THE PEDIATRIC RHEUMATOLOGY INTERNATIONAL TRIALS ORGANIZATION PROVISIONAL CRITERIA FOR THE EVALUATION OF RESPONSE TO THERAPY IN JUVENILE DERMATOMYOSITIS
Identifieur interne : 006E75 ( Main/Exploration ); précédent : 006E74; suivant : 006E76THE PEDIATRIC RHEUMATOLOGY INTERNATIONAL TRIALS ORGANIZATION PROVISIONAL CRITERIA FOR THE EVALUATION OF RESPONSE TO THERAPY IN JUVENILE DERMATOMYOSITIS
Auteurs : Nicolino Ruperto [Italie] ; Angela Pistorio [Italie] ; Angelo Ravelli [Italie] ; Lisa G. Rider [États-Unis] ; Clarissa Pilkington [Royaume-Uni] ; Sheila Oliveira [Brésil] ; Nico Wulffraat [Pays-Bas] ; Graciela Espada [Argentine] ; Stella Garay [Argentine] ; Ruben Cuttica [Argentine] ; Michael Hofer [Suisse] ; Pierre Quartier [France] ; Jose Melo-Gomes [Portugal] ; Ann M. Reed [États-Unis] ; Malgorzata Wierzbowska [Pologne] ; Brian M. Feldman [Canada] ; Miroslav Harjacek [Croatie] ; Hans-Iko Huppertz [Allemagne] ; Susan Nielsen [Danemark] ; Berit Flato [Norvège] ; Pekka Lahdenne [Finlande] ; Harmut Michels [Allemagne] ; Kevin J. Murray [Australie] ; Lynn Punaro [États-Unis] ; Robert Rennebohm [Canada] ; Ricardo Russo [Argentine] ; Zsolt Balogh [Argentine] ; Madeleine Rooney [Royaume-Uni] ; Lauren M. Pachman [États-Unis] ; Carol Wallace [États-Unis] ; Philip Hashkes [Israël] ; Daniel J. Lovell [États-Unis] ; Edward H. Giannini [États-Unis] ; Alberto Martini [Italie]Source :
- Arthritis care & research [ 2151-464X ] ; 2010.
Abstract
To develop a provisional definition for the evaluation of response to therapy in juvenile dermatomyositis (JDM) based on the PRINTO JDM core set of variables.
Thirty-seven experienced pediatric rheumatologists from 27 countries, achieved consensus on 128 difficult patient profiles as clinically improved or not improved using a stepwise approach (patients rating, statistical analysis, definition selection). Using the physicians’ consensus ratings as the “gold-standard measure”, chi-square, sensitivity, specificity, false positive and negative rate, area under the ROC, and kappa agreement for candidate definitions of improvement were calculated. Definitions with kappa >0.8 were multiplied with the face validity score to select the top definitions.
The top definition of improvement was: at least 20% improvement from baseline in 3/6 core set variables with no more than 1 of the remaining worsening by more than 30%, which cannot be muscle strength. The second highest scoring definition was at least 20% improvement from baseline in 3/6 core set variables with no more than 2 of the remaining worsening by more than 25%, which cannot be muscle strength which is definition P1 selected by the IMACS group. The third is similar to the second with the maximum amount of worsening set to 30%. This indicates convergent validity of the process.
we proposes a provisional data driven definition of improvement that reflects well the consensus rating of experienced clinicians, which incorporates clinically meaningful change in core set variables in a composite endpoint for the evaluation of global response to therapy in JDM.
Url:
DOI: 10.1002/acr.20280
PubMed: 20583105
PubMed Central: 2964396
Affiliations:
- Allemagne, Argentine, Australie, Brésil, Canada, Croatie, Danemark, Finlande, France, Israël, Italie, Norvège, Pays-Bas, Pologne, Portugal, Royaume-Uni, Suisse, États-Unis
- Angleterre, Brême (Land), Canton de Vaud, Grand Londres, Hongrie centrale, Hovedstaden, Illinois, Irlande du Nord, Maryland, Minnesota, Ohio, Ontario, Texas, Utrecht (province), Washington (État), État de Rio de Janeiro, Île-de-France, Østlandet
- Brême, Budapest, Copenhague, Lausanne, Londres, Oslo, Paris, Rio de Janeiro, Toronto, Utrecht
- Université Paris-Descartes, Université de Toronto
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Le document en format XML
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Rider, MD, NIEHS, NIH, Bethesda, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Pilkington, Clarissa" sort="Pilkington, Clarissa" uniqKey="Pilkington C" first="Clarissa" last="Pilkington">Clarissa Pilkington</name><affiliation wicri:level="3"><nlm:aff id="A5">Clarissa Pilkington, MD, Great Ormond Street Hospital for Sick Children, London, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clarissa Pilkington, MD, Great Ormond Street Hospital for Sick Children, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Oliveira, Sheila" sort="Oliveira, Sheila" uniqKey="Oliveira S" first="Sheila" last="Oliveira">Sheila Oliveira</name><affiliation wicri:level="3"><nlm:aff id="A6">Sheila Oliveira, MD, Prof, Universidade Federal do Rio de Janeiro, Instituto de Puericultura e Pediatria Martagao Gesteira, Rio de Janeiro, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Sheila Oliveira, MD, Prof, Universidade Federal do Rio de Janeiro, Instituto de Puericultura e Pediatria Martagao Gesteira, Rio de Janeiro</wicri:regionArea><placeName><settlement type="city">Rio de Janeiro</settlement><region type="state">État de Rio de Janeiro</region></placeName></affiliation></author><author><name sortKey="Wulffraat, Nico" sort="Wulffraat, Nico" uniqKey="Wulffraat N" first="Nico" last="Wulffraat">Nico Wulffraat</name><affiliation wicri:level="3"><nlm:aff id="A7">Nico Wulffraat, MD, Wilhelmina Kinderziekenhuis, Utrecht, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Nico Wulffraat, MD, Wilhelmina Kinderziekenhuis, Utrecht</wicri:regionArea><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Espada, Graciela" sort="Espada, Graciela" uniqKey="Espada