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dc.contributor.authorRypdal, Veronika Gjertsen
dc.contributor.authorGuzman, Jaime
dc.contributor.authorHenrey, A
dc.contributor.authorLoughin, T
dc.contributor.authorGlerup, Mia
dc.contributor.authorArnstad, Ellen Dalen
dc.contributor.authorAalto, Kristiina
dc.contributor.authorRygg, Marite
dc.contributor.authorNielsen, Susan M.
dc.contributor.authorHerlin, Troels
dc.contributor.authorFasth, Anders
dc.contributor.authorBerntson, Lillemor
dc.contributor.authorRypdal, Martin Wibe
dc.contributor.authorNordal, Ellen Berit
dc.date.accessioned2020-03-17T09:54:28Z
dc.date.available2020-03-17T09:54:28Z
dc.date.issued2019-12-05
dc.description.abstract<i>Background</i> - Models to predict disease course and long-term outcome based on clinical characteristics at disease onset may guide early treatment strategies in juvenile idiopathic arthritis (JIA). Before a prediction model can be recommended for use in clinical practice, it needs to be validated in a different cohort than the one used for building the model. The aim of the current study was to validate the predictive performance of the Canadian prediction model developed by Guzman et al. and the Nordic model derived from Rypdal et al. to predict severe disease course and non-achievement of remission in Nordic patients with JIA.<p><p> <i>Methods</i> - The Canadian and Nordic multivariable logistic regression models were evaluated in the Nordic JIA cohort for prediction of non-achievement of remission, and the data-driven outcome denoted severe disease course. A total of 440 patients in the Nordic cohort with a baseline visit and an 8-year visit were included. The Canadian prediction model was first externally validated exactly as published. Both the Nordic and Canadian models were subsequently evaluated with repeated fine-tuning of model coefficients in training sets and testing in disjoint validation sets. The predictive performances of the models were assessed with receiver operating characteristic curves and C-indices. A model with a C-index above 0.7 was considered useful for clinical prediction.<p><p> <i>Results</i> - The Canadian prediction model had excellent predictive ability and was comparable in performance to the Nordic model in predicting severe disease course in the Nordic JIA cohort. The Canadian model yielded a C-index of 0.85 (IQR 0.83–0.87) for prediction of severe disease course and a C-index of 0.66 (0.63–0.68) for prediction of non-achievement of remission when applied directly. The median C-indices after fine-tuning were 0.85 (0.80–0.89) and 0.69 (0.65–0.73), respectively. Internal validation of the Nordic model for prediction of severe disease course resulted in a median C-index of 0.90 (0.86–0.92).<p><p> <i>Conclusions</i> - External validation of the Canadian model and internal validation of the Nordic model with severe disease course as outcome confirm their predictive abilities. Our findings suggest that predicting long-term remission is more challenging than predicting severe disease course.en_US
dc.identifier.citationRypdal VG, Guzman J, Henrey A, Loughin T, Glerup M, Arnstad Ed, Aalto K, Rygg M, Nielsen SM, Herlin T, Fasth A, Berntson L, Rypdal Mw, Nordal E. Validation of prediction models of severe disease course and non-achievement of remission in juvenile idiopathic arthritis: part 1-results of the Canadian model in the Nordic cohort.. Arthritis Research & Therapy. 2019en_US
dc.identifier.cristinIDFRIDAID 1770413
dc.identifier.doihttps://doi.org/10.1186/s13075-019-2060-2
dc.identifier.issn1478-6354
dc.identifier.issn1478-6362
dc.identifier.urihttps://hdl.handle.net/10037/17763
dc.language.isoengen_US
dc.relation.ispartofRypdal, V.G. (2021). Prediction of unfavorable outcome in Juvenile Idiopathic Arthritis (JIA) and assessment of the long-term outcomes in JIA-associated uveitis – A prospective Nordic multicenter study of JIA from childhood to adulthood. (Doctoral thesis). <a href=https://hdl.handle.net/10037/21148>https://hdl.handle.net/10037/21148</a>
dc.relation.journalArthritis Research & Therapy
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2019 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700en_US
dc.subjectVDP::Medisinske Fag: 700en_US
dc.titleValidation of prediction models of severe disease course and non-achievement of remission in juvenile idiopathic arthritis: part 1—results of the Canadian model in the Nordic cohorten_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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