second regression model, children’s self-regulation, self-efficacy, and parents’ sleep disturbances explained 32% of the variance of parents’ self-reported SQ, (F (3,39)= 6.12, p=.002).
Conclusion
The findings suggest that self-efficacy, self-regulation, BAS in both children and parents were associated with better sleep health. Interventions that incorporate parent-child shared decision making about sleep-related knowledge, motivation, skills for setting/achieving goals, and problem-solving strategies are needed for families with children with JIA and sleep deficiency.
Support (if any)
This work was supported by the NIH/ /NINR (P30NR016585, R21NR01747).
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18
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Wahezi DM, Lo MS, Rubinstein TB, Ringold S, Ardoin SP, Downes KJ, Jones KB, Laxer RM, Pellet Madan R, Mudano AS, Turner AS, Karp DR, Mehta JJ. American College of Rheumatology Guidance for the Management of Pediatric Rheumatic Disease During the COVID-19 Pandemic: Version 1. Arthritis Rheumatol 2020; 72:1809-1819. [PMID: 32705780 PMCID: PMC7404941 DOI: 10.1002/art.41455] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/21/2020] [Indexed: 12/16/2022]
Abstract
Objective To provide clinical guidance to rheumatology providers who treat children with pediatric rheumatic disease (PRD) in the context of the coronavirus disease 2019 (COVID‐19) pandemic. Methods The task force, consisting of 7 pediatric rheumatologists, 2 pediatric infectious disease physicians, 1 adult rheumatologist, and 1 pediatric nurse practitioner, was convened on May 21, 2020. Clinical questions and subsequent guidance statements were drafted based on a review of the queries posed by the patients as well as the families and healthcare providers of children with PRD. An evidence report was generated and disseminated to task force members to assist with 3 rounds of asynchronous, anonymous voting by email using a modified Delphi approach. Voting was completed using a 9‐point numeric scoring system with predefined levels of agreement (categorized as disagreement, uncertainty, or agreement, with median scores of 1–3, 4–6, and 7–9, respectively) and consensus (categorized as low, moderate, or high). To be approved as a guidance statement, median vote ratings were required to fall into the highest tertile for agreement, with either moderate or high levels of consensus. Results The task force drafted 33 guidance statements, which were voted upon during the second and third rounds of voting. Of these 33 statements, all received median vote ratings within the highest tertile of agreement and were associated with either moderate consensus (n = 6) or high consensus (n = 27). Statements with similar recommendations were combined, resulting in 27 final guidance statements. Conclusion These guidance statements have been generated based on review of the available literature, indicating that children with PRD do not appear to be at increased risk for susceptibility to SARS–CoV‐2 infection. This guidance is presented as a “living document,” recognizing that the literature on COVID‐19 is rapidly evolving, with future updates anticipated.
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Affiliation(s)
- Dawn M Wahezi
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, New York, New York
| | - Mindy S Lo
- Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Tamar B Rubinstein
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, New York, New York
| | | | - Stacy P Ardoin
- Nationwide Children's Hospital and Ohio State University, Columbus, Ohio
| | - Kevin J Downes
- Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Karla B Jones
- Nationwide Children's Hospital and Ohio State University, Columbus, Ohio
| | - Ronald M Laxer
- University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rebecca Pellet Madan
- New York University Grossman School of Medicine and Hassenfeld Children's Hospital, New York, New York
| | | | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia
| | - David R Karp
- University of Texas Southwestern Medical Center, Dallas
| | - Jay J Mehta
- Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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19
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Mannion ML, Xie F, Horton DB, Ringold S, Correll CK, Dennos A, Beukelman T. Biologic Switching Among Nonsystemic Juvenile Idiopathic Arthritis Patients: A Cohort Study in the Childhood Arthritis and Rheumatology Research Alliance Registry. J Rheumatol 2020; 48:1322-1329. [PMID: 32934124 DOI: 10.3899/jrheum.200437] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Biologic medications have significantly improved disease control and outcomes of patients with juvenile idiopathic arthritis (JIA). Current treatment recommendations suggest escalating therapy, including changing biologics if needed, when inactive or low disease activity is not attained. The patterns and reasons for switching biologics in clinical practice in North America are not well described. METHODS We used the Childhood Arthritis and Rheumatology Research Alliance Registry and included individuals with JIA if they newly started a biologic after January 1, 2008, and had at least 12 months of subsequent observable time. Subjects with systemic JIA were excluded. We compared characteristics of switchers and nonswitchers using chi-square for categorical variables and Wilcoxon rank-sum test for continuous variables, and used linear regression for time analysis. RESULTS Of the eligible children, 1361 with JIA in the registry started a biologic (94% tumor necrosis factor inhibitors [TNFi]). Median followup time was 30 months and 349 (26%) switched biologics. Among biologic switchers, ineffectiveness/disease flare was the most common reason for switch (202, 58%). The most common documented switch was from etanercept to another TNFi (221, 63%). The median time to switch to a second biologic decreased substantially from 55.2 months in 2008 to 7.2 months in 2016. CONCLUSION In a multicenter cohort of patients with JIA starting a biologic, one-quarter switched to a second biologic, and the time to switching decreased in recent years. Additional studies should evaluate the outcomes and optimal timing of switching and preferred sequence of biologic use.
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Affiliation(s)
- Melissa L Mannion
- M.L. Mannion, MD, MSPH, Assistant Professor, T. Beukelman, MD, MSCE, Associate Professor, Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama;
| | - Fenglong Xie
- F. Xie, PhD, MS, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Daniel B Horton
- D.B. Horton, MD, MSCE, Assistant Professor, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, and Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, New Brunswick, and Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
| | - Sarah Ringold
- S. Ringold, MD, MS, Assistant Professor, Division of Pediatric Rheumatology, Seattle Children's Hospital, Seattle, Washington
| | - Colleen K Correll
- C.K. Correll, MD, MPH, Assistant Professor, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Anne Dennos
- A. Dennos, MSPH, Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
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20
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Mann CM, Schanberg LE, Wang M, von Scheven E, Lucas N, Hernandez A, Ringold S, Reeve BB. Identifying clinically meaningful severity categories for PROMIS pediatric measures of anxiety, mobility, fatigue, and depressive symptoms in juvenile idiopathic arthritis and childhood-onset systemic lupus erythematosus. Qual Life Res 2020; 29:2573-2584. [PMID: 32410143 PMCID: PMC10505945 DOI: 10.1007/s11136-020-02513-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE A key limitation to widespread adoption of patient-reported outcome (PRO) measures is the lack of interpretability of scores. We aim to identify clinical severity thresholds to distinguish categories of no problems, mild, moderate, and severe along the PROMIS® Pediatric T-score metric for measures of anxiety, mobility, fatigue, and depressive symptoms for use in populations with juvenile idiopathic arthritis (JIA) and childhood-onset systemic lupus erythematosus (cSLE). METHODS We used a modified standard setting methodology from educational testing to identify clinical severity thresholds (clinical cut scores). Using item response theory-based parameters from PROMIS item banks, we developed a series of clinical vignettes that represented different severity or ability levels along the PROMIS Pediatric T-score metric. In stakeholder workshops, participants worked individually and together to reach consensus on clinical cut scores. Median cut-score placements were taken when consensus was not reached. Focus groups were recorded and qualitative analysis was conducted to identify decision-making processes. RESULTS Nine adolescents (age 13-17 years) with JIA (33% female) and their caregivers, five adolescents (age 14-16 years) with cSLE (100% female) and their caregivers, and 12 pediatric rheumatologists (75% female) participated in bookmarking workshops. Placement of thresholds for bookmarks was highly similar across stakeholder groups (differences from 0 to 5 points on the PROMIS t-score metric) for all but one bookmark placement. CONCLUSION This study resulted in clinical thresholds for severity categories for PROMIS Pediatric measures of anxiety, mobility, fatigue, and depressive symptoms, providing greater interpretability of scores in JIA and cSLE populations.
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Affiliation(s)
- C M Mann
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - L E Schanberg
- Department of Pediatrics and Duke Clinical Research Institute, Duke Health, Durham, NC, USA
| | - M Wang
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - E von Scheven
- Division of Pediatric Rheumatology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - N Lucas
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - A Hernandez
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - S Ringold
- Division of Pediatric Rheumatology, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA
| | - B B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Pediatrics and Duke Clinical Research Institute, Duke Health, Durham, NC, USA
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21
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Ringold S, Schrandt S, Creek EL, Beukelman T, Angeles‐Han ST, Lovell DJ. Reply. Arthritis Rheumatol 2020; 72:1040-1041. [DOI: 10.1002/art.41238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Suzanne Schrandt
- ExPPect and Society to Improve Diagnosis in Medicine Arlington VA
| | | | | | - Sheila T. Angeles‐Han
- Cincinnati Children's Hospital Medical Center and University of Cincinnati Cincinnati OH
| | - Daniel J. Lovell
- Cincinnati Children's Hospital Medical Center and University of Cincinnati Cincinnati OH
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22
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Liu K, Tomlinson G, Reed AM, Huber AM, Saarela O, Bout-Tabaku SM, Curran M, Dvergsten JA, Eberhard BA, Jung LK, Kim S, Ringold S, Rouster-Steven KA, Tesher M, Wahezi DM, Feldman BM. Pilot Study of the Juvenile Dermatomyositis Consensus Treatment Plans: A CARRA Registry Study. J Rheumatol 2020; 48:114-122. [PMID: 32238513 DOI: 10.3899/jrheum.190494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To determine the feasibility of comparing the Childhood Arthritis and Rheumatology ResearchAlliance (CARRA) consensus treatment plans (CTP) in treating moderate new-onset juvenile dermatomyositis (JDM) using the CARRA registry, and to establish appropriate analytic methods to control for confounding by indication and missing data. METHODS A pilot cohort of 39 patients with JDM from the CARRA registry was studied. Patients were assigned by the treating physician, considering patient/family preferences, to 1 of 3 CTP: methotrexate (MTX) and prednisone (MP); intravenous (IV) methylprednisolone, MTX, and prednisone (MMP); or IV methylprednisolone, MTX, prednisone, and IV immunoglobulin (MMPI). The primary outcome was the proportion of patients achieving moderate improvement at 6 months under each CTP. Statistical methods including multiple imputation and inverse probability of treatment weighting were used to handle missing data and confounding by indication. RESULTS Patients received MP (n = 13), MMP (n = 18) and MMPI (n = 8). Patients in all CTP had significant improvement in disease activity. Of the 36 patients who remained in our pilot study at 6 months, 16 (44%) of them successfully achieved moderate improvement at 6 months (6/13, 46% for MP; 7/15, 47% for MMP; 3/8, 38% for MMPI). After correcting for confounding, there were no statistically significant pairwise differences between the CTP (P = 0.328-0.88). CONCLUSION We gained valuable experience and insight from our pilot study that can be used to guide the design and analysis of comparative effectiveness studies using the CARRA registry CTP approach. Our analytical methods can be adopted for future comparative effectiveness studies and applied to other rare disease observational studies.
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Affiliation(s)
- Kuan Liu
- K. Liu, MMath, B.M. Feldman, MD, MSc, FRCPC, The Hospital for Sick Children, Toronto, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - George Tomlinson
- G. Tomlinson, PhD, Department of Medicine, University Health Network, Toronto, Ontario, Canada.,G. Tomlinson, PhD, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Ann M Reed
- A.M. Reed, MD, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - Adam M Huber
- A.M. Huber, MD, MSc, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Olli Saarela
- O. Saarela, PhD, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sharon M Bout-Tabaku
- S.M. Bout-Tabaku, MD, MSCE, Department of Pediatric Medicine, Sidra Medicine, Doha, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Megan Curran
- M.L. Curran, MD, Department of Pediatrics, University of Colorado, Denver, Colorado, USA
| | - Jeffrey A Dvergsten
- J.A. Dvergsten, MD, Department of Pediatrics, Duke University Medical Center, Durham, and Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina, USA
| | - Barbara A Eberhard
- B.A. Eberhard, MBBS, MS, Division of Pediatric Rheumatology, Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, New York, and Department of Pediatrics, Hofstra Northwell School of Medicine, Hempstead, New York, USA
| | - Lawrence K Jung
- L.K. Jung, MD, Division of Rheumatology, Children's National Health System, Washington, D.C., USA
| | - Susan Kim
- S. Kim, MD, MMSc, Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Sarah Ringold
- S. Ringold, MD, Seattle Children's Hospital and Research Institute, Seattle, Washington, USA
| | - Kelly A Rouster-Steven
- K.A. Rouster-Steven, MD, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Melissa Tesher
- M. Tesher, MD, Comer Children's Hospital, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Dawn M Wahezi
- D.M. Wahezi, MD, Msc, Division of Pediatric Rheumatology, the Children's Hospital at Montefiore, Bronx, New York, USA
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23
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Do N, Ringold S, Sullivan E, Brandling-Bennett H. A retrospective study: Impact of consensus treatment plans on systemic therapy of pediatric morphea. Pediatr Dermatol 2020; 37:278-283. [PMID: 31967352 DOI: 10.1111/pde.14074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Morphea is an inflammatory and fibrosing condition that affects the skin and subcutaneous structures. Morphea is managed by dermatologists, rheumatologists, or both. Prior studies have suggested there is significant variability in approach to treatment. In 2012, the Childhood Arthritis and Rheumatology Research Alliance (CARRA) published consensus treatment plans (CTPs) for pediatric morphea to develop more standardized treatment plans for patients requiring systemic therapy. We aimed to assess whether the publication of CTPs has impacted care of patients with morphea at our institution. METHODS Data were collected via a retrospective review of medical records of 61 pediatric patients diagnosed with morphea at Seattle Children's Hospital (SCH) from January 1, 2005, to December 12,2017. RESULTS Prior to the publication of CTPs, 2 out of 24 patients (8.3%) were treated with a regimen that matched a subsequent CTP. After publication of CTPs, 29 out of 37 patients (78.4%) were treated with a regimen that matched a CTP (P < 0.001). A subanalysis was performed to assess the number of patients who needed second- or third-line therapies. Of those who followed a CTP therapy plan (n = 26), 3 patients (11.5%) needed a second-line therapy compared with 11 patients (44%) in the no-CTP followed group (n = 25), (P = 0.012). CONCLUSIONS The publication of CTPs led to a significant change in treatment approach for patients with morphea requiring systemic therapy at SCH. Patients treated with one of the treatment plans recommended by the CTPs were less likely to need second-line systemic therapy.