G" first="Graciela" last="Espada">Graciela Espada</name><affiliation wicri:level="1"><nlm:aff id="A8">Graciela Espada, MD, Hospital de Ninos Ricardo Gutierrez, Buenos Aires, Argentina</nlm:aff><country xml:lang="fr">Argentine</country><wicri:regionArea>Graciela Espada, MD, Hospital de Ninos Ricardo Gutierrez, Buenos Aires</wicri:regionArea><wicri:noRegion>Buenos Aires</wicri:noRegion></affiliation></author><author><name sortKey="Garay, Stella" sort="Garay, Stella" uniqKey="Garay S" first="Stella" last="Garay">Stella Garay</name><affiliation wicri:level="1"><nlm:aff id="A9">Stella Garay, MD, Hospital Sor Maria Ludovica, La Plata, Argentina</nlm:aff><country xml:lang="fr">Argentine</country><wicri:regionArea>Stella Garay, MD, Hospital Sor Maria Ludovica, La Plata</wicri:regionArea><wicri:noRegion>La Plata</wicri:noRegion></affiliation></author><author><name sortKey="Cuttica, Ruben" sort="Cuttica, Ruben" uniqKey="Cuttica R" first="Ruben" last="Cuttica">Ruben Cuttica</name><affiliation wicri:level="1"><nlm:aff id="A10">Ruben Cuttica, MD, Hospital General de Ninos Pedro de Elizalde, Buenos Aires, Argentina</nlm:aff><country xml:lang="fr">Argentine</country><wicri:regionArea>Ruben Cuttica, MD, Hospital General de Ninos Pedro de Elizalde, Buenos Aires</wicri:regionArea><wicri:noRegion>Buenos Aires</wicri:noRegion></affiliation></author><author><name sortKey="Hofer, Michael" sort="Hofer, Michael" uniqKey="Hofer M" first="Michael" last="Hofer">Michael Hofer</name><affiliation wicri:level="3"><nlm:aff id="A11">Michael Hofer, MD, Centre Multisite Romand de Rhumatologie Pediatrique, Lausanne, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Michael Hofer, MD, Centre Multisite Romand de Rhumatologie Pediatrique, Lausanne</wicri:regionArea><placeName><settlement 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Melo-Gomes</name><affiliation wicri:level="1"><nlm:aff id="A13">Jose Melo-Gomes, MD, Instituto Portugues de Reumatologia, Lisbon, Portugal</nlm:aff><country xml:lang="fr">Portugal</country><wicri:regionArea>Jose Melo-Gomes, MD, Instituto Portugues de Reumatologia, Lisbon</wicri:regionArea><wicri:noRegion>Lisbon</wicri:noRegion></affiliation></author><author><name sortKey="Reed, Ann M" sort="Reed, Ann M" uniqKey="Reed A" first="Ann M." last="Reed">Ann M. Reed</name><affiliation wicri:level="2"><nlm:aff id="A14">Ann M. Reed, MD, Mayo Clinic School of Medicine and Mayo Foundation, Rochester, MN, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Ann M. Reed, MD, Mayo Clinic School of Medicine and Mayo Foundation, Rochester, MN</wicri:regionArea><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Wierzbowska, Malgorzata" sort="Wierzbowska, Malgorzata" uniqKey="Wierzbowska M" first="Malgorzata" last="Wierzbowska">Malgorzata Wierzbowska</name><affiliation wicri:level="1"><nlm:aff id="A15">Malgorzata Wierzbowska, MD, Institute of Rheumatology, Warsaw, Poland</nlm:aff><country xml:lang="fr">Pologne</country><wicri:regionArea>Malgorzata Wierzbowska, MD, Institute of Rheumatology, Warsaw</wicri:regionArea><wicri:noRegion>Warsaw</wicri:noRegion></affiliation></author><author><name sortKey="Feldman, Brian M" sort="Feldman, Brian M" uniqKey="Feldman B" first="Brian M." last="Feldman">Brian M. Feldman</name><affiliation wicri:level="4"><nlm:aff id="A16">Brian M. Feldman, MD, MSc, FRCPC, University of Toronto, The Hospital for Sick Children, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Brian M. Feldman, MD, MSc, FRCPC, University of Toronto, The Hospital for Sick Children, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Harjacek, Miroslav" sort="Harjacek, Miroslav" uniqKey="Harjacek M" first="Miroslav" last="Harjacek">Miroslav Harjacek</name><affiliation wicri:level="1"><nlm:aff id="A17">Miroslav Harjacek, MD, Children's Hospital Zagreb, Zagreb, Croatia</nlm:aff><country xml:lang="fr">Croatie</country><wicri:regionArea>Miroslav Harjacek, MD, Children's Hospital Zagreb, Zagreb</wicri:regionArea><wicri:noRegion>Zagreb</wicri:noRegion></affiliation></author><author><name sortKey="Huppertz, Hans Iko" sort="Huppertz, Hans Iko" uniqKey="Huppertz H" first="Hans-Iko" last="Huppertz">Hans-Iko Huppertz</name><affiliation wicri:level="3"><nlm:aff id="A18">Hans-Iko Huppertz, MD, Klinikum Bremen-Mitte, Bremen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Hans-Iko Huppertz, MD, Klinikum Bremen-Mitte, Bremen</wicri:regionArea><placeName><region type="land" nuts="3">Brême (Land)</region><settlement type="city">Brême</settlement></placeName></affiliation></author><author><name sortKey="Nielsen, Susan" sort="Nielsen, Susan" uniqKey="Nielsen S" first="Susan" last="Nielsen">Susan Nielsen</name><affiliation wicri:level="3"><nlm:aff id="A19">Susan Nielsen, MD, Juliane Marie Centret, Rigshospitalet, Copenhagen, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Susan Nielsen, MD, Juliane Marie Centret, Rigshospitalet, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Flato, Berit" sort="Flato, Berit" uniqKey="Flato B" first="Berit" last="Flato">Berit Flato</name><affiliation wicri:level="3"><nlm:aff id="A20">Berit Flato, MD, Rikshospitalet University Hospital, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Berit Flato, MD, Rikshospitalet University Hospital, Oslo</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Lahdenne, Pekka" sort="Lahdenne, Pekka" uniqKey="Lahdenne P" first="Pekka" last="Lahdenne">Pekka Lahdenne</name><affiliation wicri:level="1"><nlm:aff