Research & Registry

Precision Decisions

Why This Is Important

Imagine a day when you are able to know ahead of time which medication has the best chance of working for you (or your child), based on your personal biology?  This day may soon become a reality for patients with polyarticular juvenile idiopathic arthritis, or pJIA! 

Currently, there are many different medications used to treat pJIA.  Doctors now know that early and effective treatment leads to better long term outcomes.  But there are no tools that help guide doctors on when to start or when to stop different types of medications in children diagnosed with pJIA.  Therefore, it is possible that some children get over-treated and some get under-treated.  Over-treating wastes time and money, and increases risks of side effects because you are exposed to medications you might not need.  Under-treating lengthens the time that arthritis is active, which not only causes pain and disability, but could also lead to permanent joint damage and poor long term outcomes.

The goal of Precision Decisions is to develop a simple inexpensive tool made up of a small number of individual tests.  This tool will help design personalized treatment guidelines for each individual patient, which will improve outcomes and quality of life for both the patient and family.

Precision Decisions is partnering with a clinical research study called STOP-JIA: participants in STOP-JIA will be able to give blood samples for Precision Decisions.

Project Description/Overview


Precisions Decisions is funded by the Arthritis Foundation and CARRA

Currently, children diagnosed with arthritis are placed into sub-groups using their symptoms.  For example, if you have 5 or more swollen joints when your arthritis starts you are in the poly-JIA sub-group.  Treatment is recommended based on this sub-group.  The Precision Decisions project uses blood samples from poly-JIA patients to:

  1. Create sub-groups within the poly-JIA group based on the child's biology.
  2. Create a biology-based tool that can predict a patient's response to treatment so there is less trial and error.
  3. Share the new tool and biology profile to propose better, more targeted care for all children so they can receive the medication that has the best chance to work first.
  4. Share newly developed ways to sort wide ranging data sets so that other forms of JIA and rheumatic diseases can create their own Precision Decisions.


48 CARRA Registry sites are participating in Precision Decisions.

The Duke Clinical Research Institute (DCRI) is the coordinating center for this study.

Who is Involved?

The lead investigator is Rae Yeung, MD, PhD (The Hospital for Sick Children, University of Toronto).