Abstract
Objective To test the association of early disease severity with grade 12 standards tests performance in individuals with childhood-onset chronic rheumatic diseases (ChildCRDs), including juvenile arthritis and systemic autoimmune rheumatic diseases.
Methods We used linked provincial administrative data to identify ChildCRD patients born between 1979 and 1998 in Manitoba, Canada. Primary outcomes were Language and Arts achievement index (LAI) and Maths achievement index (MAI) scores from grade 12 standards tests results and enrollment data. A secondary outcome was enrollment in grade 12 by age 17 years. Latent class trajectory analysis identified disease severity groups using physician visits following diagnosis. Multivariable linear regression tested the association of disease severity groups with LAI and MAI scores, and logistic regression tested the association of disease severity with age-appropriate enrollment, after adjusting for sociodemographic factors and psychiatric morbidities.
Results The study cohort included 541 patients (70.1% females). A 3-class trajectory model provided the best fit; it classified 9.7 % as severe, 54.5% as moderate and 35.8% as mild disease. After covariate adjustment, severe disease was associated with poorer LAI and MAI scores but not with age-appropriate enrollment.
Conclusion Among ChildCRD patients, those with severe disease performed more poorly in grade 12 standards tests, independent of sociodemographic and psychiatric risk factors. Clinicians should work with educators and policymakers to advocate for supports to improve education outcomes of ChildCRD patients.