id="A21">Pekka Lahdenne, MD, Hospital for Children and Adolescents, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>Pekka Lahdenne, MD, Hospital for Children and Adolescents, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Michels, Harmut" sort="Michels, Harmut" uniqKey="Michels H" first="Harmut" last="Michels">Harmut Michels</name><affiliation wicri:level="1"><nlm:aff id="A22">Harmut Michels, MD, Rheumakinderklinik Garmisch-Partenkirchen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Harmut Michels, MD, Rheumakinderklinik Garmisch-Partenkirchen</wicri:regionArea><wicri:noRegion>Rheumakinderklinik Garmisch-Partenkirchen</wicri:noRegion><wicri:noRegion>Rheumakinderklinik Garmisch-Partenkirchen</wicri:noRegion><wicri:noRegion>Rheumakinderklinik Garmisch-Partenkirchen</wicri:noRegion></affiliation></author><author><name sortKey="Murray, Kevin J" sort="Murray, Kevin J" uniqKey="Murray K" first="Kevin J." last="Murray">Kevin J. Murray</name><affiliation wicri:level="1"><nlm:aff id="A23">Kevin J. Murray, MD, Princess Margaret Hospital for Children, Perth, WA, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Kevin J. Murray, MD, Princess Margaret Hospital for Children, Perth, WA</wicri:regionArea><wicri:noRegion>WA</wicri:noRegion></affiliation></author><author><name sortKey="Punaro, Lynn" sort="Punaro, Lynn" uniqKey="Punaro L" first="Lynn" last="Punaro">Lynn Punaro</name><affiliation wicri:level="2"><nlm:aff id="A24">Lynn Punaro, MD, Texas Scottish Rite Hospital, Dallas, TX, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Lynn Punaro, MD, Texas Scottish Rite Hospital, Dallas, TX</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Rennebohm, Robert" sort="Rennebohm, Robert" uniqKey="Rennebohm R" first="Robert" last="Rennebohm">Robert Rennebohm</name><affiliation wicri:level="1"><nlm:aff id="A25">Robert Rennebohm, MD, Alberta Children's Hospital, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Robert Rennebohm, MD, Alberta Children's Hospital, Calgary</wicri:regionArea><wicri:noRegion>Calgary</wicri:noRegion></affiliation></author><author><name sortKey="Russo, Ricardo" sort="Russo, Ricardo" uniqKey="Russo R" first="Ricardo" last="Russo">Ricardo Russo</name><affiliation wicri:level="1"><nlm:aff id="A26">Ricardo Russo, MD, Hospital de Pediatria Juan P. Garrahan, Buenos Aires, Argentina</nlm:aff><country xml:lang="fr">Argentine</country><wicri:regionArea>Ricardo Russo, MD, Hospital de Pediatria Juan P. Garrahan, Buenos Aires</wicri:regionArea><wicri:noRegion>Buenos Aires</wicri:noRegion></affiliation></author><author><name sortKey="Balogh, Zsolt" sort="Balogh, Zsolt" uniqKey="Balogh Z" first="Zsolt" last="Balogh">Zsolt Balogh</name><affiliation wicri:level="3"><nlm:aff id="A27">Zsolt Balogh, MD, National Institute of Rheumatology and Physiotherapy, Budapest, Argentina</nlm:aff><country xml:lang="fr">Argentine</country><wicri:regionArea>Zsolt Balogh, MD, National Institute of Rheumatology and Physiotherapy, Budapest</wicri:regionArea><placeName><settlement type="city">Budapest</settlement><region nuts="2">Hongrie centrale</region></placeName></affiliation></author><author><name sortKey="Rooney, Madeleine" sort="Rooney, Madeleine" uniqKey="Rooney M" first="Madeleine" last="Rooney">Madeleine Rooney</name><affiliation wicri:level="2"><nlm:aff id="A28">Madeleine Rooney, MD, Musgrave Park Hospital, Belfast, Northern Ireland</nlm:aff><country>Royaume-Uni</country><placeName><region type="country">Irlande du Nord</region></placeName><wicri:cityArea>Madeleine Rooney, MD, Musgrave Park Hospital, Belfast</wicri:cityArea></affiliation></author><author><name sortKey="Pachman, Lauren M" sort="Pachman, Lauren M" uniqKey="Pachman L" first="Lauren M." last="Pachman">Lauren M. Pachman</name><affiliation wicri:level="2"><nlm:aff id="A29">Lauren M. Pachman, MD, Children's Memorial Hospital, Chicago, IL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Lauren M. Pachman, MD, Children's Memorial Hospital, Chicago, IL</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Wallace, Carol" sort="Wallace, Carol" uniqKey="Wallace C" first="Carol" last="Wallace">Carol Wallace</name><affiliation wicri:level="2"><nlm:aff id="A30">Carol Wallace, MD, University of Washington/Children's Hospital, Seattle, WA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Carol Wallace, MD, University of Washington/Children's Hospital, Seattle, WA</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Hashkes, Philip" sort="Hashkes, Philip" uniqKey="Hashkes P" first="Philip" last="Hashkes">Philip Hashkes</name><affiliation wicri:level="1"><nlm:aff id="A31">Philip Hashkes, MD, Shaare Zedek Medical Center, Jerusalem, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Philip Hashkes, MD, Shaare Zedek Medical Center, Jerusalem</wicri:regionArea><wicri:noRegion>Jerusalem</wicri:noRegion></affiliation></author><author><name sortKey="Lovell, Daniel J" sort="Lovell, Daniel J" uniqKey="Lovell D" first="Daniel J." last="Lovell">Daniel J. Lovell</name><affiliation wicri:level="2"><nlm:aff id="A32">Daniel J. Lovell, MD, MPH, Edward H. Giannini, MSc, DrPH, Children's Hospital Medical Center, Cincinnati, OH, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Daniel J. Lovell, MD, MPH, Edward H. Giannini, MSc, DrPH, Children's Hospital Medical Center, Cincinnati, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Giannini, Edward H" sort="Giannini, Edward H" uniqKey="Giannini E" first="Edward H." last="Giannini">Edward