The Provisional Paediatric Rheumatology International Trials Organisation/American College of Rheumatology/European League Against Rheumatism disease activity core set for the evaluation of response to therapy in juvenile dermatomyositis: A prospective validation study

Objective. To validate a core set of outcome measures for the evaluation of response to treatment in patients with juvenile dermatomyositis (DM). Methods. In 2001, a preliminary consensus-derived core set for evaluating response to therapy in juvenile DM was established. In the present study, the core set was validated through an evidence-based, large-scale data collection that led to the enrollment of 294 patients from 36 countries. Consecutive patients with active disease were assessed at baseline and after 6 months. The validation procedures included assessment of feasibility, responsiveness, discriminant and construct ability, concordce in the evaluation of response to therapy between physicians and parents, redundancy, internal consistency, and ability to predict a therapeutic response. Results. The following clinical measures were found to be feasible, and to have good construct validity, discriminative ability, and internal consistency; furthermore, they were not redundant, proved responsive to clinically important changes in disease activity, and were associated strongly with treatment outcome and thus were included in the final core set: 1) physician`s global assessment of disease activity, 2) muscle strength, 3) global disease activity measure, 4) parent`s global assessment of patient`s well-being, 5) functional ability, and 6) health-related quality of life. Conclusion. The members of the Paediatric Rheumatology International Trials Organisation, with the endorsement of the American College of Rheumatology and the European Leauge Against Rheumatism, propose a core set of criteria for the evaluation of response of therapy that is scientifically and clinically relevant and statistically validated. The core set will help standardize the conduct and reporting of clinical trials and assist practitioners in deciding whether a child with juvenile DM has responded adequately to therapy.

Proposal of a Brazilian accreditation program for personal dosimetry using OSL

After the development of the highly sensitive material Al(2)O(3):C, personal dosimetry using optically stimulated luminescence (OSL) has been continuously adopted in place of thermoluminescence dosimeters (TLD) by different countries (e.g. USA and Japan). In order to use a dosimetric system in Brazil it is necessary to develop a protocol and to fulfill performance and type tests in accordance with the accreditation program approved by the responsible governmental committee. This paper presents a proposal for an accreditation program for OSL personal dosimetry using a commercial dosimetric system, including tests that follow the same rules as applied to TLD and film dosimetry. The experimental results are within the reliability interval and in accordance to the expected behavior. A new test concerning re-analysis of exposed badges is also proposed. (C) 2009 Elsevier Ltd. All rights reserved.