Core Set of Responsive and Discriminatory Measures for Use in Pragmatic Trials of Youth With Axial Juvenile Spondyloarthritis
Bibliographic record
Abstract
OBJECTIVE: The objective of this study was to determine a core set of measures for youth with juvenile spondyloarthritis and axial disease (axJSpA), using the juvenile arthritis working group Outcome Measures in Rheumatology framework. METHODS: This was a prospective multicenter study of youth with axJSpA. Participants (aged 8-18 years) all initiated tumor necrosis factor inhibitor (TNFi) therapy and completed questionnaires, examinations, and magnetic resonance imaging (MRI) at baseline and 12 weeks. Responsiveness and discrimination were assessed using standardized response mean (SRM) and standardized mean difference (SMD). For highly correlated (r > |0.80|) items within domains, larger SRM and SMD were prioritized, and minimal clinically important improvement was determined for each. RESULTS: Of the evaluable cohort (N = 57), 68.4% were male, and the median age was 15.3 years; 70.2% of youth treated with TNFi had clinical response (change ≥2 in patient global assessment). Although 58% had continued MRI inflammation, 77% of those patients reported moderate clinical improvement. The final axJSpA core set contained the following: Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference (SRM 0.77, SMD 0.5), the sacroiliac joint inflammation score (SRM 1.02, SMD 0.52), PROMIS mobility (SRM 0.83, SMD 0.75), and patient global well-being (SRM 0.88, SMD not applicable). All overall and composite disease activity measures tested, except the physician global assessment, had high SRM and SMD. Subgroup analysis demonstrated differences by biologic sex and overweight status. Improvement in the MRI inflammation score was greater in male patients. Improvement in the PROMIS pain interference and mobility measures was greater in those with normal body mass index. CONCLUSION: A set of measures was developed for youth with axJSpA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.215 | 0.248 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.007 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".