H. Giannini</name><affiliation wicri:level="2"><nlm:aff id="A32">Daniel J. Lovell, MD, MPH, Edward H. Giannini, MSc, DrPH, Children's Hospital Medical Center, Cincinnati, OH, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Daniel J. Lovell, MD, MPH, Edward H. Giannini, MSc, DrPH, Children's Hospital Medical Center, Cincinnati, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Martini, Alberto" sort="Martini, Alberto" uniqKey="Martini A" first="Alberto" last="Martini">Alberto Martini</name><affiliation wicri:level="1"><nlm:aff id="A3">Angelo Ravelli, MD, Prof, Alberto Martini, MD, Prof, IRCCS G. Gaslini, Pediatria II, Reumatologia and Dipartimento di Pediatria, Università degli Studi, Genova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Angelo Ravelli, MD, Prof, Alberto Martini, MD, Prof, IRCCS G. Gaslini, Pediatria II, Reumatologia and Dipartimento di Pediatria, Università degli Studi, Genova</wicri:regionArea><wicri:noRegion>Genova</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20583105</idno><idno type="pmc">2964396</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964396</idno><idno type="RBID">PMC:2964396</idno><idno type="doi">10.1002/acr.20280</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">001439</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001439</idno><idno type="wicri:Area/Pmc/Curation">001299</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001299</idno><idno type="wicri:Area/Pmc/Checkpoint">002460</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002460</idno><idno type="wicri:Area/Ncbi/Merge">000819</idno><idno type="wicri:Area/Ncbi/Curation">000819</idno><idno type="wicri:Area/Ncbi/Checkpoint">000819</idno><idno type="wicri:doubleKey">2151-464X:2010:Ruperto N:the:pediatric:rheumatology</idno><idno type="wicri:Area/Main/Merge">007360</idno><idno type="wicri:Area/Main/Curation">006E75</idno><idno type="wicri:Area/Main/Exploration">006E75</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">THE PEDIATRIC RHEUMATOLOGY INTERNATIONAL TRIALS ORGANIZATION PROVISIONAL CRITERIA FOR THE EVALUATION OF RESPONSE TO THERAPY IN JUVENILE DERMATOMYOSITIS</title><author><name sortKey="Ruperto, Nicolino" sort="Ruperto, Nicolino" uniqKey="Ruperto N" first="Nicolino" last="Ruperto">Nicolino Ruperto</name><affiliation wicri:level="1"><nlm:aff id="A1">Nicolino Ruperto, MD, MPH, IRCCS G Gaslini, Pediatria II, Reumatologia, PRINTO, Genova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Nicolino Ruperto, MD, MPH, IRCCS G Gaslini, Pediatria II, Reumatologia, PRINTO, Genova</wicri:regionArea><wicri:noRegion>Genova</wicri:noRegion></affiliation></author><author><name sortKey="Pistorio, Angela" sort="Pistorio, Angela" uniqKey="Pistorio A" first="Angela" last="Pistorio">Angela Pistorio</name><affiliation wicri:level="1"><nlm:aff id="A2">Angela Pistorio, MD, PhD, IRCCS G Gaslini, Servizio di Epidemiologia e Biostatistica, Genova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Angela Pistorio, MD, PhD, IRCCS G Gaslini, Servizio di Epidemiologia e Biostatistica, Genova</wicri:regionArea><wicri:noRegion>Genova</wicri:noRegion></affiliation></author><author><name sortKey="Ravelli, Angelo" sort="Ravelli, Angelo" uniqKey="Ravelli A" first="Angelo" last="Ravelli">Angelo Ravelli</name><affiliation wicri:level="1"><nlm:aff id="A1">Nicolino Ruperto, MD, MPH, IRCCS G Gaslini, Pediatria II, Reumatologia, PRINTO, Genova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Nicolino Ruperto, MD, MPH, IRCCS G Gaslini, Pediatria II, Reumatologia, PRINTO, Genova</wicri:regionArea><wicri:noRegion>Genova</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A3">Angelo Ravelli, MD, Prof, Alberto Martini, MD, Prof, IRCCS G. Gaslini, Pediatria II, Reumatologia and Dipartimento di Pediatria, Università degli Studi, Genova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Angelo Ravelli, MD, Prof, Alberto Martini, MD, Prof, IRCCS G. Gaslini, Pediatria II, Reumatologia and Dipartimento di Pediatria, Università degli Studi, Genova</wicri:regionArea><wicri:noRegion>Genova</wicri:noRegion></affiliation></author><author><name sortKey="Rider, Lisa G" sort="Rider, Lisa G" uniqKey="Rider L" first="Lisa G." last="Rider">Lisa G. Rider</name><affiliation wicri:level="2"><nlm:aff id="A4">Lisa G. Rider, MD, NIEHS, NIH, Bethesda, MD, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Lisa G. Rider, MD, NIEHS, NIH, Bethesda, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Pilkington, Clarissa" sort="Pilkington, Clarissa" uniqKey="Pilkington C" first="Clarissa" last="Pilkington">Clarissa Pilkington</name><affiliation wicri:level="3"><nlm:aff id="A5">Clarissa Pilkington, MD, Great Ormond Street Hospital for Sick Children, London, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clarissa Pilkington, MD, Great Ormond Street Hospital for Sick Children, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Oliveira, Sheila" sort="Oliveira, Sheila" uniqKey="Oliveira S" first="Sheila" last="Oliveira">Sheila Oliveira</name><affiliation wicri:level="3"><nlm:aff id="A6">Sheila Oliveira, MD, Prof, Universidade Federal do Rio de Janeiro, Instituto de Puericultura e Pediatria Martagao Gesteira, Rio de Janeiro, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Sheila Oliveira, MD, Prof, Universidade Federal do Rio de Janeiro, Instituto de Puericultura e Pediatria Martagao Gesteira, Rio de Janeiro</wicri:regionArea><placeName><settlement type="city">Rio de Janeiro</settlement><region type="state">État