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In recent years, there has been an increasing interest in parent/child-reported outcomes (pcros) in pediatric rheumatology practice. Incorporation of these measures in patient assessment is deemed important as they reflect the parents' and children's perception of the disease course and the effectiveness of therapeutic interventions. Although several measures of single pcros have been developed, to date a clinical measure that groups all pcros used in the assessment of children with juvenile dermatomyositis (JDM) does not exist. Such measure would provide a physician with a thorough and systematic overview of the patient status to be scanned at the start of the visit. This would facilitate focus on matters that require attention, leading to more efficient and effective clinical care.

Background Physical function in children with juvenile dermatomyositis (JDM) is traditionally assessed through the Childhood Health Assessment Questionnaire (CHAQ), which has been originally devised for juvenile idiopathic arthritis, but has been validated for use in JDM. Recently, the first physical functional questionnaire specific for JDM, named MyoFun, has been developed. The MyoFun is a 15-item questionnaire in which the ability of the child to perform each task is scored as follows: 0 = without any difficulty; 1 = with some difficulty; 2 = with much difficulty; 3 = unable to do. Questionnaire completers are asked to note only those difficulties that are caused by myositis. The total score ranges from 0 to 45. Objectives To compare the construct validity of the CHAQ and MyoFun in children with JDM. Methods Construct validity of the CHAQ and Myofun was assessed by evaluating their Spearman’s correlation with the other traditional JDM outcome measures. Construct validity of the CHAQ and MyoFun was assessed in 3 different cross-sectional patient samples. The first and second samples, in which physical function was assessed with the CHAQ, included 327 patients enrolled in a long-term outcome study (Arthritis Care Res 2010;62:63-72) and 294 patients evaluated at disease onset or at the time of a disease flare (Arthritis Rheum 2008;59:4-13), respectively. The third sample, in which physical function was assessed with the MyoFun, was composed by 37 patients seen at study centers in the context of standard clinical care. Results Table shows Spearman’s correlations yielded by the CHAQ and MyoFun. Conclusions The construct validity of the MyoFun was overall superior to that of the CHAQ, which suggests that this tool is suitable for the assessment of physical function in children with JDM in both clinical practice and research. Disclosure of Interest None Declared

Methods The MyoFun assesses the ability of the child to perform 15 activities that require the use of all skeletal muscles and muscle groups. Each item is scored from 0 to 3 (0=with no difficulty; 1=with some difficulty; 2=with much difficulty; 3=unable to do). The total score ranges from 0 (normal physical function) to 45 (worst physical function). A parent of 27 children with JDM was asked to complete the MyoFun and the Childhood Health Assessment Questionnaire (C-HAQ) and to rate the child’s overall well-being and pain intensity on a 21numbered circle visual analog scale (VAS). The attending physician assessed the child’s muscle strength/function with the Kendall’s Manual Muscle Testing (MMT) and the Childhood Myositis Assessment Scale (CMAS). Laboratory tests included creatine phosphokinase (CK) and lactic dehydrogenase (LDH). Construct validity of the MyoFun was examined by calculating its Spearman’s correlations with the other JDM outcome measures on both cross-sectional data and change between 2 consecutive visits. Correlations were considered high, moderate or low when >0.7, 0.4-0.7, or

The recent advances in the management of juvenile idiopathic arthritis (JIA) have increased considerably the potential to achieve disease remission or, at least, low levels of disease activity, and have consequently moved the therapeutic aims towards the attainment of inactive disease (ID). Complete disease quiescence is regarded as the ideal therapeutic target because its achievement helps preventing further joint damage and disability and may enhance physical function and quality of life.

Juvenile dermatomyositis (JDM) is a multisystem vasculopathic disease characterized by muscle inflammation that causes symmetrical muscle weakness. Assessment of muscle strength is, therefore, a fundamental component of the clinical evaluation of children with JDM. This assessment is traditionally made using the 8-muscle Manual Muscle Testing (MMT) and the Childhood Myositis Assessment Scale (CMAS). However, the MMT does not cover all muscles or muscle groups affected in JDM, namely abdominal muscles. Although the CMAS is more comprehensive than the MMT, it is lengthy and, therefore, may not be feasible in a busy clinical setting or when a physical therapist is not available.