Questions regarding Juvenile Arthritis Study

Please supply two questions

1. What “patterns” of corticosteroid dosings are you considering?

2. Which is more important to monitor – height or weight?

1. Is there a measure for the seriousness of the arthritis? For example, can we quantitatively compare arthritis in different children with some sort of "arthritis score"? Does this affect dosing?

2. What is the protocol for the dosing? (Does a child receive a dosing amount proportional to his/her body weight or age? Does a child receive a more frequent dosing schedule if they are older? Etc.)

1. How long are the "longer breaks"? Growth effects may take considerable time to manifest themselves. If the longer breaks occur near the end of the study, we may not be able to tell whether reduced corticosteroid use would mitigate those effects.

2. How is the dosing determined in clinical charts?

1. Are doses of corticosteroid equally effective when ingested versus injected?

2. What are the key units of measurement for dosage patterns, and which is of the greatest interest? (i.e. dosage amount, dosage frequency)

3. What difference in growth would be scientifically relevant between a JRA case and a similar child without JRA?

1. Taking corticosteroid might have a beneficial effect on wight gain, but an adverse influence on growth in height. Then how to evaluate the effect of this treatment?

2. How to decide the pattern of dosings? Just depend on doctor's decisions or subject physical conditions? Does this variation of dosings between physicians rusult in some bias in final analysis?

1. Are the corticosteroid will be equally effective if the patterns of doses are not equal between physicians ?

2. Longer breaks between doses are helpful for the body, how they said it just previous experience or from another study ?

1. data structure. there are variables that change with time, and variables that don't change with time. It is possible to record a list of dates and corresponding changes, but that dataset becomes really big very quickly. Is this too much information?

2. Analysis of data. What analysis will be used? Data storage could be more efficient if it is designed around an analysis plan.

1. The patterns of dosing vary between physicians, can the pattern be classified into several categories? 2. The JRA has a number of particular disease types. Are the rheumatologists interested in investigating the effects of each individual type or investigating the overall JRA?

1. Do you want to analyze weight and height together, say BMI or separately? And the same with frequency and dose of corticosteroid, do you want to analyze them together as does per week/month, or treat as two explanatory variables? 2. I wonder whether they will also collect data from juveniles without rheumatoid arthritis for their height and weight, because I assume there might be strong effect modifiers, such as diet structure and age(juveniles usually grow faster in height and weight). So instead of taking many potential variables/confounders in the model, it may be better to control them in the data collection (case-control cohort?)