de Rio de Janeiro</region></placeName></affiliation></author><author><name sortKey="Wulffraat, Nico" sort="Wulffraat, Nico" uniqKey="Wulffraat N" first="Nico" last="Wulffraat">Nico Wulffraat</name><affiliation wicri:level="3"><nlm:aff id="A7">Nico Wulffraat, MD, Wilhelmina Kinderziekenhuis, Utrecht, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Nico Wulffraat, MD, Wilhelmina Kinderziekenhuis, Utrecht</wicri:regionArea><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Espada, Graciela" sort="Espada, Graciela" uniqKey="Espada G" first="Graciela" last="Espada">Graciela Espada</name><affiliation wicri:level="1"><nlm:aff id="A8">Graciela Espada, MD, Hospital de Ninos Ricardo Gutierrez, Buenos Aires, Argentina</nlm:aff><country xml:lang="fr">Argentine</country><wicri:regionArea>Graciela Espada, MD, Hospital de Ninos Ricardo Gutierrez, Buenos Aires</wicri:regionArea><wicri:noRegion>Buenos Aires</wicri:noRegion></affiliation></author><author><name sortKey="Garay, Stella" sort="Garay, Stella" uniqKey="Garay S" first="Stella" last="Garay">Stella Garay</name><affiliation wicri:level="1"><nlm:aff id="A9">Stella Garay, MD, Hospital Sor Maria Ludovica, La Plata, Argentina</nlm:aff><country xml:lang="fr">Argentine</country><wicri:regionArea>Stella Garay, MD, Hospital Sor Maria Ludovica, La Plata</wicri:regionArea><wicri:noRegion>La Plata</wicri:noRegion></affiliation></author><author><name sortKey="Cuttica, Ruben" sort="Cuttica, Ruben" uniqKey="Cuttica R" first="Ruben" last="Cuttica">Ruben Cuttica</name><affiliation wicri:level="1"><nlm:aff id="A10">Ruben Cuttica, MD, Hospital General de Ninos Pedro de Elizalde, Buenos Aires, Argentina</nlm:aff><country xml:lang="fr">Argentine</country><wicri:regionArea>Ruben Cuttica, MD, Hospital General de Ninos Pedro de Elizalde, Buenos Aires</wicri:regionArea><wicri:noRegion>Buenos Aires</wicri:noRegion></affiliation></author><author><name sortKey="Hofer, Michael" sort="Hofer, Michael" uniqKey="Hofer M" first="Michael" last="Hofer">Michael Hofer</name><affiliation wicri:level="3"><nlm:aff id="A11">Michael Hofer, MD, Centre Multisite Romand de Rhumatologie Pediatrique, Lausanne, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Michael Hofer, MD, Centre Multisite Romand de Rhumatologie Pediatrique, Lausanne</wicri:regionArea><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author><author><name sortKey="Quartier, Pierre" sort="Quartier, Pierre" uniqKey="Quartier P" first="Pierre" last="Quartier">Pierre Quartier</name><affiliation wicri:level="4"><nlm:aff id="A12">Pierre Quartier, MD, Universite Paris-Descartes, Hopital Necker-Enfants Malades, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Pierre Quartier, MD, Universite Paris-Descartes, Hopital Necker-Enfants Malades, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement><settlement type="city">Paris</settlement></placeName><orgName type="university">Université Paris-Descartes</orgName></affiliation></author><author><name sortKey="Melo Gomes, Jose" sort="Melo Gomes, Jose" uniqKey="Melo Gomes J" first="Jose" last="Melo-Gomes">Jose Melo-Gomes</name><affiliation wicri:level="1"><nlm:aff id="A13">Jose Melo-Gomes, MD, Instituto Portugues de Reumatologia, Lisbon, Portugal</nlm:aff><country xml:lang="fr">Portugal</country><wicri:regionArea>Jose Melo-Gomes, MD, Instituto Portugues de Reumatologia, Lisbon</wicri:regionArea><wicri:noRegion>Lisbon</wicri:noRegion></affiliation></author><author><name sortKey="Reed, Ann M" sort="Reed, Ann M" uniqKey="Reed A" first="Ann M." last="Reed">Ann M. Reed</name><affiliation wicri:level="2"><nlm:aff id="A14">Ann M. Reed, MD, Mayo Clinic School of Medicine and Mayo Foundation, Rochester, MN, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Ann M. Reed, MD, Mayo Clinic School of Medicine and Mayo Foundation, Rochester, MN</wicri:regionArea><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Wierzbowska, Malgorzata" sort="Wierzbowska, Malgorzata" uniqKey="Wierzbowska M" first="Malgorzata" last="Wierzbowska">Malgorzata Wierzbowska</name><affiliation wicri:level="1"><nlm:aff id="A15">Malgorzata Wierzbowska, MD, Institute of Rheumatology, Warsaw, Poland</nlm:aff><country xml:lang="fr">Pologne</country><wicri:regionArea>Malgorzata Wierzbowska, MD, Institute of Rheumatology, Warsaw</wicri:regionArea><wicri:noRegion>Warsaw</wicri:noRegion></affiliation></author><author><name sortKey="Feldman, Brian M" sort="Feldman, Brian M" uniqKey="Feldman B" first="Brian M." last="Feldman">Brian M. Feldman</name><affiliation wicri:level="4"><nlm:aff id="A16">Brian M. Feldman, MD, MSc, FRCPC, University of Toronto, The Hospital for Sick Children, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Brian M. Feldman, MD, MSc, FRCPC, University of Toronto, The Hospital for Sick Children, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Harjacek, Miroslav" sort="Harjacek, Miroslav" uniqKey="Harjacek M" first="Miroslav" last="Harjacek">Miroslav Harjacek</name><affiliation wicri:level="1"><nlm:aff id="A17">Miroslav Harjacek, MD, Children's Hospital Zagreb, Zagreb, Croatia</nlm:aff><country xml:lang="fr">Croatie</country><wicri:regionArea>Miroslav Harjacek, MD, Children's Hospital Zagreb, Zagreb</wicri:regionArea><wicri:noRegion>Zagreb</wicri:noRegion></affiliation></author><author><name sortKey="Huppertz, Hans Iko" sort="Huppertz, Hans Iko" uniqKey="Huppertz H" first="Hans-Iko" last="Huppertz">Hans-Iko Huppertz</name><affiliation wicri:level="3"><nlm:aff id="A18">Hans-Iko