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Affiliation(s)
- Ngan Do
- University of Washington School of Medicine, Seattle, Washington
| | - Sarah Ringold
- Department of Pediatrics, Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington
| | - Erin Sullivan
- Children's Core for Biomedical Statistics, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington
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24
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Horton DB, Salas J, Wec A, Kohlheim M, Kapadia P, Beukelman T, Boneparth A, Haverkamp K, Mannion ML, Moorthy LN, Ringold S, Rosenthal M. Making Decisions About Stopping Medicines for Well-Controlled Juvenile Idiopathic Arthritis: A Mixed-Methods Study of Patients and Caregivers. Arthritis Care Res (Hoboken) 2019; 73:374-385. [PMID: 31880862 DOI: 10.1002/acr.24129] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 12/17/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Improved treatments for juvenile idiopathic arthritis (JIA) have increased remission rates. We conducted this study to investigate how patients and caregivers make decisions about stopping medications when JIA is inactive. METHODS We performed a mixed-methods study of caregivers and patients affected by JIA, recruited through social media and flyers, and selected by purposive sampling. Participants discussed their experiences with JIA, medications, and decision-making through recorded telephone interviews. Of 44 interviewees, 20 were patients (50% ages <18 years), and 24 were caregivers (50% caring for children ages ≤10 years). We evaluated characteristics associated with high levels of reported concerns about JIA or medicines using Fisher's exact testing. RESULTS Decisions about stopping medicines were informed by competing risks between disease activity and treatment. Participants who expressed more concerns about JIA were more likely to report disease-related complications (P = 0.002) and more motivated to continue treatment. However, participants expressing more concern about medicines were more likely to report treatment-related complications (P = 0.04) and felt more compelled to stop treatment. Additionally, participants considered how JIA or treatments facilitated or interfered with their sense of normalcy and safety, expressed feelings of guilt and regret about previous or potential adverse events, and reflected on uncertainty and unpredictability of future harms. Decision-making was also informed by trust in rheumatologists and other information sources (e.g., family and online support groups). CONCLUSION When deciding whether to stop medicines whenever JIA is inactive, patients and caregivers weigh competing risks between disease activity and treatment. Based on our results, we suggest specific approaches for clinicians to perform shared decision-making regarding stopping medicines for JIA.
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Affiliation(s)
- Daniel B Horton
- Rutgers Robert Wood Johnson Medical School and Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey, and Rutgers School of Public Health, Piscataway, New Jersey
| | | | | | - Melanie Kohlheim
- Pediatric Rheumatology Care and Outcomes Improvement Network, Cincinnati, Ohio
| | - Pooja Kapadia
- Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
| | | | | | - Ky Haverkamp
- University of Washington School of Medicine, Seattle
| | | | - L Nandini Moorthy
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | | | - Marsha Rosenthal
- Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey
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25
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Grevich S, Lee P, Leroux B, Ringold S, Darveau R, Henstorf G, Berg J, Kim A, Velan E, Kelly J, Baltuck C, Reeves A, Leahey H, Hager K, Brittnacher M, Hayden H, Miller S, McLean J, Stevens A. Oral health and plaque microbial profile in juvenile idiopathic arthritis. Pediatr Rheumatol Online J 2019; 17:81. [PMID: 31842923 PMCID: PMC6916162 DOI: 10.1186/s12969-019-0387-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/04/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The oral microbiota has been implicated in the pathogenesis of rheumatoid arthritis through activation of mucosal immunity. This study tested for associations between oral health, microbial communities and juvenile idiopathic arthritis (JIA). METHODS A cross-sectional exploratory study of subjects aged 10-18 years with oligoarticular, extended oligoarticular and polyarticular JIA was conducted. Control groups included pediatric dental clinic patients and healthy volunteers. The primary aim was to test for an association between dental health indices and JIA; the secondary aim was to characterize the microbial profile of supragingival plaque using 16S rRNA gene sequencing. RESULTS The study included 85 patients with JIA, 62 dental patients and 11 healthy child controls. JIA patients overall had significantly more gingival inflammation compared to dental patients, as evidenced by bleeding on probing of the gingiva, the most specific sign of active inflammation (p = 0.02). Overall, however, there was a trend towards better dental hygiene in the JIA patients compared to dental patients, based on indices for plaque, decay, and periodontitis. In the JIA patients, plaque microbiota analysis revealed bacteria belonging to genera Haemophilus or Kingella elevated, and Corynebacterium underrepresented. In poly JIA, bacteria belonging to the genus Porphyromonas was overrepresented and Prevotella was underrepresented. CONCLUSION Increased gingival inflammation in JIA was independent of general oral health, and thus cannot be attributed to poor dental hygiene secondary to disability. The variation of microbial profile in JIA patients could indicate a possible link between gingivitis and synovial inflammation.
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Affiliation(s)
- Sriharsha Grevich
- Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA. .,Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA.
| | - Peggy Lee
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Brian Leroux
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Sarah Ringold
- 0000 0000 9026 4165grid.240741.4Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105 USA ,0000000122986657grid.34477.33Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000 0000 9026 4165grid.240741.4Center for Clinical and Translational Research, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
| | - Richard Darveau
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Gretchen Henstorf
- 0000 0000 9026 4165grid.240741.4Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
| | - Joel Berg
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Amy Kim
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Elizabeth Velan
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Joseph Kelly
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Camille Baltuck
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Anne Reeves
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Hannah Leahey
- 0000 0000 9026 4165grid.240741.4Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
| | - Kyle Hager
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Mitchell Brittnacher
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Hillary Hayden
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Samuel Miller
- 0000000122986657grid.34477.33Department of Microbiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000000122986657grid.34477.33Department of Genome Sciences, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000000122986657grid.34477.33Department of Medicine, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Jeffrey McLean
- 0000000122986657grid.34477.33Department of Periodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Anne Stevens
- 0000 0000 9026 4165grid.240741.4Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA 98105 USA ,0000000122986657grid.34477.33Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 USA ,0000 0000 9026 4165grid.240741.4Center for Immunity and Immunotherapies, Seattle Children’s Research Institute, 1900 9th Ave, Seattle, WA 98101 USA
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Halyabar O, Mehta J, Ringold S, Rumsey DG, Horton DB. Treatment Withdrawal Following Remission in Juvenile Idiopathic Arthritis: A Systematic Review of the Literature. Paediatr Drugs 2019; 21:469-492. [PMID: 31673960 PMCID: PMC7301222 DOI: 10.1007/s40272-019-00362-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Early diagnosis and treatment of juvenile idiopathic arthritis (JIA) with conventional and biologic disease-modifying anti-rheumatic drugs have vastly improved outcomes for children with these diseases. Currently, a large proportion of children with JIA are able to achieve clinical inactive disease and remission. With this success, important questions have arisen about when medications can be stopped and how to balance the risks and benefits of continuing medications versus the potential for flare after stopping. AIM The aim was to conduct a systematic review of the available literature to summarize current evidence about medication withdrawal for JIA in remission. METHODS We conducted a systematic literature search in PubMed and Embase from 1990 to 2019. References were first screened by title and then independently screened by title and abstract by two authors. A total of 77 original papers were selected for full-text review. Data were extracted from 30 papers on JIA and JIA-associated uveitis, and the quality of the evidence was evaluated using National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI) tools. Studies on biochemical and radiologic biomarkers were also reviewed and summarized. RESULTS Most studies investigating treatment withdrawal in JIA have been observational and of poor or fair quality; interpretations of these studies have been limited by differences in study populations, disease and remission durations, the medications withdrawn, approaches to withdrawal, and definitions of disease outcomes. Overall the data suggest that flares are common after stopping JIA medications, particularly biologic medications. Clinical characteristics associated with increased risks of flare have not been consistently identified. Biochemical biomarkers and ultrasound findings have been shown to predict outcomes after stopping medications, but to date, no such predictor has been consistently validated across JIA populations. Studies have also not identified optimal strategies for withdrawing medication for well-controlled JIA. Promising withdrawal strategies include discontinuing methotrexate before biologic medications in children receiving combination therapy, dose reduction for children on biologics, and treat-to-target approaches to withdrawal. These and other strategies require further investigation in larger, high-quality studies. CONCLUSIONS The published literature on treatment withdrawal in JIA has varied in design and quality, yielding little conclusive evidence thus far on the management of JIA in remission. Given the importance of this question, international collaborative efforts are underway to study clinical and biologic predictors of successful medication withdrawal in JIA. These efforts may ultimately support the development of personalized approaches to withdrawing medication in children with JIA in remission.
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Affiliation(s)
- Olha Halyabar
- Department of Pediatrics, Boston Children’s
Hospital, Boston, Massachusetts, USA
| | - Jay Mehta
- Department of Pediatrics, Children’s Hospital of
Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sarah Ringold
- Department of Pediatrics, Seattle Children’s
Hospital, Seattle, Washington, USA
| | - Dax G. Rumsey
- Department of Pediatrics, University of Alberta, Edmonton,
Alberta, Canada
| | - Daniel B. Horton
- Department of Pediatrics, Rutgers Robert Wood Johnson
Medical School, New Brunswick, NJ, USA,Rutgers Center for Pharmacoepidemiology and Treatment
Science, Institute for Health, Health Care Policy and Aging Research, New Brunswick,
NJ, USA,Department of Biostatistics and Epidemiology, Rutgers
School of Public Health, Piscataway, NJ, USA
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27
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Schanberg LE, Ramanan AV, De Benedetti F, Beukelman T, Eakin GS, Del Gaizo V, Ringold S, Vesely R, Schrandt S, Jaki T, Bili A, Chung JB, De Bono S, Douglass W, Enejosa JV, Kanik KS, Knobe K, Kunder R, Leite-Schnell JC, Suehiro RM, Wong RL, Mieszkalski KL, Marrow LC, Siebenaler K, Fraulo E, Kimura Y. Toward Accelerated Authorization and Access to New Medicines for Juvenile Idiopathic Arthritis. Arthritis Rheumatol 2019; 71:1976-1984. [PMID: 31313532 DOI: 10.1002/art.41043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 07/11/2019] [Indexed: 12/14/2022]
Abstract
A meeting was organized to bring together multiple stakeholders involved in the testing and authorization of new medications for juvenile idiopathic arthritis (JIA) to discuss current issues surrounding clinical trials and access to new medications for children and adolescents with JIA. The Childhood Arthritis and Rheumatology Research Alliance invited representatives of regulatory agencies (Food and Drug Administration and European Medicines Agency), and major pharmaceutical companies with JIA-approved products or products in development, patient and parent representatives, representatives of an advocacy organization (Arthritis Foundation), and pediatric rheumatology clinicians/investigators to a 1-day meeting in April 2018. The participants engaged in discussion regarding issues in clinical trials. As the pharmacologic options to treat inflammatory arthritis rapidly expand, registration trial designs to test medications in JIA patients must adapt. Many methodologies successfully used in the recent past are no longer feasible. The pool of patients meeting entry criteria who are willing to participate is shrinking while the number of medications to be tested is growing. Suggested solutions included proposing innovative clinical trial methods to regulatory agencies, as well as open discussions among stakeholders. Ensuring that new medications are authorized in a timely manner to meet the needs of JIA patients worldwide is critical. Approaches should include open dialog between regulatory agencies, pharmaceutical companies, and other stakeholders to develop and implement novel study designs, including patient and clinician perspectives to define meaningful trial outcomes, and changing existing study plans.
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Affiliation(s)
| | - Athimalaipet V Ramanan
- University Hospitals Bristol NHS Foundation Trust, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | | | - Vincent Del Gaizo
- Childhood Arthritis and Rheumatology Research Alliance, Milwaukee, Wisconsin
| | | | | | | | | | | | | | | | | | | | - Keith S Kanik
- Global Product Development, Pfizer Inc., New London, Connecticut
| | | | | | | | | | | | - Kelly L Mieszkalski
- Childhood Arthritis and Rheumatology Research Alliance, Milwaukee, Wisconsin
| | | | | | | | - Yukiko Kimura
- Hackensack University Medical Center, Hackensack, New Jersey
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Do N, Ringold S, Brandling-Bennett H. Cutaneous polyarteritis nodosa in pediatric patients successfully treated with TNF-α inhibitor and methotrexate: Case series and literature review. Pediatr Dermatol 2019; 36:932-935. [PMID: 31576593 DOI: 10.1111/pde.14005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cutaneous polyarteritis nodosa (CPAN) is a rare necrotizing vasculitis affecting small- to medium-sized arteries. Reported treatments include oral corticosteroids alone or in combination with non-steroidal antiinflammatory drugs, intravenous immunoglobulins, cyclophosphamide, azathioprine, colchicine, or dapsone. However, some patients with CPAN do not respond to such treatments and continue to experience exacerbations over prolonged periods. This series provides support for the use of TNF-α inhibitors in the treatment of recalcitrant CPAN in pediatric patients.
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Affiliation(s)
- Ngan Do
- University of Washington School of Medicine, Seattle, Washington
| | - Sarah Ringold
- Department of Pediatrics, Division of Rheumatology, University of Washington/Seattle Children's Hospital, Seattle, Washington
| | - Heather Brandling-Bennett
- Department of Pediatrics, Division of Dermatology, University of Washington/Seattle Children's Hospital, Seattle, Washington
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29
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Angeles-Han ST, Ringold S, Beukelman T, Lovell D, Cuello CA, Becker ML, Colbert RA, Feldman BM, Holland GN, Ferguson PJ, Gewanter H, Guzman J, Horonjeff J, Nigrovic PA, Ombrello MJ, Passo MH, Stoll ML, Rabinovich CE, Sen HN, Schneider R, Halyabar O, Hays K, Shah AA, Sullivan N, Szymanski AM, Turgunbaev M, Turner A, Reston J. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Screening, Monitoring, and Treatment of Juvenile Idiopathic Arthritis-Associated Uveitis. Arthritis Care Res (Hoboken) 2019; 71:703-716. [PMID: 31021540 DOI: 10.1002/acr.23871] [Citation(s) in RCA: 122] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/27/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To develop recommendations for the screening, monitoring, and treatment of uveitis in children with juvenile idiopathic arthritis (JIA). METHODS Pediatric rheumatologists, ophthalmologists with expertise in uveitis, patient representatives, and methodologists generated key clinical questions to be addressed by this guideline. This was followed by a systematic literature review and rating of the available evidence according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. A group consensus process was used to compose the final recommendations and grade their strength as conditional or strong. RESULTS Due to a lack of literature with good quality of evidence, recommendations were formulated on the basis of available evidence and a consensus expert opinion. Regular ophthalmic screening of children with JIA is recommended because of the risk of uveitis, and the frequency of screening should be based on individual risk factors. Regular ophthalmic monitoring of children with uveitis is recommended, and intervals should be based on ocular examination findings and treatment regimen. Ophthalmic monitoring recommendations were strong primarily because of concerns of vision-threatening complications of uveitis with infrequent monitoring. Topical glucocorticoids should be used as initial treatment to achieve control of inflammation. Methotrexate and the monoclonal antibody tumor necrosis factor inhibitors adalimumab and infliximab are recommended when systemic treatment is needed for the management of uveitis. The timely addition of nonbiologic and biologic drugs is recommended to maintain uveitis control in children who are at continued risk of vision loss. CONCLUSION This guideline provides direction for clinicians and patients/parents making decisions on the screening, monitoring, and management of children with JIA and uveitis, using GRADE methodology and informed by a consensus process with input from rheumatology and ophthalmology experts, current literature, and patient/parent preferences and values.
