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4 results on '"Tzielan Chang Lee"'

1. Consensus Approach to a Treat-to-target Strategy in Juvenile Idiopathic Arthritis Care: Report From the 2020 PR-COIN Consensus Conference

Author

Tala El Tal, Meghan E. Ryan, Brian M. Feldman, Catherine April Bingham, Jon M. Burnham, Michelle Batthish, Danielle Bullock, Kerry Ferraro, Mileka Gilbert, Miriah Gillispie-Taylor, Beth Gottlieb, Julia G. Harris, Melissa Hazen, Ronald M. Laxer, Tzielan Chang Lee, Daniel Lovell, Melissa Mannion, Laura Noonan, Edward Oberle, Janalee Taylor, Jennifer E. Weiss, Cagri Yildirim Toruner, and Esi M. Morgan

Subjects
Consensus, Cost of Illness, Rheumatology, Immunology, Immunology and Allergy, Humans, Patient Participation, Child, Arthritis, Juvenile
Abstract

ObjectiveTreat to target (T2T) is a strategy of adjusting treatment until a target is reached. An international task force recommended T2T for juvenile idiopathic arthritis (JIA) treatment. Implementing T2T in a standard and reliable way in clinical practice requires agreement on critical elements of (1) target setting, (2) T2T strategy, (3) identifying barriers to implementation, and (4) patient eligibility. A consensus conference was held among Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) stakeholders to inform a statement of understanding regarding the PR-COIN approach to T2T.MethodsPR-COIN stakeholders including 16 healthcare providers and 4 parents were invited to form a voting panel. Using the nominal group technique, 2 rounds of voting were held to address the above 4 areas to select the top 10 responses by rank order.ResultsIncorporation of patient goals ranked most important when setting a treatment target. Shared decision making (SDM), tracking measurable outcomes, and adjusting treatment to achieve goals were voted as the top elements of a T2T strategy. Workflow considerations, and provider buy-in were identified as key barriers to T2T implementation. Patients with JIA who had poor prognostic factors and were at risk for high disease burden were leading candidates for a T2T approach.ConclusionThis consensus conference identified the importance of incorporating patient goals as part of target setting and of the influence of patient stakeholder involvement in drafting treatment recommendations. The network approach to T2T will be modified to address the above findings, including solicitation of patient goals, optimizing SDM, and better workflow integration.

Published
2022

2. Consensus Approach to a Treat-to-target Strategy in Juvenile Idiopathic Arthritis Care: Report From the 2020 PR-COIN Consensus Conference.

Author

El Tal, Tala, Ryan, Meghan E., Feldman, Brian M., Bingham, Catherine April, Burnham, Jon M., Batthish, Michelle, Bullock, Danielle, Ferraro, Kerry, Gilbert, Mileka, Gillispie-Taylor, Miriah, Gottlieb, Beth, Harris, Julia G., Hazen, Melissa, Laxer, Ronald M., Tzielan Chang Lee, Lovell, Daniel, Mannion, Melissa, Noonan, Laura, Oberle, Edward, and Taylor, Janalee

Published
2022
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3. Treatment of Juvenile Idiopathic Arthritis

Author

Joyce J. Hsu, Tzielan Chang Lee, and Christy I. Sandborg

Subjects
musculoskeletal diseases, Pediatrics, medicine.medical_specialty, Oligoarthritis, business.industry, Arthritis, medicine.disease, Rheumatology, Internal medicine, medicine, Rheumatoid factor, Polyarthritis, Age of onset, business, Rheumatism, Juvenile rheumatoid arthritis
Abstract

In the past, different groups had used various types of nomenclature to classify children with persistent arthritis including “juvenile rheumatoid arthritis” (American College of Rheumatology [ACR]) and “juvenile chronic arthritis” (European League Against Rheumatism), which created problems in comparing research studies and outcomes. The goal of the International League of Associations for Rheumatology (ILAR) is to identify subtypes of JIA for research purposes that are homogeneous and mutually exclusive. JIA classification is currently based on predominant clinical and laboratory features and the number of involved joints at disease onset. There is a continual renewal process, with the second revision occurring in Edmonton in 2001, which is presented in Table 107-1. However, classification systems are ever evolving, and categorization may evolve to more biologically and genetically similar subgrouping, especially with recent advances in etiology and pathogenesis. For example, age of onset may be a more biologically relevant parameter to distinguish between subtypes of JIA than classification based on number of involved joints. PBMC gene expression analysis reveals biologic differences between patients with early-onset ( 6 years) JIA, which was independent of oligoarthritis or polyarthritis subtype. Ravelli and colleagues provided clinical support for this approach, showing that antinuclear antibody (ANA)-positive patients with oligoarthritis and rheumatoid factor (RF)-negative polyarthritis were similar in terms of early age at onset, female predilection, increased frequency of asymmetric arthritis, and increased frequency of uveitis. Pattern recognition is perhaps the most significant skill needed by clinicians in the diagnostic evaluation of patients. The usual patterns in children with rheumatic diseases often overlap with malignancies, infection, and trauma (especially nonaccidental). Therefore it is crucial to evaluate these diagnostic possibilities first before accepting the diagnosis of JIA. The ILAR categories are meant to simplify classification and are useful for typical presentations of KEY POINTS

Published
2013
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4. Contributors