Huppertz, MD, Klinikum Bremen-Mitte, Bremen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Hans-Iko Huppertz, MD, Klinikum Bremen-Mitte, Bremen</wicri:regionArea><placeName><region type="land" nuts="3">Brême (Land)</region><settlement type="city">Brême</settlement></placeName></affiliation></author><author><name sortKey="Nielsen, Susan" sort="Nielsen, Susan" uniqKey="Nielsen S" first="Susan" last="Nielsen">Susan Nielsen</name><affiliation wicri:level="3"><nlm:aff id="A19">Susan Nielsen, MD, Juliane Marie Centret, Rigshospitalet, Copenhagen, Denmark</nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea>Susan Nielsen, MD, Juliane Marie Centret, Rigshospitalet, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Flato, Berit" sort="Flato, Berit" uniqKey="Flato B" first="Berit" last="Flato">Berit Flato</name><affiliation wicri:level="3"><nlm:aff id="A20">Berit Flato, MD, Rikshospitalet University Hospital, Oslo, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Berit Flato, MD, Rikshospitalet University Hospital, Oslo</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Lahdenne, Pekka" sort="Lahdenne, Pekka" uniqKey="Lahdenne P" first="Pekka" last="Lahdenne">Pekka Lahdenne</name><affiliation wicri:level="1"><nlm:aff id="A21">Pekka Lahdenne, MD, Hospital for Children and Adolescents, Helsinki, Finland</nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea>Pekka Lahdenne, MD, Hospital for Children and Adolescents, Helsinki</wicri:regionArea><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Michels, Harmut" sort="Michels, Harmut" uniqKey="Michels H" first="Harmut" last="Michels">Harmut Michels</name><affiliation wicri:level="1"><nlm:aff id="A22">Harmut Michels, MD, Rheumakinderklinik Garmisch-Partenkirchen, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Harmut Michels, MD, Rheumakinderklinik Garmisch-Partenkirchen</wicri:regionArea><wicri:noRegion>Rheumakinderklinik Garmisch-Partenkirchen</wicri:noRegion><wicri:noRegion>Rheumakinderklinik Garmisch-Partenkirchen</wicri:noRegion><wicri:noRegion>Rheumakinderklinik Garmisch-Partenkirchen</wicri:noRegion></affiliation></author><author><name sortKey="Murray, Kevin J" sort="Murray, Kevin J" uniqKey="Murray K" first="Kevin J." last="Murray">Kevin J. Murray</name><affiliation wicri:level="1"><nlm:aff id="A23">Kevin J. Murray, MD, Princess Margaret Hospital for Children, Perth, WA, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Kevin J. Murray, MD, Princess Margaret Hospital for Children, Perth, WA</wicri:regionArea><wicri:noRegion>WA</wicri:noRegion></affiliation></author><author><name sortKey="Punaro, Lynn" sort="Punaro, Lynn" uniqKey="Punaro L" first="Lynn" last="Punaro">Lynn Punaro</name><affiliation wicri:level="2"><nlm:aff id="A24">Lynn Punaro, MD, Texas Scottish Rite Hospital, Dallas, TX, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Lynn Punaro, MD, Texas Scottish Rite Hospital, Dallas, TX</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Rennebohm, Robert" sort="Rennebohm, Robert" uniqKey="Rennebohm R" first="Robert" last="Rennebohm">Robert Rennebohm</name><affiliation wicri:level="1"><nlm:aff id="A25">Robert Rennebohm, MD, Alberta Children's Hospital, Calgary, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Robert Rennebohm, MD, Alberta Children's Hospital, Calgary</wicri:regionArea><wicri:noRegion>Calgary</wicri:noRegion></affiliation></author><author><name sortKey="Russo, Ricardo" sort="Russo, Ricardo" uniqKey="Russo R" first="Ricardo" last="Russo">Ricardo Russo</name><affiliation wicri:level="1"><nlm:aff id="A26">Ricardo Russo, MD, Hospital de Pediatria Juan P. Garrahan, Buenos Aires, Argentina</nlm:aff><country xml:lang="fr">Argentine</country><wicri:regionArea>Ricardo Russo, MD, Hospital de Pediatria Juan P. Garrahan, Buenos Aires</wicri:regionArea><wicri:noRegion>Buenos Aires</wicri:noRegion></affiliation></author><author><name sortKey="Balogh, Zsolt" sort="Balogh, Zsolt" uniqKey="Balogh Z" first="Zsolt" last="Balogh">Zsolt Balogh</name><affiliation wicri:level="3"><nlm:aff id="A27">Zsolt Balogh, MD, National Institute of Rheumatology and Physiotherapy, Budapest, Argentina</nlm:aff><country xml:lang="fr">Argentine</country><wicri:regionArea>Zsolt Balogh, MD, National Institute of Rheumatology and Physiotherapy, Budapest</wicri:regionArea><placeName><settlement type="city">Budapest</settlement><region nuts="2">Hongrie centrale</region></placeName></affiliation></author><author><name sortKey="Rooney, Madeleine" sort="Rooney, Madeleine" uniqKey="Rooney M" first="Madeleine" last="Rooney">Madeleine Rooney</name><affiliation wicri:level="2"><nlm:aff id="A28">Madeleine Rooney, MD, Musgrave Park Hospital, Belfast, Northern Ireland</nlm:aff><country>Royaume-Uni</country><placeName><region type="country">Irlande du Nord</region></placeName><wicri:cityArea>Madeleine Rooney, MD, Musgrave Park Hospital, Belfast</wicri:cityArea></affiliation></author><author><name sortKey="Pachman, Lauren M" sort="Pachman, Lauren M" uniqKey="Pachman L" first="Lauren M." last="Pachman">Lauren M. Pachman</name><affiliation wicri:level="2"><nlm:aff id="A29">Lauren M. Pachman, MD, Children's Memorial Hospital, Chicago, IL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Lauren M. Pachman, MD, Children's Memorial Hospital, Chicago, IL</wicri:regionArea><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Wallace, Carol" sort="Wallace, Carol" uniqKey="Wallace C" first="Carol" last="Wallace">Carol Wallace</name><affiliation