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Affiliation(s)
- Sheila T Angeles-Han
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | | | | | - Daniel Lovell
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | | | | | | | - Brian M Feldman
- The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Gary N Holland
- UCLA Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California
| | | | - Harry Gewanter
- Children's Hospital of Richmond, Virginia Commonwealth University, Richmond
| | - Jaime Guzman
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | | | - Peter A Nigrovic
- Brigham & Women's Hospital and Boston Children's Hospital, Boston, Massachusetts
| | | | | | | | | | - H Nida Sen
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Rayfel Schneider
- The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | | | | | | - Amy Turner
- American College of Rheumatology, Atlanta, Georgia
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30
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Ringold S, Angeles-Han ST, Beukelman T, Lovell D, Cuello CA, Becker ML, Colbert RA, Feldman BM, Ferguson PJ, Gewanter H, Guzman J, Horonjeff J, Nigrovic PA, Ombrello MJ, Passo MH, Stoll ML, Rabinovich CE, Schneider R, Halyabar O, Hays K, Shah AA, Sullivan N, Szymanski AM, Turgunbaev M, Turner A, Reston J. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Non-Systemic Polyarthritis, Sacroiliitis, and Enthesitis. Arthritis Rheumatol 2019; 71:846-863. [PMID: 31021537 DOI: 10.1002/art.40884] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/27/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To develop treatment recommendations for children with juvenile idiopathic arthritis manifesting as non-systemic polyarthritis, sacroiliitis, or enthesitis. METHODS The Patient/Population, Intervention, Comparison, and Outcomes (PICO) questions were developed and refined by members of the guideline development teams. A systematic review was conducted to compile evidence for the benefits and harms associated with treatments for these conditions. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of evidence. A group consensus process was conducted among the Voting Panel to generate the final recommendations and grade their strength. A Parent and Patient Panel used a similar consensus approach to provide patient/caregiver preferences for key questions. RESULTS Thirty-nine recommendations were developed (8 strong and 31 conditional). The quality of supporting evidence was very low or low for 90% of the recommendations. Recommendations are provided for the use of nonsteroidal antiinflammatory drugs, disease-modifying antirheumatic drugs, biologics, and intraarticular and oral glucocorticoids. Recommendations for the use of physical and occupational therapy are also provided. Specific recommendations for polyarthritis address general medication use, initial and subsequent treatment, and adjunctive therapies. Good disease control, with therapeutic escalation to achieve low disease activity, was recommended. The sacroiliitis and enthesitis recommendations primarily address initial therapy and adjunctive therapies. CONCLUSION This guideline provides direction for clinicians, caregivers, and patients making treatment decisions. Clinicians, caregivers, and patients should use a shared decision-making process that accounts for patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.
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Affiliation(s)
| | - Sheila T Angeles-Han
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | | | - Daniel Lovell
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | | | | | | | - Brian M Feldman
- The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada
| | | | - Harry Gewanter
- Children's Hospital of Richmond, Virginia Commonwealth University, Richmond
| | - Jaime Guzman
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | | | - Peter A Nigrovic
- Brigham & Women's Hospital and Boston Children's Hospital, Boston, Massachusetts
| | | | | | | | | | - Rayfel Schneider
- The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | | | | | | - Amy Turner
- American College of Rheumatology, Atlanta, Georgia
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31
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Angeles-Han ST, Ringold S, Beukelman T, Lovell D, Cuello CA, Becker ML, Colbert RA, Feldman BM, Holland GN, Ferguson PJ, Gewanter H, Guzman J, Horonjeff J, Nigrovic PA, Ombrello MJ, Passo MH, Stoll ML, Rabinovich CE, Sen HN, Schneider R, Halyabar O, Hays K, Shah AA, Sullivan N, Szymanski AM, Turgunbaev M, Turner A, Reston J. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Screening, Monitoring, and Treatment of Juvenile Idiopathic Arthritis-Associated Uveitis. Arthritis Rheumatol 2019; 71:864-877. [PMID: 31021511 DOI: 10.1002/art.40885] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/27/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To develop recommendations for the screening, monitoring, and treatment of uveitis in children with juvenile idiopathic arthritis (JIA). METHODS Pediatric rheumatologists, ophthalmologists with expertise in uveitis, patient representatives, and methodologists generated key clinical questions to be addressed by this guideline. This was followed by a systematic literature review and rating of the available evidence according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. A group consensus process was used to compose the final recommendations and grade their strength as conditional or strong. RESULTS Due to a lack of literature with good quality of evidence, recommendations were formulated on the basis of available evidence and a consensus expert opinion. Regular ophthalmic screening of children with JIA is recommended because of the risk of uveitis, and the frequency of screening should be based on individual risk factors. Regular ophthalmic monitoring of children with uveitis is recommended, and intervals should be based on ocular examination findings and treatment regimen. Ophthalmic monitoring recommendations were strong primarily because of concerns of vision-threatening complications of uveitis with infrequent monitoring. Topical glucocorticoids should be used as initial treatment to achieve control of inflammation. Methotrexate and the monoclonal antibody tumor necrosis factor inhibitors adalimumab and infliximab are recommended when systemic treatment is needed for the management of uveitis. The timely addition of nonbiologic and biologic drugs is recommended to maintain uveitis control in children who are at continued risk of vision loss. CONCLUSION This guideline provides direction for clinicians and patients/parents making decisions on the screening, monitoring, and management of children with JIA and uveitis, using GRADE methodology and informed by a consensus process with input from rheumatology and ophthalmology experts, current literature, and patient/parent preferences and values.
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Affiliation(s)
- Sheila T Angeles-Han
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | | | | | - Daniel Lovell
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | | | | | | | - Brian M Feldman
- The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Gary N Holland
- UCLA Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California
| | | | - Harry Gewanter
- Children's Hospital of Richmond, Virginia Commonwealth University, Richmond
| | - Jaime Guzman
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | | | - Peter A Nigrovic
- Brigham & Women's Hospital and Boston Children's Hospital, Boston, Massachusetts
| | | | | | | | | | - H Nida Sen
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Rayfel Schneider
- The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | | | | | | - Amy Turner
- American College of Rheumatology, Atlanta, Georgia
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32
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Ringold S, Angeles-Han ST, Beukelman T, Lovell D, Cuello CA, Becker ML, Colbert RA, Feldman BM, Ferguson PJ, Gewanter H, Guzman J, Horonjeff J, Nigrovic PA, Ombrello MJ, Passo MH, Stoll ML, Rabinovich CE, Schneider R, Halyabar O, Hays K, Shah AA, Sullivan N, Szymanski AM, Turgunbaev M, Turner A, Reston J. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Non-Systemic Polyarthritis, Sacroiliitis, and Enthesitis. Arthritis Care Res (Hoboken) 2019; 71:717-734. [PMID: 31021516 DOI: 10.1002/acr.23870] [Citation(s) in RCA: 151] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/27/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To develop treatment recommendations for children with juvenile idiopathic arthritis manifesting as non-systemic polyarthritis, sacroiliitis, or enthesitis. METHODS The Patient/Population, Intervention, Comparison, and Outcomes (PICO) questions were developed and refined by members of the guideline development teams. A systematic review was conducted to compile evidence for the benefits and harms associated with treatments for these conditions. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of evidence. A group consensus process was conducted among the Voting Panel to generate the final recommendations and grade their strength. A Parent and Patient Panel used a similar consensus approach to provide patient/caregiver preferences for key questions. RESULTS Thirty-nine recommendations were developed (8 strong and 31 conditional). The quality of supporting evidence was very low or low for 90% of the recommendations. Recommendations are provided for the use of nonsteroidal antiinflammatory drugs, disease-modifying antirheumatic drugs, biologics, and intraarticular and oral glucocorticoids. Recommendations for the use of physical and occupational therapy are also provided. Specific recommendations for polyarthritis address general medication use, initial and subsequent treatment, and adjunctive therapies. Good disease control, with therapeutic escalation to achieve low disease activity, was recommended. The sacroiliitis and enthesitis recommendations primarily address initial therapy and adjunctive therapies. CONCLUSION This guideline provides direction for clinicians, caregivers, and patients making treatment decisions. Clinicians, caregivers, and patients should use a shared decision-making process that accounts for patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.
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Affiliation(s)
| | - Sheila T Angeles-Han
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | | | - Daniel Lovell
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | | | | | | | - Brian M Feldman
- The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada
| | | | - Harry Gewanter
- Children's Hospital of Richmond, Virginia Commonwealth University, Richmond
| | - Jaime Guzman
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | | | - Peter A Nigrovic
- Brigham & Women's Hospital and Boston Children's Hospital, Boston, Massachusetts
| | | | | | | | | | - Rayfel Schneider
- The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | | | | | | - Amy Turner
- American College of Rheumatology, Atlanta, Georgia
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Morgan EM, Munro JE, Horonjeff J, Horgan B, Shea B, Feldman BM, Clairman H, Bingham CO, Thornhill S, Strand V, Alongi A, Magni-Manzoni S, van Rossum MA, Vesely R, Vojinovic J, Brunner HI, Harris JG, Horton DB, Lovell DJ, Mannion M, Rahimi H, Ravelli A, Ringold S, Ruperto N, Schrandt MS, Shenoi S, Shiff NJ, Toupin-April K, Tzaribachev N, Weiss P, Consolaro A. Establishing an Updated Core Domain Set for Studies in Juvenile Idiopathic Arthritis: A Report from the OMERACT 2018 JIA Workshop. J Rheumatol 2019; 46:1006-1013. [DOI: 10.3899/jrheum.181088] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2019] [Indexed: 11/22/2022]
Abstract
Objective.The current Juvenile Idiopathic Arthritis (JIA) Core Set used in randomized controlled trials (RCT) and longitudinal observational studies (LOS) was developed without the input of patients/parents. At the Outcome Measures in Rheumatology (OMERACT) 2016, a special interest group voted to reconsider the core set, incorporating broader input. We describe subsequent work culminating in an OMERACT 2018 plenary and consensus voting.Methods.Candidate domains were identified through literature review, qualitative surveys, and online discussion boards (ODB) held with patients with JIA and parents in Australia, Italy, and the United States. A Delphi process with parents, patients, healthcare providers, researchers, and regulators served to edit the domain list and prioritize candidate domains. After the presentation of results, OMERACT workshop participants voted, with consensus set at > 70%.Results.Participants in ODB were 53 patients with JIA (ages 15–24 yrs) and 55 parents. Three rounds of Delphi considering 27 domains were completed by 190 (response rate 85%), 201 (84%), and 182 (77%) people, respectively, from 50 countries. There was discordance noted between domains prioritized by patients/parents compared to others. OMERACT conference voting approved domains for JIA RCT and LOS with 83% endorsement. Mandatory domains are pain, joint inflammatory signs, activity limitation/physical function, patient’s perception of disease activity (overall well-being), and adverse events. Mandatory in specific circumstances: inflammation/other features relevant to specific JIA categories.Conclusion.Following the OMERACT methodology, we developed an updated JIA Core Domain Set. Next steps are to identify and systematically evaluate best outcome measures for these domains.
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Stoustrup P, Resnick CM, Pedersen TK, Abramowicz S, Michelotti A, Küseler A, Verna C, Kellenberger CJ, Nordal EB, Caserta G, Jankovska I, Halbig JM, Kristensen KD, Arvidsson LZ, Spiegel L, Stoll ML, Lerman M, Glerup M, Defabianis P, Frid P, Alstergren P, Cron RQ, Ringold S, Nørholt SE, Peltomäki T, Herlin T, Peacock ZS, Twilt M. Standardizing Terminology and Assessment for Orofacial Conditions in Juvenile Idiopathic Arthritis: International, Multidisciplinary Consensus-based Recommendations. J Rheumatol 2019; 46:518-522. [PMID: 30647179 DOI: 10.3899/jrheum.180785] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To propose multidisciplinary, consensus-based, standardization of operational terminology and method of assessment for temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA). METHODS Using a sequential expert group-defined terminology and methods-of-assessment approach by (1) establishment of task force, (2) item generation, (3) working group consensus, (4) external expert content validity testing, and (5) multidisciplinary group of experts final Delphi survey consensus. RESULTS Seven standardized operational terms were defined: TMJ arthritis, TMJ involvement, TMJ arthritis management, dentofacial deformity, TMJ deformity, TMJ symptoms, and TMJ dysfunction. CONCLUSION: Definition of 7 operational standardized terms provides an optimal platform for communication across healthcare providers involved in JIA-TMJ arthritis management.
