How Does Juvenile Idiopathic Arthritis Affect the Employment and Usual Activities of Adolescents? The UCAN CAN-DU and CURE International Prospective Study
Bibliographic record
Abstract
Objectives To measure changes in work productivity and daily activities of patients with Juvenile idiopathic arthritis (JIA), and explore factors affecting these impacts. Methods The Canada-Netherlands Personalized Medicine Network in Childhood Arthritis and Rheumatic Diseases (UCAN CAN-DU) and CURE study captures consecutive caregiver reported data including the standardized instrument Work Productivity and Activity Impairment (WPAI) questionnaire for patients at working age. The cohort includes all subtypes of JIA, and full disease trajectory from new diagnosis to starting or stopping biologic medications. Generalized estimating equations were used to model productivity loss and activity impairment over a 1-year-period from study enrollment. Covariates included JIA activity state (eg, inactive, minimal, moderate/high) and time from enrollment (ie, baseline, 3, 6, 9, 12 months). Results Overall, 154 working-age-patients had at least 1 WPAI entry during the 1-year period from enrollment in the study. Their median age was 17 years (IQR = 16-17) and most of them were female (65.8%). GEE estimates are as follows. Over the 1-year-period, we estimate 8.9% of missed work time due to their JIA (absenteeism). However, we found high levels of presenteeism, with 27.6% of work impairment while at work. Accounting for both, patient work productivity impairment was 30% on average. Patients also reported 28.5% activity impairment, due to JIA. The impact of JIA on all measures remained stable over time. The impact varied with JIA activity state: patients with more severe JIA experience higher levels of burden for all measures. Conclusion Our study is the first to capture work productivity loss and activity impairment on JIA patients at working age. Moreover, we capture this across all subtypes of JIA and over time, capturing varying treatment trajectories. Future work should further investigate the clinical determinants of productivity loss and activity impairment to better understand JIA impact on patients at working age and where extra support for managing JIA in the workplace, and for work accommodations could ease their burden.
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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 | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".