OBJECTIVES: To develop consensus-based recommendations for physician's global assessment of disease activity (PhGA) scoring and to standardise definitions of disease activity. METHODS: An international task force of 34 members was assembled, and recommendations were developed in 3 phases: (1) 2 preliminary surveys of paediatric rheumatologists and a literature review; (2) 14 videoconference meetings, informed by multicriteria decision analysis and formal anonymous voting; and (3) a 2-day in-person consensus conference using structured nominal group technique discussions and formal voting. The threshold for achieving consensus was ≥78% of voting task force members. Agreement with the final statements was rated using a numerical rating scale from 0, strongly disagree, to 10, strongly agree. RESULTS: Eighteen points to consider were agreed upon. All statements achieved consensus (≥78%), with a level of agreement ≥9.2. Points included the definition of disease activity in juvenile idiopathic arthritis (JIA), factors to assess in nonsystemic JIA and systemic JIA, consideration of available imaging and laboratory tests, the role of extra-articular manifestations, the evaluation of treatment, and the timing of PhGA scoring. CONCLUSIONS: The task force developed consensus-based recommendations when scoring the PhGA in nonsystemic and systemic JIA. These recommendations will lead to more reliable scoring of disease activity in patients with JIA.

Centre for Paediatric Rheumatology and Autoinflammatory Diseases ERN RITA Department of Paediatrics and Inherited Metabolic Disorders General University Hospital Prague Czech Republic; 1st Faculty of Medicine Charles University Prague Prague Czech Republic

Department of Clinical Immunology and Rheumatology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India

Department of Pediatrics Alberta Children's Hospital Cumming School of Medicine University of Calgary Calgary AB Canada

Department of Pediatrics Division of Rheumatology University of Washington Seattle WA USA; Department of Pediatric Rheumatology Seattle Children's Hospital and Research Center Seattle WA USA

Department of Pediatrics The Wellbeing Services County of Ostrobothnia Vaasa Finland; Research Unit of Clinical Medicine University of Oulu Oulu Finland

Department of Pediatrics University Hospital of North Norway Tromsø Norway

Department of Pediatrics University Hospital of North Norway Tromsø Norway; Department of Clinical Medicine UIT the Arctic University of Norway Tromsø Norway

Dipartimento di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno Infantili Università degli Studi di Genova Genoa Italy; IRCCS Istituto Giannina Gaslini Genoa Italy

Division of Pediatric Rheumatology Department of Pediatrics Rutgers Robert Wood Johnson Medical School New Brunswick NJ USA; Center for Pharmacoepidemiology and Treatment Science Institute for Health Health Care Policy and Aging Reaserch New Brunswick NJ USA; Department of Biostatistics and Epidemiology Rutgers School of Public Health Piscataway NJ USA

Division of Pediatric Rheumatology Hospital for Special Surgery Department of Pediatrics Weill Medical College of Cornell University New York NY USA

Division of Pediatric Rheumatology University of British Columbia Vancouver BC Canada

Division of Rheumatology and Clinical Futures Children's Hospital of Philadelphia Philadelphia PA USA; Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA

Division of Rheumatology Cincinnati Children's Hospital Medical Center Department of Pediatrics University of Cincinnati Cincinnati OH USA

Division of Rheumatology IRCCS Ospedale Pediatrico Bambino Gesù Roma Rome Italy

Division of Rheumatology Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Pediatrico Bambino Gesù Rome Italy

ENCA The Global Foundation for Children and Families with Rheumatic and Musculoskeletal Conditions and KOURIR Paris France

IRCCS Istituto Giannina Gaslini Genoa Italy; Università degli Studi di Genova Genova Italy

IRCCS Istituto Giannina Gaslini UOC Gaslini Trial Centre Servizio di Sperimentazioni Cliniche Pediatriche Genoa Italy

Northwell Health Cohen Children's Medical Center Division of Pediatric Rheumatology New Hyde Park NY USA

Pediatric Immuno Rheumatology Unit Fondazione IRCSS Ca' Granda Ospedale Maggiore Policlinico Milan Italy

Pediatric Research Center Helsinki University Hospital and University of Helsinki New Children's Hospital Helsinki Finland

Research Unit of Clinical Medicine University of Oulu; Department of Children and Adolescents Oulu University Hospital; and Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland

Rheumatology Service Department of General Medicine Royal Children's Hospital Melbourne Victoria and Murdoch Children's Research Institute Melbourne VIC Australia

São Paulo State University Botucatu São Paulo Brazil

Systemic JIA Foundation Cincinnati OH USA

The Hospital for Sick Children University of Toronto Toronto ON Canada

Università Milano Bicocca Milan Italy; IRCCS Fondazione San Gerardo dei Tintori Clinica Pediatrica Fondazione PRINTO Monza Italy

University of Nis Faculty of Medicine Clinic for Pediatrics University Clinical Center Nis Nis Serbia

Wilhelmina Children's Hospital University Medical Center Utrecht and University of Utrecht Utrecht The Netherlands

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