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Affiliation(s)
- Peter Stoustrup
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland. .,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital.
| | - Cory M Resnick
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Thomas Klit Pedersen
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Shelly Abramowicz
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Ambra Michelotti
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Annelise Küseler
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Carlalberta Verna
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Christian J Kellenberger
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Ellen Berit Nordal
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Giuliana Caserta
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Iveta Jankovska
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Josefine Mareile Halbig
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Kasper Dahl Kristensen
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Linda Z Arvidsson
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Lynn Spiegel
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Mathew L Stoll
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Melissa Lerman
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Mia Glerup
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Patrizia Defabianis
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Paula Frid
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Per Alstergren
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Randy Q Cron
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Sarah Ringold
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Sven Erik Nørholt
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Timo Peltomäki
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Troels Herlin
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Zachary S Peacock
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
| | - Marinka Twilt
- From the Department of Dentistry and Oral Health, Aarhus University; Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; Department of Orthodontics, Aarhus University; Department of Pediatrics, Aarhus University Hospital; Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Section of Oral Surgery and Oral Pathology, Aarhus University, Aarhus, Denmark; Harvard School of Dental Medicine and Harvard Medical School; Department of Plastic and Oral Surgery, Boston Children's Hospital; Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts; Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; University of Alabama at Birmingham, Birmingham, Alabama; Perelman School of Medicine, University of Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Seattle Children's Hospital, Seattle, Washington, USA; Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II, Naples; Dental School, Section of Paediatric Dentistry, University of Turin, Turin, Italy; Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine, Basel; Department of Diagnostic Imaging, University Children's Hospital Zurich, Switzerland; Department of Pediatrics, University of North Norway and Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso; Section of Orthodontics, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo; Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway; The Public Dental Service Competence Centre of North Norway; Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromso, Norway; Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University, Riga, Latvia; Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario; Department of Pediatrics, Cumming School of Medicine, University of Calgary; Alberta Children's Hospital, Calgary, Alberta, Canada; Malmo University, Faculty of Odontology, Orofacial Pain Unit, Malmo and Skane University Hospital, Specialized Pain Rehabilitation, Lund, Sweden; Department of Ear and Oral Diseases, Tampere University Hospital; Faculty of Medicine and Life Sciences, University of Tampere; Institute of Dentistry and University of Eastern Finland, Kuopio, Finland.,P. Stoustrup, Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; C.M. Resnick, Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, and Department of Plastic and Oral Surgery, Boston Children's Hospital; T.K. Pedersen, PhD, Consultant Orthodontist, Professor, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Section of Orthodontics, Aarhus University; S. Abramowicz, DMD, MPH, FACS, Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta; A. Michelotti, DDS, Orthodontist, Department of Neuroscience, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples Federica II; A. Küseler, DDS, PhD, Department of Orthodontics, Aarhus University Hospital; C. Verna, DDS, PhD, Professor, Head, Department of Orthodontics and Pediatric Dentistry, UZB, University Center for Dental Medicine; C.J. Kellenberger, MD, Prof., Dr. med., Department of Diagnostic Imaging, University Children's Hospital Zurich; E. Berit Nordal, MD, PhD, Department of Pediatrics, University of North Norway, and Department of Clinical Medicine, UiT the Arctic University of Norway; G. Caserta, DDS, Lecturer, CIR - Dental School, Section of Paediatric Dentistry, University of Turin; I. Jankovska, DDS, PhD, Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Rigas Stradins University; J.M. Halbig, Dr. med. Dent., DDS, The Public Dental Service Competence Centre of North Norway; K.D. Kristensen, DDS, PhD, Guest Researcher, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University; L.Z. Arvidsson, DDS, PhD, Associate Professor, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo; L. Spiegel, MD, FRCPC, Department of Pediatrics, Division of Rheumatology, The Hospital for Sick Children, University of Toronto; M.L. Stoll, MD, PhD, MSCS, University of Alabama at Birmingham; M. Lerman, MD, MSc, PhD, Assistant Professor of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia; M. Glerup, MD, Department of Pediatrics, Aarhus University Hospital; P. Defabianis, MD, DDS, Associate Professor, Chairman and Program Director of Pediatric Dentistry, Section of Pediatric Dentistry, CIR-Dental School, University of Turin; P. Frid, DDS, Department of Otorhino-laryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, and Public Dental Service Competence Centre of North Norway, and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway; P. Alstergren, DDS, PhD, Malmo University, Faculty of Odontology, Orofacial Pain Unit, and Skane University Hospital, Specialized Pain Rehabilitation; R.Q. Cron, MD, PhD, University of Alabama at Birmingham; S. Ringold, MD, MS, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Clinical Professor, Consultant Surgeon, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, and Section of Oral Surgery and Oral Pathology, Aarhus University; T. Peltomäki, DDS, PhD, Department of Ear and Oral Diseases, Tampere University Hospital, and Faculty of Medicine and Life Sciences, University of Tampere, and Institute of Dentistry and University of Eastern Finland; T. Herlin, MD, DMSci, Pediatric Rheumatology Clinic, Pediatrics and Adolescent Medicine, Aarhus University Hospital; Z.S. Peacock, DMD, MD, Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Harvard School of Dental Medicine; M. Twilt, MD, MSCE, PhD, Assistant Professor, Department of Pediatrics, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital
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Lovell DJ, Brunner HI, Ringold S, Weiss PF, Martin N, Consolaro A, Bovis F, Ruperto N. The American English version of the Juvenile Arthritis Multidimensional Assessment Report (JAMAR). Rheumatol Int 2018; 38:35-42. [PMID: 29637338 PMCID: PMC5893750 DOI: 10.1007/s00296-018-3984-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 01/11/2018] [Indexed: 11/28/2022]
Abstract
The Juvenile Arthritis Multidimensional Assessment Report (JAMAR) is a new parent/patient-reported outcome measure that enables a thorough assessment of the disease status in children with juvenile idiopathic arthritis (JIA). We report the results of the cross-cultural adaptation and validation of the parent and patient versions of the JAMAR in the American English language. The reading comprehension of the questionnaire was tested in 10 JIA parents and patients. Each participating centre was asked to collect demographic, clinical data and the JAMAR in 100 consecutive JIA patients or all consecutive patients seen in a 6-month period and to administer the JAMAR to 100 healthy children and their parents. The statistical validation phase explored descriptive statistics and the psychometric issues of the JAMAR: the 3 Likert assumptions, floor/ceiling effects, internal consistency, Cronbach's alpha, interscale correlations, test-retest reliability, and construct validity (convergent and discriminant validity). A total of 315 JIA patients (5.1% systemic, 31.1% oligoarticular, 34% RF negative polyarthritis, 29.8% other categories) and 98 healthy children, were enrolled in three centres. The JAMAR components discriminated well healthy subjects from JIA patients. All JAMAR components revealed good psychometric performances. In conclusion, the American English version of the JAMAR is a valid tool for the assessment of children with JIA and is suitable for use both in routine clinical practice and clinical research.
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Affiliation(s)
- Daniel J Lovell
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 4010, Cincinnati, OH, 45229-3039, USA.
| | - Hermine I Brunner
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 4010, Cincinnati, OH, 45229-3039, USA
| | - Sarah Ringold
- Division of Rheumatology, Seattle Children's Hospital, Seattle, WA, USA
| | - Pamela F Weiss
- Division of Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Neil Martin
- Rheumatology Department, Royal Hospital for Children, Glasgow, UK
| | - Alessandro Consolaro
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy.,Dipartimento di Pediatria, Università di Genova, Genoa, Italy
| | - Francesca Bovis
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy
| | - Nicolino Ruperto
- Clinica Pediatrica e Reumatologia, Paediatric Rheumatology International Trials Organisation (PRINTO), Istituto Giannina Gaslini, Via Gaslini 5, 16147, Genoa, Italy.
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Ringold S, Nigrovic PA, Feldman BM, Tomlinson GA, von Scheven E, Wallace CA, Huber AM, Schanberg LE, Li SC, Weiss PF, Fuhlbrigge RC, Morgan EM, Kimura Y. The Childhood Arthritis and Rheumatology Research Alliance Consensus Treatment Plans. Arthritis Rheumatol 2018; 70:669-678. [DOI: 10.1002/art.40395] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 11/29/2017] [Indexed: 01/17/2023]
Affiliation(s)
| | - Peter A. Nigrovic
- Brigham and Women's Hospital and Boston Children's Hospital; Boston Massachusetts
| | | | | | | | - Carol A. Wallace
- University of Washington School of Medicine and Seattle Children's Hospital; Seattle Washington
| | - Adam M. Huber
- IWK Health Centre; Dalhousie University; Halifax Nova Scotia Canada
| | | | - Suzanne C. Li
- Hackensack University Medical Center; Hackensack New Jersey
| | - Pamela F. Weiss
- Children's Hospital of Philadelphia; Philadelphia Pennsylvania
| | | | - Esi M. Morgan
- Cincinnati Children's Hospital Medical Center; Cincinnati Ohio
| | - Yukiko Kimura
- Hackensack University Medical Center; Hackensack New Jersey
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Weitzman ER, Wisk LE, Salimian PK, Magane KM, Dedeoglu F, Hersh AO, Kimura Y, Mandl KD, Ringold S, Natter M. Adding patient-reported outcomes to a multisite registry to quantify quality of life and experiences of disease and treatment for youth with juvenile idiopathic arthritis. J Patient Rep Outcomes 2018; 2:16. [PMID: 29645010 PMCID: PMC5891162 DOI: 10.1186/s41687-017-0025-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 12/14/2017] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Children with Juvenile Idiopathic Arthritis (JIA) often have poor health-related quality of life (HRQOL) despite advances in treatment. Patient-centered research may shed light on how patient experiences of treatment and disease contribute to HRQOL, pinpointing directions for improving care and enhancing outcomes. METHODS Parent proxies of youth enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry shared patient-reported outcomes about their child's HRQOL and experiences of disease and treatment burden (pain interference, morning stiffness, history of medication side effects and methotrexate intolerance). Contributions of these measures to HRQOL were estimated using generalized estimating equations accounting for site and patient demographics. RESULTS Patients (N = 180) were 81.1% white non-Hispanic and 76.7% female. Mean age was 11.8 (SD = 3.6) years, mean disease duration was 7.7 years (SD = 3.5). Mean Total Pediatric Quality of Life was 76.7 (SD = 18.2). Mean pain interference score was 50.1 (SD = 11.1). Nearly one-in-five (17.8%) youth experienced >15 min of morning stiffness on a typical day, more than one quarter (26.7%) reported ≥1 serious medication side effect and among 90 methotrexate users, 42.2% met criteria for methotrexate intolerance. Measures of disease and treatment burden were independently negatively associated with HRQOL (all p-values <0.01). Negative associations among measures of treatment burden and HRQOL were attenuated after controlling for disease burden and clinical characteristics but remained significant. CONCLUSIONS For youth with JIA, HRQOL is multidimensional, reflecting disease as well as treatment factors. Adverse treatment experiences undermine HRQOL even after accounting for disease symptoms and disease activity and should be assessed routinely to improve wellbeing.
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Affiliation(s)
- Elissa R. Weitzman
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 USA
- Department of Pediatrics, Harvard Medical School, Boston, 02115 USA
- Computational Health Informatics Program, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 USA
| | - Lauren E. Wisk
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 USA
- Department of Pediatrics, Harvard Medical School, Boston, 02115 USA
| | - Parissa K. Salimian
- Division of Developmental Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 USA
| | - Kara M. Magane
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 USA
| | - Fatma Dedeoglu
- Rheumatology Program, Division of Immunology, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 USA
| | - Aimee O. Hersh
- Division of Pediatric Rheumatology, University of Utah School of Medicine and Primary Children’s Medical Center, Salt Lake City, UT 84113 USA
| | - Yukiko Kimura
- Division of Pediatric Rheumatology, Hackensack University Medical Center, Hackensack, NJ 07601 USA
| | - Kenneth D. Mandl
- Department of Pediatrics, Harvard Medical School, Boston, 02115 USA
- Computational Health Informatics Program, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 USA
- Department of Biomedical Informatics, Harvard Medical School, Boston, 02115 USA
| | - Sarah Ringold
- Division of Rheumatology, Seattle Children’s Hospital, Seattle, WA 98105 USA
| | - Marc Natter
- Department of Pediatrics, Harvard Medical School, Boston, 02115 USA
- Computational Health Informatics Program, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 USA
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Morgan EM, Riebschleger MP, Horonjeff J, Consolaro A, Munro JE, Thornhill S, Beukelman T, Brunner HI, Creek EL, Harris JG, Horton DB, Lovell DJ, Mannion ML, Olson JC, Rahimi H, Gallo MC, Calandra S, Ravelli A, Ringold S, Shenoi S, Stinson J, Toupin-April K, Strand V, Bingham CO. Evidence for Updating the Core Domain Set of Outcome Measures for Juvenile Idiopathic Arthritis: Report from a Special Interest Group at OMERACT 2016. J Rheumatol 2017; 44:1884-1888. [PMID: 28811355 PMCID: PMC5914507 DOI: 10.3899/jrheum.161389] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The current Juvenile Idiopathic Arthritis (JIA) Core Set was developed in 1997 to identify the outcome measures to be used in JIA clinical trials using statistical and consensus-based techniques, but without patient involvement. The importance of patient/parent input into the research process has increasingly been recognized over the years. An Outcome Measures in Rheumatology (OMERACT) JIA Core Set Working Group was formed to determine whether the outcome domains of the current core set are relevant to those involved or whether the core set domains should be revised. METHODS Twenty-four people from the United States, Canada, Australia, and Europe, including patient partners, formed the working group. Guided by the OMERACT Filter 2.0 process, we performed (1) a systematic literature review of outcome domains, (2) a Web-based survey (142 patients, 343 parents), (3) an idea-generation study (120 parents), (4) 4 online discussion boards (24 patients, 20 parents), and (5) a Special Interest Group (SIG) activity at the OMERACT 13 (2016) meeting. RESULTS A MEDLINE search of outcome domains used in studies of JIA yielded 5956 citations, of which 729 citations underwent full-text review, and identified additional domains to those included in the current JIA Core Set. Qualitative studies on the effect of JIA identified multiple additional domains, including pain and participation. Twenty-one participants in the SIG achieved consensus on the need to revise the entire JIA Core Set. CONCLUSION The results of qualitative studies and literature review support the need to expand the JIA Core Set, considering, among other things, additional patient/parent-centered outcomes, clinical data, and imaging data.