wicri:level="2"><nlm:aff id="A30">Carol Wallace, MD, University of Washington/Children's Hospital, Seattle, WA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Carol Wallace, MD, University of Washington/Children's Hospital, Seattle, WA</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Hashkes, Philip" sort="Hashkes, Philip" uniqKey="Hashkes P" first="Philip" last="Hashkes">Philip Hashkes</name><affiliation wicri:level="1"><nlm:aff id="A31">Philip Hashkes, MD, Shaare Zedek Medical Center, Jerusalem, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Philip Hashkes, MD, Shaare Zedek Medical Center, Jerusalem</wicri:regionArea><wicri:noRegion>Jerusalem</wicri:noRegion></affiliation></author><author><name sortKey="Lovell, Daniel J" sort="Lovell, Daniel J" uniqKey="Lovell D" first="Daniel J." last="Lovell">Daniel J. Lovell</name><affiliation wicri:level="2"><nlm:aff id="A32">Daniel J. Lovell, MD, MPH, Edward H. Giannini, MSc, DrPH, Children's Hospital Medical Center, Cincinnati, OH, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Daniel J. Lovell, MD, MPH, Edward H. Giannini, MSc, DrPH, Children's Hospital Medical Center, Cincinnati, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Giannini, Edward H" sort="Giannini, Edward H" uniqKey="Giannini E" first="Edward H." last="Giannini">Edward H. Giannini</name><affiliation wicri:level="2"><nlm:aff id="A32">Daniel J. Lovell, MD, MPH, Edward H. Giannini, MSc, DrPH, Children's Hospital Medical Center, Cincinnati, OH, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Daniel J. Lovell, MD, MPH, Edward H. Giannini, MSc, DrPH, Children's Hospital Medical Center, Cincinnati, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Martini, Alberto" sort="Martini, Alberto" uniqKey="Martini A" first="Alberto" last="Martini">Alberto Martini</name><affiliation wicri:level="1"><nlm:aff id="A3">Angelo Ravelli, MD, Prof, Alberto Martini, MD, Prof, IRCCS G. Gaslini, Pediatria II, Reumatologia and Dipartimento di Pediatria, Università degli Studi, Genova, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Angelo Ravelli, MD, Prof, Alberto Martini, MD, Prof, IRCCS G. Gaslini, Pediatria II, Reumatologia and Dipartimento di Pediatria, Università degli Studi, Genova</wicri:regionArea><wicri:noRegion>Genova</wicri:noRegion></affiliation></author></analytic><series><title level="j">Arthritis care & research</title><idno type="ISSN">2151-464X</idno><idno type="eISSN">2151-4658</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">To develop a provisional definition for the evaluation of response to therapy in juvenile dermatomyositis (JDM) based on the PRINTO JDM core set of variables.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">Thirty-seven experienced pediatric rheumatologists from 27 countries, achieved consensus on 128 difficult patient profiles as clinically improved or not improved using a stepwise approach (patients rating, statistical analysis, definition selection). Using the physicians’ consensus ratings as the “gold-standard measure”, chi-square, sensitivity, specificity, false positive and negative rate, area under the ROC, and kappa agreement for candidate definitions of improvement were calculated. Definitions with kappa >0.8 were multiplied with the face validity score to select the top definitions.</p></sec><sec id="S3"><title>Results</title><p id="P3">The top definition of improvement was: at least 20% improvement from baseline in 3/6 core set variables with no more than 1 of the remaining worsening by more than 30%, which cannot be muscle strength. The second highest scoring definition was at least 20% improvement from baseline in 3/6 core set variables with no more than 2 of the remaining worsening by more than 25%, which cannot be muscle strength which is definition P1 selected by the IMACS group. The third is similar to the second with the maximum amount of worsening set to 30%. This indicates convergent validity of the process.</p></sec><sec id="S4"><title>Conclusion</title><p id="P4">we proposes a provisional data driven definition of improvement that reflects well the consensus rating of experienced clinicians, which incorporates clinically meaningful change in core set variables in a composite endpoint for the evaluation of global response to therapy in JDM.</p></sec></div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Argentine</li><li>Australie</li><li>Brésil</li><li>Canada</li><li>Croatie</li><li>Danemark</li><li>Finlande</li><li>France</li><li>Israël</li><li>Italie</li><li>Norvège</li><li>Pays-Bas</li><li>Pologne</li><li>Portugal</li><li>Royaume-Uni</li><li>Suisse</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Brême (Land)</li><li>Canton de Vaud</li><li>Grand Londres</li><li>Hongrie centrale</li><li>Hovedstaden</li><li>Illinois</li><li>Irlande du Nord</li><li>Maryland</li><li>Minnesota</li><li>Ohio</li><li>Ontario</li><li>Texas</li><li>Utrecht (province)</li><li>Washington (État)</li><li>État de Rio de Janeiro</li><li>Île-de-France</li><li>Østlandet</li></region><settlement><li>Brême</li><li>Budapest</li><li>Copenhague</li><li>Lausanne</li><li>Londres</li><li>Oslo</li><li>Paris</li><li>Rio de Janeiro</li><li>Toronto</li><li>Utrecht</li></settlement><orgName><li>Université Paris-Descartes</li><li>Université de Toronto</li></orgName></list><tree><country name="Italie"><noRegion><name sortKey="Ruperto, Nicolino" sort="Ruperto, Nicolino" uniqKey="Ruperto N" first="Nicolino" last="Ruperto">Nicolino Ruperto</name></noRegion><name