Development of a scoring system to assist clinicians in the early referral of patients with suspected juvenile idiopathic arthritis: the EasyJIA score.
| Title: | Development of a scoring system to assist clinicians in the early referral of patients with suspected juvenile idiopathic arthritis: the EasyJIA score. |
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| Authors: | Marino A; Unit of Pediatric Rheumatology, ASST G. Pini-CTO, Piazza Cardinal Ferrari 1, Milan, 20122, Italy. achille.marino@asst-pini-cto.it.; Scirè CA; Rheumatology Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.; School of Medicine, University of Milano-Bicocca, Milan, Italy.; Baldassarre P; Department of Biomedical and Clinical Sciences, Buzzi Children's Hospital, University of Milan, Milan, Italy.; Ferrigno C; Department of Biomedical and Clinical Sciences, Buzzi Children's Hospital, University of Milan, Milan, Italy.; Costi S; Unit of Pediatric Rheumatology, ASST G. Pini-CTO, Piazza Cardinal Ferrari 1, Milan, 20122, Italy.; Baldo F; Unit of Pediatric Rheumatology, ASST G. Pini-CTO, Piazza Cardinal Ferrari 1, Milan, 20122, Italy.; Gattinara MV; Unit of Pediatric Rheumatology, ASST G. Pini-CTO, Piazza Cardinal Ferrari 1, Milan, 20122, Italy.; Rozza D; Epidemiology Unit, Italian Society for Rheumatology (SIR), Milan, Italy.; Chighizola CB; Unit of Pediatric Rheumatology, ASST G. Pini-CTO, Piazza Cardinal Ferrari 1, Milan, 20122, Italy.; Department of Clinical Sciences and Community Health, Research Center for Pediatric and Adult Rheumatic Diseases (RECAP.RD), University of Milan, Milan, Italy.; Caporali RF; Unit of Pediatric Rheumatology, ASST G. Pini-CTO, Piazza Cardinal Ferrari 1, Milan, 20122, Italy.; Department of Clinical Sciences and Community Health, Research Center for Pediatric and Adult Rheumatic Diseases (RECAP.RD), University of Milan, Milan, Italy. |
| Source: | Arthritis research & therapy [Arthritis Res Ther] 2026 Jan 09; Vol. 28 (1), pp. 28. Date of Electronic Publication: 2026 Jan 09. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 101154438 Publication Model: Electronic Cited Medium: Internet ISSN: 1478-6362 (Electronic) Linking ISSN: 14786354 NLM ISO Abbreviation: Arthritis Res Ther Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central, 2003- |
| MeSH Terms: | Arthritis, Juvenile*/diagnosis ; Referral and Consultation* ; Severity of Illness Index*; Humans ; Female ; Male ; Child ; Prospective Studies ; Child, Preschool ; Retrospective Studies ; Adolescent ; Cohort Studies |
| Abstract: | Objective: Juvenile idiopathic arthritis (JIA) is the most common chronic pediatric rheumatic disease. Early referral to a specialized center is crucial for prompt diagnosis and treatment. This study aims to develop and validate a scoring system to assist clinicians in efficiently identifying and referring patients suspected of having non-systemic JIA.; Methods: We conducted a cohort study with a mixed design (retrospective and prospective), involving consecutive patients presenting with joint complaints who were referred for the first time to the Pediatric Rheumatology Unit at ASST G. Pini-CTO Hospital. The model was developed using multivariate logistic regression with bootstrap resampling and the Lasso (Least Absolute Shrinkage and Selection Operator) method for variable selection.; Results: A total of 342 patients were included, of whom 61 (18%) were diagnosed with JIA. The selected variables for the model were: type of joint (large), daily symptoms, joint swelling, activity as a precipitating factor, a positive squeeze test of the metatarsophalangeal/metacarpophalangeal (MTP/MCP) joints, normal bending of the interphalangeal (IF) joints of the hands, morning limping and/or stiffness, and sacroiliac tenderness. The ROC curve, based on the model's regression score, showed an AUC of 0.92 with an overall accuracy of 0.88 (95% CI: 0.84-0.91) using a cutoff of 3 points, yielding a sensitivity of 95% and a specificity of 71%. Initial internal validation of the model revealed an AUC of 0.92 (95% CI: 0.89-0.95).; Conclusion: This study presents and initially validates a simple and efficient scoring system to aid clinicians in the early referral of patients suspected of having non-systemic JIA.; Clinical Trial Number: Not applicable.; (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Ethics approval and consent to participate: Approval was granted by our center’s Institutional Review Board (IRB) (4085_S_P). Informed consent for medical chart data collection was obtained from all patients or their legal guardians. Consent for publication: not applicable. Competing interests: The authors declare no competing interests. |
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| Entry Date(s): | Date Created: 20260108 Date Completed: 20260207 Latest Revision: 20260209 |
| Update Code: | 20260209 |
| PubMed Central ID: | PMC12882273 |
| DOI: | 10.1186/s13075-025-03719-0 |
| PMID: | 41508146 |
| Database: | MEDLINE |
Journal Article