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Affiliation(s)
- Esi M Morgan
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University.
| | - Meredith P Riebschleger
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Jennifer Horonjeff
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Alessandro Consolaro
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Jane E Munro
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Susan Thornhill
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Timothy Beukelman
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Hermine I Brunner
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Emily L Creek
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Julia G Harris
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Daniel B Horton
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Daniel J Lovell
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Melissa L Mannion
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Judyann C Olson
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Homaira Rahimi
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Maria Chiara Gallo
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Serena Calandra
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Angelo Ravelli
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Sarah Ringold
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Susan Shenoi
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Jennifer Stinson
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Karine Toupin-April
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Vibeke Strand
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
| | - Clifton O Bingham
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital, Ann Arbor, Michigan; Office of Research, Division of Rheumatology, Columbia University Medical Center, New York; Division of Rheumatology, University of Rochester, Golisano Children's Hospital, Rochester, New York; Thornhill Associates, Hermosa Beach; Division of Immunology/Rheumatology, Stanford University, Stanford, California; Division of Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Arthritis Foundation, Atlanta, Georgia; Division of Rheumatology, Children's Mercy, Kansas City, Missouri; Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey; Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Rheumatology, Seattle Children's Hospital, Seattle, Washington; Johns Hopkins Arthritis Center, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Istituto Giannina Gaslini; University of Genoa, Genoa, Italy; Rheumatology, Royal Children's Hospital; Murdoch Children's Research Institute, Melbourne, Australia; The Hospital for Sick Children, and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- E.M. Morgan, MD, Associate Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.P. Riebschleger, MD, Clinical Lecturer, Pediatric Rheumatology and Pediatric Health Services Research, University of Michigan CS Mott Children's Hospital; J. Horonjeff, PhD, Instructor, Office of Research, Division of Rheumatology, Columbia University Medical Center; A. Consolaro, MD, PhD, Assistant Professor, Division of Rheumatology, Istituto Giannina Gaslini, and University of Genoa; J.E. Munro, MBBS, Associate Professor, Head of Rheumatology at the Royal Children's Hospital, and Group Leader, Arthritis Research, Murdoch Children's Research Institute; S. Thornhill, AA, Qualitative Research Consultant, Thornhill Associates; T. Beukelman, MD, Associate Professor, Division of Rheumatology, University of Alabama at Birmingham; H.I. Brunner, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; E.L. Creek, MBA, Senior Director, Help and Support, Arthritis Foundation; J.G. Harris, MD, Assistant Professor, Division of Rheumatology, Children's Mercy; D.B. Horton, MD, Assistant Professor, Division of Pediatric Rheumatology, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research; D.J. Lovell, MD, Professor, Division of Rheumatology, Cincinnati Children's Hospital Medical Center; M.L. Mannion, MD, Assistant Professor of Rheumatology, University of Alabama at Birmingham; J.C. Olson, MD, Associate Professor, Medical College of Wisconsin; H. Rahimi, MD, Assistant Professor, Division of Rheumatology, University of Rochester, Golisano Children's Hospital; M.C. Gallo, MD, Research Contract, Istituto Giannina Gaslini; S. Calandra, MD, Pediatric Resident, Istituto Giannina Gaslini; A. Ravelli, MD, Professor of Pediatrics, University of Genoa and Istituto Giannina Gaslini; S. Ringold, MD, Assistant Professor, Division of Rheumatology, Seattle Children's Hospital; S. Shenoi, MBBS, Assistant Professor, Seattle Children's Hospital; J. Stinson, PhD, Senior Scientist, The Hospital for Sick Children, and Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto; K. Toupin-April, PhD, Associate Scientist, Children's Hospital of Eastern Ontario Research Institute, and Assistant Professor, Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; V. Strand, MD, Adjunct Clinical Professor, Division of Immunology/Rheumatology, Stanford University; C.O. Bingham III, MD, Professor of Medicine, Director, Johns Hopkins Arthritis Center, Johns Hopkins University
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P, Wiener A, Hügle B, Denecke B, Costa-Filho I, Haas JP, Tenbrock K, Popp D, Boltjes A, Rühle F, Herresthal S, de Jager W, van Wijk F, Schultze J, Stoll M, Klotz L, Vogl T, Roth J, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Sánchez AMM, Borrell RP, Barril SM, Gallo MM, Caballero CM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Giner T, Hackl L, Albrecht J, Würzner R, Brunner J, Pastore S, Minute M, Parentin F, Tesser A, Nocerino A, Taddio A, Tommasini A, Nørgaard M, Herlin T, Alberdi-Saugstrup M, Zak MS, Nielsen SM, Herlin T, Nordal E, Berntson L, Fasth A, Rygg M, Müller KG, Avramovič MZ, Dolžan V, Toplak N, Avčin T, Ruperto N, Lovell DJ, Wallace C, Toth M. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461533 DOI: 10.1186/s12969-017-0142-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kimura Y, Grevich S, Beukelman T, Morgan E, Nigrovic PA, Mieszkalski K, Graham TB, Ibarra M, Ilowite N, Klein-Gitelman M, Onel K, Prahalad S, Punaro M, Ringold S, Toib D, Van Mater H, Weiss JE, Weiss PF, Schanberg LE. Pilot study comparing the Childhood Arthritis & Rheumatology Research Alliance (CARRA) systemic Juvenile Idiopathic Arthritis Consensus Treatment Plans. Pediatr Rheumatol Online J 2017; 15:23. [PMID: 28399931 PMCID: PMC5387287 DOI: 10.1186/s12969-017-0157-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 03/29/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To assess the feasibility of studying the comparative effectiveness of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) consensus treatment plans (CTPs) for systemic Juvenile Idiopathic Arthritis (JIA) using an observational registry. METHODS Untreated systemic JIA patients enrolled in the CARRA Registry were begun on one of 4 CTPs chosen by the treating physician and patient/family (glucocorticoid [GC] alone; methotrexate [MTX] ± GC; IL1 inhibitor [IL1i] ± GC; IL6 inhibitor [IL6i] ± GC). The primary outcome of clinical inactive disease (CID) without current GC use was assessed at 9 months. TRIAL REGISTRATION clinicaltrials.gov NCT01697254; first registered 9/28/12 (retrospectively enrolled). RESULTS Thirty patients were enrolled at 13 sites; eight patients were started on a non-biologic CTP (2 GC, 6 MTX) and 22 patients on a biologic CTP (12 IL1i, 10 IL6i) at disease onset. Demographic and disease features were similar between CTP groups. CTP choice appeared to segregate by site preference. CID off GC was achieved by 37% (11 of 30) including 11/22 (50%) starting a biologic CTP compared to 0/8 starting a non-biologic CTP (p = 0.014). There were four serious adverse events: two infections, one appendicitis and one macrophage activation syndrome. CONCLUSIONS The CARRA systemic JIA CTP pilot study demonstrated successful implementation of CTPs using the CARRA registry infrastructure. Having demonstrated feasibility, a larger study using CTP response to better determine the relative effectiveness of treatments for new-onset systemic JIA is now underway.
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Affiliation(s)
- Yukiko Kimura
- Pediatric rheumatology, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, 30 Prospect Ave, Hackensack, NJ, 07601, USA.
| | - Sriharsha Grevich
- grid.240741.4Pediatric rheumatology, Seattle Children’s Hospital, Seattle, USA
| | - Timothy Beukelman
- grid.265892.2Pediatric rheumatology, University of Alabama at Birmingham, Birmingham, USA
| | - Esi Morgan
- grid.239573.9Rheumatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
| | - Peter A. Nigrovic
- grid.62560.37Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, USA
| | - Kelly Mieszkalski
- Childhood Arthritis & Rheumatology Research Alliance, Milwaukee, USA
| | - T Brent Graham
- grid.152326.1Pediatric rheumatology, Vanderbilt University, Nashville, USA
| | - Maria Ibarra
- grid.239559.1Pediatric rheumatology, Children’s Mercy Hospital, Kansas City, USA
| | - Norman Ilowite
- grid.414114.5Pediatric rheumatology, Children’s Hospital at Montefiore, Bronx, NY USA
| | - Marisa Klein-Gitelman
- grid.413808.6Pediatric rheumatology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA
| | - Karen Onel
- grid.170205.1Pediatric rheumatology, University of Chicago, Chicago, USA
| | - Sampath Prahalad
- grid.189967.8Pediatric rheumatology, Emory University School of Medicine, Atlanta, USA
| | - Marilynn Punaro
- grid.416991.2Pediatric rheumatology, Texas Scottish Rite Hospital, Dallas, USA
| | - Sarah Ringold
- grid.240741.4Pediatric rheumatology, Seattle Children’s Hospital, Seattle, USA
| | - Dana Toib
- Pediatric rheumatology, St. Christopher’s Hospital, Philadelphia, USA
| | - Heather Van Mater
- grid.26009.3dPediatric rheumatology, Duke University, Durham, NC USA
| | - Jennifer E. Weiss
- grid.239835.6Pediatric rheumatology, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center, 30 Prospect Ave, Hackensack, NJ 07601 USA
| | - Pamela F. Weiss
- grid.239552.aPediatric rheumatology, Children’s Hospital of Philadelphia, Philadelphia, USA
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Ward TM, Beebe DW, Chen ML, Landis CA, Ringold S, Pike K, Wallace CA. Sleep Disturbances and Neurobehavioral Performance in Juvenile Idiopathic Arthritis. J Rheumatol 2017; 44:361-367. [PMID: 28089981 PMCID: PMC5334283 DOI: 10.3899/jrheum.160556] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine the extent of polysomnographic (PSG) sleep disturbances [obstructive apnea hypopnea index (OAHI), number of wake bouts, arousals, periodic limb movements] and the effect of OAHI on neurobehavioral performance in juvenile idiopathic arthritis (JIA) with obstructive sleep apnea (OSA), JIA without OSA, and controls without OSA, adjusting for intelligence quotient (IQ), pain, medications, daytime sleepiness, and wake bouts. METHODS Children 6-11 years, 68 with JIA and 67 controls, underwent 1 night of PSG and completed self-reported daytime sleepiness surveys, multiple sleep latency tests for physiological sleepiness, and neurobehavioral performance tests the next day. RESULTS Compared with JIA and controls without OSA, mean OAHI and arousals were significantly higher in JIA with OSA (p < 0.001, respectively). In comparison with JIA and controls without OSA, mean simple reaction time and sustained attention were significantly slower in JIA with OSA, adjusting for IQ, pain, any medication, daytime sleepiness, and wake bouts. CONCLUSION Elevated OAHI is suggestive of obstructive sleep apnea and a comorbidity in JIA that may predispose children with JIA to daytime sleepiness and impaired neurobehavioral performance.
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Affiliation(s)
- Teresa M Ward
- From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
- T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine.
| | - Dean W Beebe
- From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine
| | - Maida Lynn Chen
- From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine
| | - Carol A Landis
- From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine
| | - Sarah Ringold
- From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine
| | - Ken Pike
- From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine
| | - Carol A Wallace
- From the School of Nursing, University of Washington; Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine, Seattle, Washington; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- T.M. Ward, PhD, Associate Professor, School of Nursing, University of Washington; D.W. Beebe, PhD, ABPP, Professor, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine; M.L. Chen, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine; C.A. Landis, PhD, Professor, School of Nursing, University of Washington; S. Ringold, MS, MD, Associate Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine; K. Pike, PhD, Statistician, School of Nursing, University of Washington; C.A. Wallace, MD, Professor, Seattle Children's Hospital, Department of Pediatrics, Division of Rheumatology, University of Washington School of Medicine
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Horton DB, Onel KB, Beukelman T, Ringold S. Attitudes and Approaches for Withdrawing Drugs for Children with Clinically Inactive Nonsystemic JIA: A Survey of the Childhood Arthritis and Rheumatology Research Alliance. J Rheumatol 2017; 44:352-360. [PMID: 28148696 DOI: 10.3899/jrheum.161078] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the attitudes and strategies of pediatric rheumatology clinicians toward withdrawing medications for children with clinically inactive juvenile idiopathic arthritis (JIA). METHODS Members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) completed an anonymous electronic survey on decision making and approaches for withdrawing medications for inactive nonsystemic JIA. Data were analyzed using descriptive statistics. RESULTS Of 388 clinicians in CARRA, 124 completed surveys (32%), predominantly attending pediatric rheumatologists. The most highly ranked factors in decision making for withdrawing medications were the duration of clinical inactivity, drug toxicity, duration of prior activity, patient/family preferences, joint damage, and JIA category. Diagnoses of rheumatoid factor-positive polyarthritis and persistent oligoarthritis made respondents less likely and more likely, respectively, to withdraw JIA medications. Three-quarters of respondents waited for 6-12 months of inactive disease before stopping methotrexate (MTX) or biologics, but preferences varied. There was also considerable variability in the strategies used to reduce, taper, or stop medications for clinically inactive JIA; most commonly, clinicians reported slow medication tapers lasting at least 2 months. For children receiving combination MTX-biologic therapy, 63% of respondents preferred stopping MTX first. Most clinicians reported using imaging only seldom or sometimes to guide decision making, but most were also reluctant to withdraw medications in the presence of asymptomatic imaging abnormalities suggestive of subclinical inflammation. CONCLUSION Considerable variability exists among pediatric rheumatology clinicians regarding when and how to withdraw medications for children with clinically inactive JIA. More research is needed to identify the most effective approaches to withdraw medications and predictors of outcomes.
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Affiliation(s)
- Daniel B Horton
- From the Division of Pediatric Rheumatology, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey; Division of Pediatric Rheumatology, Department of Pediatrics, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Division of Pediatric Rheumatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama; Seattle Children's Hospital and Research Institute, University of Washington School of Medicine, Seattle, Washington, USA. .,D.B. Horton, MD, MSCE, Assistant Professor of Pediatrics, Division of Pediatric Rheumatology, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, Rutgers Biomedical and Health Sciences; K.B. Onel, MD, Chief, Division of Pediatric Rheumatology, Department of Pediatrics, Hospital for Special Surgery, Weill Cornell Medical College; T. Beukelman, MD, MSCE, Associate Professor, Division of Pediatric Rheumatology, Department of Pediatrics, University of Alabama at Birmingham; S. Ringold, MD, MS, Assistant Professor, Seattle Children's Hospital, University of Washington School of Medicine.