Author

Steven B. Abramson, Kai-Nan An, Felipe Andrade, John P. Atkinson, Dominique Baeten, Robert P. Baughman, Dorcas E. Beaton, Robert Bennett, Susanne M. Benseler, George Bertsias, Nina Bhardwaj, Johannes W.J. Bijlsma, Linda K. Bockenstedt, Maarten Boers, Francesco Boin, Dimitrios T. Boumpas, Barry Bresnihan, Doreen B. Brettler, Christopher D. Buckley, Ralph C. Budd, Christopher M. Burns, Amy C. Cannella, Eliza F. Chakravarty, Christopher Chang, Joseph S. Cheng, Christopher P. Chiodo, Leslie G. Cleland, Megan E. Clowse, Paul P. Cook, Joseph E. Craft, Leslie J. Crofford, Bruce N. Cronstein, Mary K. Crow, Gaye Cunnane, John J. Cush, Maurizio Cutolo, Maria Dall'Era, Kathryn H. Dao, Erika Darrah, John M. Davis, Jeroen DeGroot, Clint Devin, Betty Diamond, Federico Díaz-González, Paul E. Di Cesare, Rajiv Dixit, Joost P.H. Drenth, Michael L. Dustin, Hani S. El-Gabalawy, Keith B. Elkon, Doruk Erkan, Antonios Fanouriakis, Max Field, Andrew Filer, Gary S. Firestein, Oliver Fitzgerald, John P. Flaherty, Adrienne M. Flanagan, Karen A. Fortner, Sherine E. Gabriel, J.S. Hill Gaston, Steffen Gay, M. Eric Gershwin, Allan Gibofsky, Mark H. Ginsberg, Mary B. Goldring, Steven R. Goldring, Yvonne M. Golightly, Stuart Goodman, Siamon Gordon, Walter Grassi, Adam Greenspan, Peter K. Gregersen, Christine Grimaldi, Rula A. Hajj-Ali, Lorraine Harper, Edward D. Harris, Dominik R. Haudenschild, David B. Hellmann, Rikard Holmdahl, Joyce J. Hsu, James I. Huddleston, Thomas W.J. Huizinga, Gene G. Hunder, Emily W. Hung, Robert D. Inman, Maura Daly Iversen, Johannes W.G. Jacobs, Joanne M. Jordan, Joseph L. Jorizzo, Kenton R. Kaufman, William S. Kaufman, Arthur Kavanaugh, Robert T. Keenan, Shaukat Khan, Alisa E. Koch, Dwight H. Kono, Deborah Krakow, Robert G.W. Lambert, Robert B.M. Landewé, Nancy E. Lane, Carol A. Langford, Daniel M. Laskin, Ronald M. Laxer, David M. Lee, Lela A. Lee, Tzielan Chang Lee, Michael D. Lockshin, Rik Lories, Carlos J. Lozada, Ingrid E. Lundberg, Raashid Luqmani, Frank P. Luyten, Reuven Mader, Walter P. Maksymowych, Brian Mandell, Scott David Martin, Eric L. Matteson, Matthew J. McGirt, Iain B. McInnes, Elizabeth Kaufman McNamara, Ted R. Mikuls, Mark S. Miller, Kevin G. Moder, Kanneboyina Nagaraju, Stanley J. Naides, Amanda E. Nelson, Peter A. Nigrovic, Kiran Nistala, Johannes Nowatzky, James R. O'Dell, Yasunori Okada, Nataly Manjarrez Orduño, Caroline Ospelt, Mikkel Østergaard, Bradley M. Palmer, Richard S. Panush, Stanford L. Peng, Michael H. Pillinger, Gregory R. Polston, Steven A. Porcelli, Mark D. Price, Johannes J. Rasker, John D. Reveille, W. Neal Roberts, Monika Ronneberger, Antony Rosen, James T. Rosenbaum, Andrew E. Rosenberg, Eric M. Ruderman, Merja Ruutu, Jane E. Salmon, Jonathan Samuels, Christy I. Sandborg, Caroline O.S. Savage, Amit Saxena, Jose U. Scher, Georg Schett, David C. Seldin, Anna Simon, Dawd S. Siraj, Martha Skinner, E. William St. Clair, Lisa K. Stamp, John H. Stone, Rainer H. Straub, Susan E. Sweeney, Nadera J. Sweiss, Carrie R. Swigart, Deborah Symmons, Zoltan Szekanecz, Paul-Peter Tak, Peter C. Taylor, Robert Terkeltaub, Argyrios N. Theofilopoulos, Ranjeny Thomas, Thomas S. Thornhill, Karina D. Torralba, Michael J. Toth, Peter Tugwell, Zuhre Tutuncu, Katherine S. Upchurch, Désirée M.F.M. van der Heijde, Annette H.M. van der Helm-van Mil, Sjef M. van der Linden, Jos W.M. van der Meer, Jacob M. van Laar, John Varga, Mark S. Wallace, David M. Warshaw, Lucy R. Wedderburn, Victoria P. Werth, Fredrick M. Wigley, Christopher M. Wise, David Wofsy, Frederick Wolfe, Frank A. Wollheim, Robert L. Wortmann, Edward Yelin, David Yu, John B. Zabriskie, Robert B. Zurier, and Anne-Marie Zuurmond

Published
2013
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