KQ 1–4—Blank ET/Data Abstraction Form

StudyInterventions and study designPatient characteristicsResultsComments/quality/applicability
StudyIDGeographical location:

Study dates:

Funding source:

Setting:

Study design:
RCT
Nonrandomized comparative study
Other

Intervention(s):
-

DMARD name:

-

Dose:

-

Titration:

-

N:

Comparator(s):

Were additional arthritis medications allowed?:

If Yes to above, was this done:
Per protocol At discretion of clinician/investigator NR

Study duration:

Primary outcome(s):

Secondary outcome(s):		Number of patients:
-

Screened for inclusion:

-

Eligible for inclusion:

-

Randomized:

-

Began treatment:

-

Completed treatment:

-

Withdrawals/losses to followup:

Age:
-

Mean (SD):

-

Median:

-

Range:

Sex:
-

Female:

-

Male:

Race/ethnicity:

JIA diagnosis:
JRA
JCA
JIA
Spondyloarthropathy
Psoriatic arthritis
Other (describe)

Baseline severity:
Active joint count:
Duration of disease:
Other (specify):
NR

Percentage with uveitis:

Inclusion criteria:

Exclusion criteria:
  1. Active joint count:
  2. Quality of life/functional status:
  3. Number of joints with limited range of motion:
  4. Global assessment of current status:
    -

    Physician:

    -

    Patient/Parent:

  5. Laboratory measures of inflammation:
    -

    ESR:

    -

    Other:

  6. Radiographic evidence of progression of disease:
  7. Pain control:
  8. Clinical remission:
  9. Flare of disease:
  10. Discontinuation of DMARD due to:
    -

    Remission of disease:

    -

    Inefficacy:

    -

    Intolerance/AEs:

  11. Mortality:
  12. Adverse events reported?:
    • Yes
    • No
  13. Other:
Exclusion reasons (if appropriate):

General comments:

Quality assessment:
Primary outcome:
-

Overall rating:

-

Comments:

Adverse events:
-

Overall rating:

-

Comments:

Applicability:

This article is relevant to:
Question #_____

From: Appendix C, Data Abstraction Forms

Cover of Disease-Modifying Antirheumatic Drugs (DMARDs) in Children With Juvenile Idiopathic Arthritis (JIA)
Disease-Modifying Antirheumatic Drugs (DMARDs) in Children With Juvenile Idiopathic Arthritis (JIA) [Internet].
Comparative Effectiveness Reviews, No. 28.
Kemper AR, Coeytaux R, Sanders GD, et al.
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