| | - Karen B Onel
- From the Division of Pediatric Rheumatology, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey; Division of Pediatric Rheumatology, Department of Pediatrics, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Division of Pediatric Rheumatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama; Seattle Children's Hospital and Research Institute, University of Washington School of Medicine, Seattle, Washington, USA.,D.B. Horton, MD, MSCE, Assistant Professor of Pediatrics, Division of Pediatric Rheumatology, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, Rutgers Biomedical and Health Sciences; K.B. Onel, MD, Chief, Division of Pediatric Rheumatology, Department of Pediatrics, Hospital for Special Surgery, Weill Cornell Medical College; T. Beukelman, MD, MSCE, Associate Professor, Division of Pediatric Rheumatology, Department of Pediatrics, University of Alabama at Birmingham; S. Ringold, MD, MS, Assistant Professor, Seattle Children's Hospital, University of Washington School of Medicine
| | - Timothy Beukelman
- From the Division of Pediatric Rheumatology, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey; Division of Pediatric Rheumatology, Department of Pediatrics, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Division of Pediatric Rheumatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama; Seattle Children's Hospital and Research Institute, University of Washington School of Medicine, Seattle, Washington, USA.,D.B. Horton, MD, MSCE, Assistant Professor of Pediatrics, Division of Pediatric Rheumatology, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, Rutgers Biomedical and Health Sciences; K.B. Onel, MD, Chief, Division of Pediatric Rheumatology, Department of Pediatrics, Hospital for Special Surgery, Weill Cornell Medical College; T. Beukelman, MD, MSCE, Associate Professor, Division of Pediatric Rheumatology, Department of Pediatrics, University of Alabama at Birmingham; S. Ringold, MD, MS, Assistant Professor, Seattle Children's Hospital, University of Washington School of Medicine
| | - Sarah Ringold
- From the Division of Pediatric Rheumatology, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey; Division of Pediatric Rheumatology, Department of Pediatrics, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York; Division of Pediatric Rheumatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama; Seattle Children's Hospital and Research Institute, University of Washington School of Medicine, Seattle, Washington, USA.,D.B. Horton, MD, MSCE, Assistant Professor of Pediatrics, Division of Pediatric Rheumatology, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Institute for Health, Health Care Policy and Aging Research, Rutgers Biomedical and Health Sciences; K.B. Onel, MD, Chief, Division of Pediatric Rheumatology, Department of Pediatrics, Hospital for Special Surgery, Weill Cornell Medical College; T. Beukelman, MD, MSCE, Associate Professor, Division of Pediatric Rheumatology, Department of Pediatrics, University of Alabama at Birmingham; S. Ringold, MD, MS, Assistant Professor, Seattle Children's Hospital, University of Washington School of Medicine
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Stoustrup P, Twilt M, Spiegel L, Kristensen KD, Koos B, Pedersen TK, Küseler A, Cron RQ, Abramowicz S, Verna C, Peltomäki T, Alstergren P, Petty R, Ringold S, Nørholt SE, Saurenmann RK, Herlin T. Clinical Orofacial Examination in Juvenile Idiopathic Arthritis: International Consensus-based Recommendations for Monitoring Patients in Clinical Practice and Research Studies. J Rheumatol 2017; 44:326-333. [PMID: 28089967 DOI: 10.3899/jrheum.160796] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To develop international consensus-based recommendations for the orofacial examination of patients with juvenile idiopathic arthritis (JIA), for use in clinical practice and research. METHODS Using a sequential phased approach, a multidisciplinary task force developed and evaluated a set of recommendations for the orofacial examination of patients with JIA. Phase 1: A Delphi survey was conducted among 40 expert physicians and dentists with the aim of identifying and ranking the importance of items for inclusion. Phase 2: The task force developed consensus about the domains and items to be included in the recommendations. Phase 3: A systematic literature review was performed to assess the evidence supporting the consensus-based recommendations. Phase 4: An independent group of orofacial and JIA experts were invited to assess the content validity of the task force's recommendations. RESULTS Five recommendations were developed to assess the following 5 domains: medical history, orofacial symptoms, muscle and temporomandibular joint function, orofacial function, and dentofacial growth. After application of data search criteria, 56 articles were included in the systematic review. The level of evidence for the 5 recommendations was derived primarily from descriptive studies, such as cross-sectional and case-control studies. CONCLUSION Five recommendations are proposed for the orofacial examination of patients with JIA to improve the clinical practice and aid standardized data collection for future studies. The task force has formulated a future research program based on the proposed recommendations.
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Affiliation(s)
- Peter Stoustrup
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland. .,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University.
| | - Marinka Twilt
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Lynn Spiegel
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Kasper Dahl Kristensen
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Bernd Koos
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Thomas Klit Pedersen
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Annelise Küseler
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Randy Q Cron
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Shelly Abramowicz
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Carlalberta Verna
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Timo Peltomäki
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Per Alstergren
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Ross Petty
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Sarah Ringold
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Sven Erik Nørholt
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
| | - Rotraud K Saurenmann
- From the Section of Orthodontics, and the Department of Oral and Maxillofacial Surgery, and the Department of Pediatrics, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary, Calgary, Alberta; Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada; the Specialist Oral Health Center for Western Norway, Rogaland, Stavanger, Norway; Department of Orthodontics, University of Rostock, Rostock, Germany; Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama; Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital, Tampere, Finland; Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden; Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada; Seattle Children's Hospital; Seattle, Washington, USA; Cantonal Hospital Wintherthur, University of Zürich, Zürich, Switzerland.,P. Stoustrup, DDS, PhD, Section of Orthodontics, Aarhus University; M. Twilt, MD, PhD, Department of Pediatrics, Division of Rheumatology, Alberta Children's Hospital, University of Calgary; L. Spiegel, MD, FRCPC, Division of Rheumatology, The Hospital for Sick Children; K.D. Kristensen, DDS, PhD, Specialist Oral Health Center for Western Norway; B. Koos, DMD, Department of Orthodontics, University of Rostock; T.K. Pedersen, DDS, PhD, Department of Oral and Maxillofacial Surgery, and Section of Orthodontics, Aarhus University; A. Küseler, DDS, PhD, Section of Orthodontics, Aarhus University; R.Q. Cron, MD, PhD, Division of Pediatric Rheumatology, University of Alabama at Birmingham; S. Abramowicz, DMD, MPH, Oral and Maxillofacial Surgery and Pediatrics, Emory University, and Children's Healthcare of Atlanta; C. Verna, DDS, PhD, Clinic for Orthodontics and Pediatric Dentistry, University Center for Dental Medicine, University of Basel; T. Peltomäki, DDS, PhD, Field of Dentistry, School of Medicine, University of Tampere and Oral and Maxillofacial Unit, Tampere University Hospital; P. Alstergren, DDS, PhD, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Scandinavian Center for Orofacial Neurosciences; R. Petty, MD, PhD, FRCPC, Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital; S. Ringold, MD, Division of Rheumatology, Seattle Children's Hospital; S.E. Nørholt, DDS, PhD, Department of Oral and Maxillofacial Surgery, Aarhus University Hospital; R.K. Saurenmann, MD, Cantonal Hospital Wintherthur, University of Zürich; T. Herlin, MD, DMSc, Department of Pediatrics, Aarhus University
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Ward TM, Chen ML, Landis CA, Ringold S, Beebe DW, Pike KC, Wallace CA. Congruence between polysomnography obstructive sleep apnea and the pediatric sleep questionnaire: fatigue and health-related quality of life in juvenile idiopathic arthritis. Qual Life Res 2016; 26:779-788. [PMID: 27987106 DOI: 10.1007/s11136-016-1475-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To examine the congruence between polysomnography obstructive apnea hypopnea index (OAHI) and parent-reported obstructive sleep apnea (OSA) symptoms in 6- to 11-year-old children with juvenile idiopathic arthritis (JIA) and controls; and to compare fatigue and quality of life in JIA and control children based on OAHI and OSA symptoms. METHODS Sixty-eight children with JIA and 75 controls and a parent participated. Children underwent one night of polysomnography in a sleep laboratory. Parents completed the sleep-related breathing disorders scale-pediatric sleep questionnaire (PSQ), and both children and parents completed the Pediatric Quality of Life Generic Core Scale and the Multidimensional Fatigue Scale. RESULTS In JIA, 86% who met the OAHI clinical criteria for OSA (≥1.5) were above the PSQ OSA symptom cut-off score with a sensitivity of 0.86 and a specificity of 0.28. In the control group, 63% who met the OAHI clinical criteria for OSA were above the PSQ OSA symptom cut-off score, with a sensitivity of 0.63 and a specificity of 0.42. All children above both the clinical criteria for OAHI and OSA symptom cut-off score had the most impaired quality of life and greater fatigue compared to those below both the clinical criteria for OAHI and the OSA symptom cut-off score. CONCLUSION Children who meet clinical criteria for OSA and also scored high on a parent-reported screening tool for OSA symptoms had the most impaired quality of life and more fatigue. The PSQ has potential to identify children at risk for OSA.
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Affiliation(s)
- Teresa M Ward
- Department of Family and Child Nursing, School of Nursing, University of Washington, Box 357262, Seattle, WA, 98195-7266, USA.
| | - Maida Lynn Chen
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Carol A Landis
- Department of Family and Child Nursing, School of Nursing, University of Washington, Box 357262, Seattle, WA, 98195-7266, USA
| | - Sarah Ringold
- Division of Rheumatology, Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Dean W Beebe
- Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kenneth C Pike
- Department of Family and Child Nursing, School of Nursing, University of Washington, Box 357262, Seattle, WA, 98195-7266, USA
| | - Carol A Wallace
- Division of Rheumatology, Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
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Fotis L, Shaikh N, Baszis K, French A, Tarr P, Grevich S, Lee P, Ringold S, Leroux B, Leahey H, Yuasa M, Foster J, Sokolove J, Lahey L, Robinson W, Newsom J, Stevens A, Karasawa R, Tamaki M, Tanaka M, Sato T, Yudoh K, Jarvis JN, Moncrieffe H, Bennett MF, Tsoras M, Luyrink L, Xu H, Prahalad S, Morris P, Dare J, Nigrovic PA, Rosenkranz M, Becker M, O’Neil KM, Griffin T, Lovell DJ, Grom AA, Medvedovic M, Thompson SD, Zhu L, Jiang K, Wong L, Buck MJ, Chen Y, Moncrieffe H, Brungs L, Liu T, Wang T, Jarvis JN, Alsaeid K, Alfailakawi J, Alenezi H, Alsaeed H, Beukelman T, Natter M, Ilowite N, Mieszkalski K, Burrell G, Best B, Bristow H, Carr S, Dennos A, Kaufmann R, Kimura Y, Schanberg L, Blier PR, Boneparth A, Wenderfer SE, Moorthy LN, Radhakrishna SM, Sagcal-Gironella ACP, von Scheven E, Gedik KC, Siddique S, Aguiar CL, Erkan D, Cohen E, Lee Y, Dossett M, Mehta D, Davis R, Gilbert M, Goilav B, Meidan E, Hsu J, Boneparth A, Chua A, Ardoin S, Wenderfer SE, Von Scheven E, Ruth NM, Hui-Yuen J, Gedik KC, Bermudez L, Cook A, Imundo L, Starr A, Eichenfield A, Askanase A, Janow G, Schanberg LE, Setoguchi S, Hasselblad V, Mellins ED, Schneider R, Kimura Y, Kimura Y, Grevich S, Beukelman T, Morgan E, Graham TB, Ibarra M, Ruas YS, Klein-Gitelman M, Onel K, Prahalad S, Punaro M, Ringold S, Toib D, Van Mater H, Weiss JE, Weiss PF, Mieszkalski K, Schanberg LE, Kwok TSH, Bisaillon J, Smith C, Brosseau L, Stinson J, Huber AM, Duffy CM, April KT, Lewandowski LB, Scott C, Li SC, Torok KS, Rabinovich CE, Hong SD, Becker ML, Dedeoglu F, Ibarra MF, Ferguson PJ, Fuhbrigge RC, Stewart KG, Pope E, Laxer RM, Mason TG, Higgins GC, Li X, Punaro MG, Tomlinson G, Pullenayegum E, Matelski J, Schanberg L, Feldman BM, Manthiram K, Correa H, Edwards K, Oberle EJ, Bayer M, Co DO, Baris HE, Chiu Y, Huber A, Kim S, Oberle EJ, Beukelman T, Orandi AB, Baszis KW, Dharnidharka V, Hoeltzel MF, Reed A, Huber A, Tomlinson G, Pullenayegum E, Matelski J, Goh YI, Schanberg L, Feldman BM, Schnabel A, Range U, Hahn G, Siepmann T, Berner R, Hedrich CM, Stevens B, Torok KS, Li S, Hershey N, Curran M, Higgins G, Moore K, Rabinovich E, Stevens AM, Stinson J, Connelly M, Huber A, Luca N, Spiegel L, Tsimicalis A, Luca S, Tajuddin N, Berard R, Barsalou J, Campillo S, Dancey P, Duffy C, Feldman B, Johnson N, McGrath P, Shiff N, Tse S, Tucker L, Victor C, Stinson J, Lalloo C, Harris L, Cafazzo J, Spiegel L, Feldman B, Luca N, Laxer R, Bullock DR, Vehe RK, Zhang L, Correll CK, Ganguli S, Shenberger M, Korumilli R, Gottlieb B, Rodriguez M, de Ranieri D, Onel K, Wagner-Weiner L, Tesher M, Wojcicki ER, Maletta KL, Co DO, Malloy M, Thomson S, Olson JC, Wenderfer SE, Gilbert M, Hsu J, Sule S, Rubinstein TB, Goilav B, Okamura DM, Chua A, Greenbaum LA, Lane JC, von Scheven E, Ardoin SP, Ruth NM, Woo JMP, Malloy MM, Jegers JA, Hahn DJ, Hintermeyer MK, Martinetti SM, Heckel GR, Roth-Wojcicki EL, Co DO. Proceedings of the 2016 Childhood Arthritis and Rheumatology Research Alliance (CARRA) Scientific Meeting : Toronto, Canada. 14-17 April 2016. Pediatr Rheumatol Online J 2016; 14 Suppl 1:41. [PMID: 27409414 PMCID: PMC4943514 DOI: 10.1186/s12969-016-0098-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