sortKey="Martini, Alberto" sort="Martini, Alberto" uniqKey="Martini A" first="Alberto" last="Martini">Alberto Martini</name><name sortKey="Pistorio, Angela" sort="Pistorio, Angela" uniqKey="Pistorio A" first="Angela" last="Pistorio">Angela Pistorio</name><name sortKey="Ravelli, Angelo" sort="Ravelli, Angelo" uniqKey="Ravelli A" first="Angelo" last="Ravelli">Angelo Ravelli</name><name sortKey="Ravelli, Angelo" sort="Ravelli, Angelo" uniqKey="Ravelli A" first="Angelo" last="Ravelli">Angelo Ravelli</name></country><country name="États-Unis"><region name="Maryland"><name sortKey="Rider, Lisa G" sort="Rider, Lisa G" uniqKey="Rider L" first="Lisa G." last="Rider">Lisa G. Rider</name></region><name sortKey="Giannini, Edward H" sort="Giannini, Edward H" uniqKey="Giannini E" first="Edward H." last="Giannini">Edward H. Giannini</name><name sortKey="Lovell, Daniel J" sort="Lovell, Daniel J" uniqKey="Lovell D" first="Daniel J." last="Lovell">Daniel J. Lovell</name><name sortKey="Pachman, Lauren M" sort="Pachman, Lauren M" uniqKey="Pachman L" first="Lauren M." last="Pachman">Lauren M. Pachman</name><name sortKey="Punaro, Lynn" sort="Punaro, Lynn" uniqKey="Punaro L" first="Lynn" last="Punaro">Lynn Punaro</name><name sortKey="Reed, Ann M" sort="Reed, Ann M" uniqKey="Reed A" first="Ann M." last="Reed">Ann M. Reed</name><name sortKey="Wallace, Carol" sort="Wallace, Carol" uniqKey="Wallace C" first="Carol" last="Wallace">Carol Wallace</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Pilkington, Clarissa" sort="Pilkington, Clarissa" uniqKey="Pilkington C" first="Clarissa" last="Pilkington">Clarissa Pilkington</name></region><name sortKey="Rooney, Madeleine" sort="Rooney, Madeleine" uniqKey="Rooney M" first="Madeleine" last="Rooney">Madeleine Rooney</name></country><country name="Brésil"><region name="État de Rio de Janeiro"><name sortKey="Oliveira, Sheila" sort="Oliveira, Sheila" uniqKey="Oliveira S" first="Sheila" last="Oliveira">Sheila Oliveira</name></region></country><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Wulffraat, Nico" sort="Wulffraat, Nico" uniqKey="Wulffraat N" first="Nico" last="Wulffraat">Nico Wulffraat</name></region></country><country name="Argentine"><noRegion><name sortKey="Espada, Graciela" sort="Espada, Graciela" uniqKey="Espada G" first="Graciela" last="Espada">Graciela Espada</name></noRegion><name sortKey="Balogh, Zsolt" sort="Balogh, Zsolt" uniqKey="Balogh Z" first="Zsolt" last="Balogh">Zsolt Balogh</name><name sortKey="Cuttica, Ruben" sort="Cuttica, Ruben" uniqKey="Cuttica R" first="Ruben" last="Cuttica">Ruben Cuttica</name><name sortKey="Garay, Stella" sort="Garay, Stella" uniqKey="Garay S" first="Stella" last="Garay">Stella Garay</name><name sortKey="Russo, Ricardo" sort="Russo, Ricardo" uniqKey="Russo R" first="Ricardo" last="Russo">Ricardo Russo</name></country><country name="Suisse"><region name="Canton de Vaud"><name sortKey="Hofer, Michael" sort="Hofer, Michael" uniqKey="Hofer M" first="Michael" last="Hofer">Michael Hofer</name></region></country><country name="France"><region name="Île-de-France"><name sortKey="Quartier, Pierre" sort="Quartier, Pierre" uniqKey="Quartier P" first="Pierre" last="Quartier">Pierre Quartier</name></region></country><country name="Portugal"><noRegion><name sortKey="Melo Gomes, Jose" sort="Melo Gomes, Jose" uniqKey="Melo Gomes J" first="Jose" last="Melo-Gomes">Jose Melo-Gomes</name></noRegion></country><country name="Pologne"><noRegion><name sortKey="Wierzbowska, Malgorzata" sort="Wierzbowska, Malgorzata" uniqKey="Wierzbowska M" first="Malgorzata" last="Wierzbowska">Malgorzata Wierzbowska</name></noRegion></country><country name="Canada"><region name="Ontario"><name sortKey="Feldman, Brian M" sort="Feldman, Brian M" uniqKey="Feldman B" first="Brian M." last="Feldman">Brian M. Feldman</name></region><name sortKey="Rennebohm, Robert" sort="Rennebohm, Robert" uniqKey="Rennebohm R" first="Robert" last="Rennebohm">Robert Rennebohm</name></country><country name="Croatie"><noRegion><name sortKey="Harjacek, Miroslav" sort="Harjacek, Miroslav" uniqKey="Harjacek M" first="Miroslav" last="Harjacek">Miroslav Harjacek</name></noRegion></country><country name="Allemagne"><region name="Brême (Land)"><name sortKey="Huppertz, Hans Iko" sort="Huppertz, Hans Iko" uniqKey="Huppertz H" first="Hans-Iko" last="Huppertz">Hans-Iko Huppertz</name></region><name sortKey="Michels, Harmut" sort="Michels, Harmut" uniqKey="Michels H" first="Harmut" last="Michels">Harmut Michels</name></country><country name="Danemark"><region name="Hovedstaden"><name sortKey="Nielsen, Susan" sort="Nielsen, Susan" uniqKey="Nielsen S" first="Susan" last="Nielsen">Susan Nielsen</name></region></country><country name="Norvège"><region name="Østlandet"><name sortKey="Flato, Berit" sort="Flato, Berit" uniqKey="Flato B" first="Berit" last="Flato">Berit Flato</name></region></country><country name="Finlande"><noRegion><name sortKey="Lahdenne, Pekka" sort="Lahdenne, Pekka" uniqKey="Lahdenne P" first="Pekka" last="Lahdenne">Pekka Lahdenne</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Murray, Kevin J" sort="Murray, Kevin J" uniqKey="Murray K" first="Kevin J." last="Murray">Kevin J. Murray</name></noRegion></country><country name="Israël"><noRegion><name sortKey="Hashkes, Philip" sort="Hashkes, Philip" uniqKey="Hashkes P" first="Philip" last="Hashkes">Philip Hashkes</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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