Juvenile idiopathic arthritis (JIA) is heterogeneous in both its clinical presentation and etiology1,2. JIA can result in permanent physical disability due to joint damage, while additional morbidity can be related to its treatment and to effects on growth and development. Children with inadequately treated or recalcitrant JIA may have chronic pain, mood disturbances, and difficulty with peer relationships, school performance, and attainment of educational and vocational goals3,4,5,6,7,8. Improved health related quality of life (HRQOL) and physical function are increasingly recognized as key treatment goals because of the influence of this illness on all aspects of a child’s life9. Accurate evaluation of this multidimensional and heterogeneous disease is challenging, but crucial to improve the quality of care and outcomes in JIA.
Over the last decade there has been an increasing commitment to the assessment and improvement of quality of care following the report of The Institute of Medicine (IOM) Committee on Quality of Healthcare in America, “To Err is Human”10. The American College of Rheumatology (ACR) and American Board of Pediatrics have charged …
Address correspondence to Dr. Laxer. E-mail: ronald.laxer{at}sickkids.ca