P1 Serologic evidence of gut-driven systemic inflammation in juvenile idiopathic arthritis Lampros Fotis, Nur Shaikh, Kevin Baszis, Anthony French, Phillip Tarr P2 Oral health and anti-citrullinated peptide antibodies (ACPA) in juvenile idiopathic arthritis Sriharsha Grevich, Peggy Lee, Sarah Ringold, Brian Leroux, Hannah Leahey, Megan Yuasa, Jessica Foster, Jeremy Sokolove, Lauren Lahey, William Robinson, Joshua Newsom, Anne Stevens P3 Novel autoantigens for endothelial cell antibodies in pediatric rheumatic diseases identified by proteomics Rie Karasawa, Mayumi Tamaki, Megumi Tanaka, Toshiko Sato, Kazuo Yudoh, James N. Jarvis P4 Transcriptional profiling reveals monocyte signature associated with JIA patient poor response to methotrexate Halima Moncrieffe, Mark F. Bennett, Monica Tsoras, Lorie Luyrink, Huan Xu, Sampath Prahalad, Paula Morris, Jason Dare, Peter A. Nigrovic, Margalit Rosenkranz, Mara Becker, Kathleen M. O’Neil, Thomas Griffin, Daniel J. Lovell, Alexei A. Grom, Mario Medvedovic, Susan D. Thompson P5 A multi-dimensional genomic map for polyarticular juvenile idiopathic arthritis Lisha Zhu, Kaiyu Jiang, Laiping Wong, Michael J Buck, Yanmin Chen, Halima Moncrieffe, Laura Brungs, Tao Liu, Ting Wang, James N Jarvis P6 Tocilizumab for treatment of children with refractory JIA Khaled Alsaeid, Jasim Alfailakawi, Hamid Alenezi, Hazim Alsaeed P7 Clinical characteristics of the initial patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry Tim Beukelman, Marc Natter, Norm Ilowite, Kelly Mieszkalski, Grendel Burrell, Brian Best, Helen Bristow, Shannon Carr, Anne Dennos, Rachel Kaufmann, Yukiko Kimura, Laura Schanberg P8 Comparative performance of small and large clinical centers in a comprehensive pediatric rheumatology disease registry Peter R Blier P9 Clinical characteristics of children with membranous lupus nephritis: The Childhood Arthritis and Rheumatology Research Alliance Legacy Registry Alexis Boneparth, Scott E. Wenderfer, L. Nandini Moorthy, Suhas M. Radhakrishna, Anna Carmela P. Sagcal-Gironella, Emily von Scheven P10 Rituximab use in pediatric lupus anticoagulant hypoprothrombinemia syndrome - a two center experience Kader Cetin Gedik, Salma Siddique, Cassyanne L. Aguiar, Doruk Erkan P11 Predictors of complementary and alternative medicine use and response in children with musculoskeletal conditions Ezra Cohen, Yvonne Lee, Michelle Dossett, Darshan Mehta, Roger Davis P12 Comparison of pediatric rheumatology and nephrology survey results for the treatment of refractory proliferative lupus nephritis and renal flare in juvenile SLE Mileka Gilbert, Beatrice Goilav, Esra Meidan, Joyce Hsu, Alexis Boneparth, Anabelle Chua, Stacy Ardoin, Scott E. Wenderfer, Emily Von Scheven, Natasha M. Ruth P13 Transitioning lupus patients from pediatric to adult rheumatology Joyce Hui-Yuen, Kader Cetin Gedik, Liza Bermudez, Ashlea Cook, Lisa Imundo, Amy Starr, Andrew Eichenfield, Anca Askanase P14 The systemic juvenile idiopathic arthritis cohort of the Childhood Arthritis & Rheumatology Research Alliance Registry Ginger Janow, Laura E. Schanberg, Soko Setoguchi, Victor Hasselblad, Elizabeth D. Mellins, Rayfel Schneider, Yukiko Kimura, The CARRA Legacy Registry Investigators P15 Results of the pilot study of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) consensus treatment plans for new-onset systemic juvenile idiopathic arthritis Yukiko Kimura, Sriharsha Grevich, Timothy Beukelman, Esi Morgan, T Brent Graham, Maria Ibarra, Yonit Sterba Ruas, Marisa Klein-Gitelman, Karen Onel, Sampath Prahalad, Marilynn Punaro, Sarah Ringold, Dana Toib, Heather Van Mater, Jennifer E. Weiss, Pamela F. Weiss, Kelly Mieszkalski, Laura E. Schanberg P16 A systemic review of pain relief modalities in juvenile idiopathic arthritis: First step in developing a novel decision support intervention Timothy S. H. Kwok, Jacinthe Bisaillon, Christine Smith, Lucie Brosseau, Jennifer Stinson, Adam M. Huber, Ciaran M. Duffy, Karine Toupin April P17 Barriers and facilitators to care retention for pediatric systemic lupus erythematous patients in South Africa: A qualitative study Laura B Lewandowski, Christiaan Scott P18 Evaluating the feasibility of conducting comparative effectiveness studies in juvenile Localized Scleroderma (jLS) Suzanne C. Li, Kathryn S. Torok, C. Egla Rabinovich, Sandy D. Hong, Mara L Becker, Fatma Dedeoglu, Maria F. Ibarra, Polly J Ferguson, Rob C. Fuhbrigge, Katie G. Stewart, Elena Pope, Ronald M. Laxer, Thomas G. Mason, Gloria C. Higgins, Xiaohu Li, Marilynn G. Punaro, George Tomlinson, Eleanor Pullenayegum, John Matelski, Laura Schanberg, Brian M. Feldman P19 Tonsillar histology in patients with periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome Kalpana Manthiram, Hernan Correa, Kathryn Edwards P20 Clinical course of juvenile dermatomyositis presenting as skin predominant disease Edward J. Oberle, Michelle Bayer, Dominic O. Co, Hatice Ezgi Baris, Yvonne Chiu, Adam Huber, Susan Kim P21 A Survey of musculoskeletal ultrasound practices of pediatric rheumatologists in North America Edward J Oberle, Timothy Beukelman P22 Assessment, classification and treatment of calcinosis as a complication of juvenile dermatomyositis: A survey of pediatric rheumatologists by the Childhood Arthritis and Rheumatology Research Alliance Amir B. Orandi, Kevin W. Baszis, Vikas Dharnidharka, Mark F. Hoeltzel, for the CARRA JDM Committee P23 CARRA dermatomyositis CTP pilot study Ann Reed, Adam Huber, George Tomlinson, Eleanor Pullenayegum, John Matelski, Y. Ingrid Goh, Laura Schanberg, Brian M. Feldman P24 Unexpectedly high incidences and prolonged disease activity in children with chronic non-bacterial osteomyelitis (CNO) as compared to bacterial osteomyelitis Anja Schnabel, Ursula Range, Gabriele Hahn, Timo Siepmann, Reinhard Berner, Christian Michael Hedrich P25 Juvenile systemic sclerosis cohort within the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry: Follow up characteristics Brandi Stevens, Kathryn S. Torok, Suzanne Li, Nicole Hershey, Megan Curran, Gloria Higgins, Katharine Moore, Egla Rabinovich, Anne M. Stevens, for the CARRA Registry Investigators P26 Development and usability testing of an iPad and desktop psycho-educational game for children with Juvenile Idiopathic Arthritis and their parents Jennifer Stinson, Mark Connelly, Adam Huber, Nadia Luca, Lynn Spiegel, Argerie Tsimicalis, Stephanie Luca, Naweed Tajuddin, Roberta Berard, Julia Barsalou, Sarah Campillo, Paul Dancey, Ciaran Duffy, Brian Feldman, Nicole Johnson, Patrick McGrath, Natalie Shiff, Shirley Tse, Lori Tucker, Charles Victor P27 iCanCopeTM: User-centred design and development of a smartphone app to support self-management for youth with arthritis pain Jennifer Stinson, Chitra Lalloo, Lauren Harris, Joseph Cafazzo, Lynn Spiegel, Brian Feldman, Nadia Luca, Ronald Laxer P28 Accessing pediatric rheumatology care: Despite barriers, few parents prefer telemedicine Danielle R. Bullock, Richard K. Vehe, Lei Zhang, Colleen K. Correll1 P29 Exploration of factors contributing to time to achieve clinically inactive disease (CID) in juvenile idiopathic arthritis (JIA): A preliminary report Suhas Ganguli, Max Shenberger, Ritesh Korumilli, Beth Gottlieb P30 Pediatric rheumatology referral patterns: Presenting complaints of new patients at a large, urban academic center Martha Rodriguez, Deirdre de Ranieri, Karen Onel, Linda Wagner-Weiner, Melissa Tesher P31 Quality improvement (QI) initiatives in childhood systemic lupus erythematosus (cSLE) Elizabeth Roth Wojcicki, Kristyn L. Maletta, Dominic O. Co, Marsha Malloy, Sarah Thomson, Judyann C. Olson P32 Proliferative lupus nephritis in juvenile SLE: Support from the pediatric nephrology community for the definitions of responsiveness and flare in the 2012 consensus treatment plans Scott E. Wenderfer, Mileka Gilbert, Joyce Hsu, Sangeeta Sule, Tamar B. Rubinstein, Beatrice Goilav, Daryl M. Okamura, Annabelle Chua, Laurence A. Greenbaum, Jerome C. Lane, Emily von Scheven, Stacy P. Ardoin, Natasha M. Ruth P33 The steroid taper app: Making of a mobile app Jennifer M. P. Woo, Marsha M. Malloy, James A. Jegers, Dustin J. Hahn, Mary K. Hintermeyer, Stacey M. Martinetti, Gretchen R. Heckel, Elizabeth L. Roth-Wojcicki, Dominic O. Co
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Affiliation(s)
- Lampros Fotis
- Washington University School of Medicine, St Louis, Missouri USA
| | - Nur Shaikh
- Washington University School of Medicine, St Louis, Missouri USA
| | - Kevin Baszis
- Washington University School of Medicine, St Louis, Missouri USA
| | - Anthony French
- Washington University School of Medicine, St Louis, Missouri USA
| | - Phillip Tarr
- Washington University School of Medicine, St Louis, Missouri USA
| | - Sriharsha Grevich
- Department of Pediatrics, Division of Rheumatology, University of Washington, Seattle, WA USA
| | - Peggy Lee
- Department of Oral Medicine, University of Washington, Seattle, WA USA
| | - Sarah Ringold
- Department of Rheumatology, Seattle Children’s Hospital, Seattle, WA USA
| | - Brian Leroux
- Department of Oral Health Sciences, University of Washington, Seattle, WA USA
| | | | | | | | - Jeremy Sokolove
- Department of Medicine, Division of Immunology and Rheumatology, Stanford University, Stanford, CA USA
| | - Lauren Lahey
- Department of Medicine, Division of Immunology and Rheumatology, Stanford University, Stanford, CA USA
| | - William Robinson
- Department of Medicine, Division of Immunology and Rheumatology, Stanford University, Stanford, CA USA
| | | | - Anne Stevens
- Department of Pediatrics, Division of Rheumatology, University of Washington, Seattle, WA USA ,Seattle Children’s Research Institute, Seattle, WA USA
| | - Rie Karasawa
- St. Marianna University School of Medicine, Kawasaki, Japan
| | - Mayumi Tamaki
- St. Marianna University School of Medicine, Kawasaki, Japan
| | - Megumi Tanaka
- St. Marianna University School of Medicine, Kawasaki, Japan
| | - Toshiko Sato
- St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kazuo Yudoh
- St. Marianna University School of Medicine, Kawasaki, Japan
| | - James N. Jarvis
- University at Buffalo, State University of New York, Buffalo, NY USA
| | - Halima Moncrieffe
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,University of Cincinnati, Cincinnati, OH USA
| | | | - Monica Tsoras
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Lorie Luyrink
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Huan Xu
- University of Cincinnati, Cincinnati, OH USA
| | | | - Paula Morris
- Arkansas Children’s Hospital Research Institute, Little Rock, AR USA
| | - Jason Dare
- Arkansas Children’s Hospital Research Institute, Little Rock, AR USA
| | | | | | - Mara Becker
- Children’s Mercy Hospital, Kansas City, MO USA
| | | | | | - Daniel J. Lovell
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Alexei A. Grom
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | | | - Susan D. Thompson
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,University of Cincinnati, Cincinnati, OH USA
| | - Lisha Zhu
- University at Buffalo, The State University of New York, Buffalo, NY USA
| | - Kaiyu Jiang
- University at Buffalo, The State University of New York, Buffalo, NY USA
| | - Laiping Wong
- University at Buffalo, The State University of New York, Buffalo, NY USA
| | - Michael J Buck
- University at Buffalo, The State University of New York, Buffalo, NY USA
| | - Yanmin Chen
- University at Buffalo, The State University of New York, Buffalo, NY USA
| | | | | | - Tao Liu
- University at Buffalo, The State University of New York, Buffalo, NY USA
| | - Ting Wang
- Washington University, St. Louis, MO USA
| | - James N Jarvis
- University at Buffalo, The State University of New York, Buffalo, NY USA
| | - Khaled Alsaeid
- Department of Pediatrics, Kuwait University, Kuwait City, Kuwait ,Mubarak Hospital, Jabriya, Kuwait
| | | | | | | | - Tim Beukelman
- University of Alabama at Birmingham, Birmingham, AL USA
| | - Marc Natter
- Tufts University, Medford, MA USA ,Harvard University, Boston, MA USA
| | - Norm Ilowite
- The Children’s Hospital at Montefiore, Bronx, NY USA
| | | | | | | | | | | | | | | | - Yukiko Kimura
- Hackensack University Medical Center, Hackensack, NJ USA
| | | | - Peter R. Blier
- Baystate Children’s Hospital, Springfield, MA USA ,Tufts University School of Medicine, Boston, MA USA
| | - Alexis Boneparth
- Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ USA
| | | | | | | | | | | | | | - Salma Siddique
- Hospital for Special Surgery-Weill Cornell Medical Center, New York, NY USA
| | | | - Doruk Erkan
- Hospital for Special Surgery-Weill Cornell Medical Center, New York, NY USA
| | - Ezra Cohen
- Boston Children’s Hospital, Boston, MA USA
| | - Yvonne Lee
- Brigham and Women’s Hospital, Boston, MA USA
| | | | | | | | - Mileka Gilbert
- Medical University of South Carolina, Charleston, SC USA
| | | | | | - Joyce Hsu
- Stanford University, Stanford, CA USA
| | | | | | - Stacy Ardoin
- Nationwide Children’s Hospital, Columbus, OH USA
| | | | | | | | - Joyce Hui-Yuen
- Division of Pediatric Rheumatology, Cohen Children’s Medical Center, New Hyde Park, NY USA
| | - Kader Cetin Gedik
- Division of Pediatric Rheumatology, Cohen Children’s Medical Center, New Hyde Park, NY USA
| | - Liza Bermudez
- Division of Pediatric Rheumatology, Morgan Stanley Children’s Hospital of New York-Presbyterian, Columbia University Medical Center, New York, NY USA
| | - Ashlea Cook
- Division of Pediatric Rheumatology, Morgan Stanley Children’s Hospital of New York-Presbyterian, Columbia University Medical Center, New York, NY USA
| | - Lisa Imundo
- Division of Adult Rheumatology, Columbia University Medical Center, New York, NY USA
| | - Amy Starr
- Division of Pediatric Rheumatology, Morgan Stanley Children’s Hospital of New York-Presbyterian, Columbia University Medical Center, New York, NY USA
| | - Andrew Eichenfield
- Division of Pediatric Rheumatology, Morgan Stanley Children’s Hospital of New York-Presbyterian, Columbia University Medical Center, New York, NY USA
| | - Anca Askanase
- Division of Adult Rheumatology, Columbia University Medical Center, New York, NY USA
| | - Ginger Janow
- Pediatrics, Joseph M Sanzari Children’s Hospital, Hackensack, NJ USA
| | - Laura E. Schanberg
- Pediatrics, Duke University, Durham, NC USA ,Duke Clinical Research Institute, Durham, NC USA
| | | | | | | | - Rayfel Schneider
- Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Yukiko Kimura
- Pediatrics, Joseph M Sanzari Children’s Hospital, Hackensack, NJ USA
| | | | - Yukiko Kimura
- Hackensack University Medical Center, Hackensack, NJ USA
| | | | | | - Esi Morgan
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | | | | | | | | | - Karen Onel
- Comer Children’s Hospital of Chicago, Chicago, IL USA
| | | | | | | | - Dana Toib
- St. Christopher’s Hospital for Children, Philadelphia, PA USA
| | | | | | | | | | | | - Timothy S. H. Kwok
- Undergraduate Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, Ontario Canada
| | - Jacinthe Bisaillon
- School of Nursing Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario Canada
| | - Christine Smith
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario Canada
| | - Lucie Brosseau
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario Canada
| | - Jennifer Stinson
- Hospital for Sick Children, Lawrence S. Bloomberg Faculty of Nursing University of Toronto, Toronto, Ontario Canada
| | - Adam M. Huber
- Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia Canada
| | - Ciaran M. Duffy
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario Canada
| | - Karine Toupin April
- Department of Pediatrics, Children’s Hospital of Eastern Ontario Research Institute, Faculty of Medicine, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario Canada
| | - Laura B. Lewandowski
- Pediatric Rheumatology, Duke University Medical Center, Durham, NC USA ,Duke Global Health Institute, Duke University, Durham, NC USA ,Paediatric Rheumatology, Red Cross War Memorial Children’s Hospital and University of Cape Town, Cape Town, South Africa ,National Institute of Arthritis, Musculoskeletal, and Skin Diseases, NIH, Bethesda, MD USA
| | - Christiaan Scott
- Paediatric Rheumatology, Red Cross War Memorial Children’s Hospital and University of Cape Town, Cape Town, South Africa
| | - Suzanne C. Li
- Hackensack University Medical Center, Hackensack, NJ USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xiaohu Li
- Stevens Institute of Technology, Hoboken, NJ USA
| | | | | | | | | | | | | | - Kalpana Manthiram
- Division of Pediatric Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN USA
| | - Hernan Correa
- Department of Pathology, Immunology, and Microbiology, Vanderbilt University School of Medicine, Nashville, TN USA
| | - Kathryn Edwards
- Division of Pediatric Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN USA
| | - Edward J. Oberle
- Nationwide Children’s Hospital, The Ohio State University, Columbus, OH USA
| | - Michelle Bayer
- Children’s Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI USA
| | - Dominic O. Co
- Children’s Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI USA
| | | | - Yvonne Chiu
- Children’s Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI USA
| | - Adam Huber
- IWK Health Centre, Dalhousie University, Halifax, NS Canada
| | - Susan Kim
- Boston Children’s Hospital, Boston, MA USA ,Harvard Medical School, Boston, MA USA
| | - Edward J. Oberle
- Nationwide Children’s Hospital, Columbus, OH USA ,The Ohio State University, Columbus, OH USA
| | | | - Amir B. Orandi
- St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis, MO USA
| | - Kevin W. Baszis
- St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis, MO USA
| | - Vikas Dharnidharka
- St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis, MO USA
| | - Mark F. Hoeltzel
- Mott Children’s Hospital, University of Michigan Medical School, Ann Arbor, MI USA
| | | | | | - Adam Huber
- Dalhousie University, Halifax, NS Canada
| | | | | | | | | | | | | | - Anja Schnabel
- Pediatric Rheumatology and Immunology, Children’s Hospital Dresden, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ursula Range
- Institute for Medical Informatics and Biometry, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Gabriele Hahn
- Department of Radiology, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Timo Siepmann
- Division of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, Dresden, Germany
| | - Reinhard Berner
- Pediatric Rheumatology and Immunology, Children’s Hospital Dresden, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian Michael Hedrich
- Pediatric Rheumatology and Immunology, Children’s Hospital Dresden, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Brandi Stevens
- Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA USA
| | | | - Suzanne Li
- Hackensack University Medical Center, Hackensack, NJ USA
| | - Nicole Hershey
- Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA USA
| | - Megan Curran
- Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | | | | | | | - Anne M. Stevens
- Seattle Children’s Research Institute, University of Washington, Seattle, WA USA
| | | | - Jennifer Stinson
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Mark Connelly
- University of Kansas Medical Center, Kansas City, MO USA
| | - Adam Huber
- IWK Health Centre, Halifax, Nova Scotia Canada
| | - Nadia Luca
- Alberta Children’s Hospital, Calgary, Alberta Canada
| | - Lynn Spiegel
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | | | - Stephanie Luca
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Naweed Tajuddin
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | | | | | | | - Paul Dancey
- Memorial University of Newfoundland, Newfoundland, Canada
| | - Ciaran Duffy
- Children’s Hospital of Eastern Ontario, Ottawa, Canada
| | - Brian Feldman
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | | | | | | | - Shirley Tse
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Lori Tucker
- British Columbia Children’s Hospital, Vancouver, British Columbia Canada
| | | | | | | | - Lauren Harris
- The Hospital for Sick Children, Toronto, Canada ,University of Toronto, Toronto, Canada ,Centre for Global eHealth Innovation, Toronto, Canada
| | | | | | | | - Nadia Luca
- Alberta Children’s Hospital, Calgary, Alberta Canada
| | | | - Danielle R. Bullock
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, MN USA
| | - Richard K. Vehe
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, MN USA
| | - Lei Zhang
- Clinical and Translational Sciences Institute, University of Minnesota, Minneapolis, MN USA
| | - Colleen K. Correll
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, MN USA
| | - Suhas Ganguli
- Pediatric Rheumatology, Cohen Children’s Medical Center, New York, NY 11040 USA
| | - Max Shenberger
- Pediatric Rheumatology, Cohen Children’s Medical Center, New York, NY 11040 USA
| | - Ritesh Korumilli
- Pediatrics, Flushing Hospital Medical Center, New York, NY 11355 USA
| | - Beth Gottlieb
- Pediatric Rheumatology, Cohen Children’s Medical Center, New York, NY 11040 USA
| | - Martha Rodriguez
- University of Chicago Medicine Comer Children’s Hospital, Chicago, IL USA
| | - Deirdre de Ranieri
- University of Chicago Medicine Comer Children’s Hospital, Chicago, IL USA
| | - Karen Onel
- University of Chicago Medicine Comer Children’s Hospital, Chicago, IL USA
| | | | - Melissa Tesher
- University of Chicago Medicine Comer Children’s Hospital, Chicago, IL USA
| | | | | | | | | | | | | | | | - Mileka Gilbert
- Medical University of South Carolina, Charleston, SC USA
| | - Joyce Hsu
- Stanford University, Stanford, CA USA
| | - Sangeeta Sule
- Johns Hopkins Children’s Hospital, Baltimore, MD USA
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Yuwen W, Chen ML, Cain KC, Ringold S, Wallace CA, Ward TM. Daily Sleep Patterns, Sleep Quality, and Sleep Hygiene Among Parent-Child Dyads of Young Children Newly Diagnosed With Juvenile Idiopathic Arthritis and Typically Developing Children. J Pediatr Psychol 2016; 41:651-60. [PMID: 26994855 DOI: 10.1093/jpepsy/jsw007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 01/23/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Describe daily sleep patterns, sleep quality, and sleep hygiene in 2-5-year-old children newly diagnosed with juvenile idiopathic arthritis (JIA) and their parents in comparison with typically developing (TD) children and parents. METHODS Participants (13 JIA, 16 TD parent-child dyads) wore actigraphs for 10 days. Parents completed sleep diaries and sleep hygiene survey. RESULTS Children with JIA had significantly less total sleep time, lower sleep efficiency (SE), and longer naps than TD children. Parents of children with JIA had significantly earlier bedtimes, more wake after sleep onset (WASO) and lower SE than TD parents. Parent-child SE and WASO were interrelated in JIA dyads. Sleep hygiene practices were inconsistent in both groups of children. CONCLUSIONS Inadequate amounts of sleep and poor sleep quality were common in parent-child dyads. Early interventions to improve sleep duration and promote sleep hygiene practices may alleviate future sleep problems and improve parent and child well-being.
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Affiliation(s)
| | - Maida Lynn Chen
- Division of Pulmonary and Sleep Medicine, Seattle Children's Hospital, Department of Pediatrics, School of Medicine, University of Washington, and
| | | | - Sarah Ringold
- Department of Pediatrics, School of Medicine, University of Washington, and Division of Rheumatology, Seattle Children's Hospital
| | - Carol A Wallace
- Department of Pediatrics, School of Medicine, University of Washington, and Division of Rheumatology, Seattle Children's Hospital
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47
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Abstract
OBJECTIVES (1) To compare sleep (nighttime sleep duration and sleep efficiency) and sleep fragmentation (movement and fragmentation index), as measured by actigraphy, and symptoms (pain and fatigue) in 8- to 14-year-old children with polyarticular and extended oligoarticular juvenile idiopathic arthritis (JIA) and (2) to examine the associations between sleep fragmentation (movement and fragmentation index) and the calcium-binding protein biomarkers S100A12 and myeloid-related protein (MRP8/14). METHOD Participants included 40 children with extended oligoarticular (n = 15) or polyarticular (n = 25) JIA and their parents. Serum protein samples were obtained during routine rheumatology clinic visits. Children completed the PedsQL Multidimensional Fatigue Scale and daily pain and sleep diaries and wore actigraphy monitors for 9 consecutive days. Parents completed the Children's Sleep Habits Questionnaire (CSHQ). RESULTS Of the 40 children, 68% scored above the CSHQ clinical cutoff score for sleep disturbances. Mean nighttime sleep duration was 7.5 hr, and mean sleep efficiency was 85.3%. Group differences were not found for nighttime sleep duration, sleep efficiency, movement and fragmentation index, or S100A12 and MRP8/14 protein concentrations. In a stepwise regression, medications, joint count, and movement and fragmentation index explained 21% of the variance in MRP8/14 concentration. CONCLUSION Decreased nighttime sleep duration, poor sleep efficiency, and fragmented sleep were observed in our sample, regardless of JIA category. Sleep fragmentation was a significant predictor of MRP8/14 protein concentration. Additional research is needed to understand the interrelations among sleep fragmentation, effects of medication, and S100A12 and MRP8/14 protein biomarkers in JIA.
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Affiliation(s)
- Teresa M Ward
- Department of Family and Child Nursing, School of Nursing, University of Washington, Seattle, WA, USA
| | - Weichao Yuwen
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Joachim Voss
- Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA, USA
| | - Dirk Foell
- Pediatric Rheumatology and Immunology, University Children's Hospital, Muenster, Germany
| | - Faekah Gohar
- Pediatric Rheumatology and Immunology, University Children's Hospital, Muenster, Germany
| | - Sarah Ringold
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
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48
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Aggarwal R, Ringold S, Khanna D, Neogi T, Johnson SR, Miller A, Brunner HI, Ogawa R, Felson D, Ogdie A, Aletaha D, Feldman BM. Distinctions between diagnostic and classification criteria? Arthritis Care Res (Hoboken) 2015; 67:891-7. [PMID: 25776731 DOI: 10.1002/acr.22583] [Citation(s) in RCA: 332] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 02/27/2015] [Accepted: 03/10/2015] [Indexed: 12/26/2022]
Affiliation(s)
| | | | | | - Tuhina Neogi
- Boston University School of Medicine, Boston, Massachusetts
| | - Sindhu R Johnson
- Toronto Western Hospital, Mount Sinai Hospital, and University of Toronto, Toronto, Ontario, Canada
| | - Amy Miller
- American College of Rheumatology, Atlanta, Georgia
| | | | | | - David Felson
- Boston University School of Medicine, Boston, Massachusetts
| | | | | | - Brian M Feldman
- Toronto Western and Mount Sinai Hospitals, The Hospital for Sick Children, and University of Toronto, Toronto, Ontario, Canada
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49
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Ward T, Voss J, Yuwen W, Foll D, Gohar F, Ringold S. AB1017 Sleep Fragmentation and Biomarkers in Juvenile Idiopathic Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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50
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Ringold S, Hendrickson A, Abramson L, Beukelman T, Blier PR, Bohnsack J, Chalom EC, Gewanter HL, Gottlieb B, Hollister R, Hsu J, Hudgins A, Ilowite NT, Klein-Gitelman M, Lindsley C, Lopez Benitez JM, Lovell DJ, Mason T, Milojevic D, Moorthy LN, Nanda K, Onel K, Prahalad S, Rabinovich CE, Ray L, Rouster-Stevens K, Ruth N, Shishov M, Spalding S, Syed R, Stoll M, Vehe RK, Weiss JE, White AJ, Wallace CA, Sobel RE. Novel Method to Collect Medication Adverse Events in Juvenile Arthritis: Results From the Childhood Arthritis and Rheumatology Research Alliance Enhanced Drug Safety Surveillance Project. Arthritis Care Res (Hoboken) 2015; 67:529-37. [DOI: 10.1002/acr.22487] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 09/23/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Sarah Ringold
- Seattle Children's Hospital and Research Institute; Seattle Washington
| | | | | | | | - Peter R. Blier
- Baystate Children's Hospital, Springfield, and Tufts University School of Medicine; Boston Massachusetts
| | | | | | | | - Beth Gottlieb
- Cohen Children's Medical Center of New York; New Hyde Park
| | | | - Joyce Hsu
- Stanford University Medical Center; Stanford California
| | | | | | | | | | | | | | | | - Diana Milojevic
- Floating Hospital for Children, Tufts Medical Center; Boston Massachusetts
| | - Lakshmi N. Moorthy
- Robert Wood Johnson Medical School, Rutgers University; New Brunswick New Jersey
| | - Kabita Nanda
- Comer Children's Hospital, University of Chicago; Chicago Illinois
| | - Karen Onel
- Emory University School of Medicine and Children's Healthcare of Atlanta; Atlanta Georgia
| | - Sampath Prahalad
- Emory University School of Medicine and Children's Healthcare of Atlanta; Atlanta Georgia
| | | | | | - Kelly Rouster-Stevens
- Emory University School of Medicine and Children's Healthcare of Atlanta; Atlanta Georgia
| | - Natasha Ruth
- The Medical University of South Carolina; Charleston
| | | | | | - Reema Syed
- Saint Louis University; St. Louis Missouri
| | | | | | | | | | - Carol A. Wallace
- Seattle Children's Hospital and Research Institute; Seattle Washington
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