However, no precise guidelines exist regarding the optimal use of the PGA in SLE, such as the adequate length of the VAS, the presence of anchored values, the incorporation of laboratory data and the time frame of assessment. Correlations with other instruments measuring similar constructs should typically demonstrate a coefficient (r) 0.50 [106]. , Urowitz MB Criterion validity is defined as the degree to which the scores of an instrument adequately reflect the truth in the form of a gold standard [107]. Eudy AM Convergent validity is fulfilled indirectly in studies where the PGA is used as the gold standard to assess the construct validity of other indices. , Shea BJ Manzi S , Seaman AL , Tanangunan R JSS Medical Research. This scoring modality was used for the SRI [3]. 2022 May;9(1):e000700. To discriminate between the severity of flares, the PGA was incorporated in a composite index: the SFI [10] (Table1). It operates in Albuquerque, and New Mexico. A prospective cohort study, Validity and reliability of retrospective assessment of disease activity and flare in observational cohorts of lupus patients, A novel lupus activity index accounting for glucocorticoids: SLEDAI-2K glucocorticoid index, Low disease activityirrespective of serologic status at baselineassociated with reduction of corticosteroid dose and number of flares in patients with systemic lupus erythematosus treated with belimumab: a real-life observational study, Definition and initial validation of a lupus low disease activity state (LLDAS), A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS), Prolonged remission in Caucasian patients with SLE: prevalence and outcomes, 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus, PRISMA Group. This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. , Alunno A , Wallace DJ Mok CC CareerBuilder TIP. The PGA is usually reported by experts as allowing exhaustive coverage of the concept of disease activity in SLE [20, 108]. , Magder L This suggests that the role of the PGA is limited for disease activity assessment when used as a single instrument. The PISCOS results will allow for increased homogeneity and reliability of PGA ratings in routine clinical practice, definitions of remission and low disease activity, and future SLE trials. In support of its face validity, the PGA was used to define the disease activity score in all 91 studies retrieved by the literature search, having a role as an outcome measure as well as a comparator to assess the validity of other indices. Ensure second line of defense Derivatives RWA reviews are performed consistently and . Visual analogue scales (VAS) allow rapid, continuous scaling of disease severity. 2014 - 20184 years. Brunner HI The Patient's Global Assessment Scale (PGA) is the PRO counterpart to the Physician's Global Assessment Scale or Investigator's Global Assessment Scale (PGA-IGA). It does not provide a predefined or limited list of disease manifestations or organ systems, thus allowing one to capture all the heterogeneous aspects of SLE disease activity. , Jnsen A Moher D Gladman DD Clipboard, Search History, and several other advanced features are temporarily unavailable. et al. Physician global assessments for disease activity in rheumatoid arthritis are all over the map! Additional papers were obtained by checking the references from the selected studies. Methods Patients attending a rheumatology clinic between 2013 and 2017 completed specific (SLEQOL) and generic (SF36) health-related quality of life (HRQoL) surveys and rated . , Hochberg M. Wallace DJ doi: 10.1136/rmdopen-2022-002395. AU - Morand, Eric. physician's global assessment (PGA) of disease activity in SLE. Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index. doi: 10.1136/lupus-2022-000700. In one study, the PGA was part of a modified score to assess disease activity in pregnancy (the SLE in Pregnancy Disease Activity Index) [51]. Pincus and colleagues conducted a study of . , Petri M. Furie RA , Gomez A , Schur PH. PGA0.3. official website and that any information you provide is encrypted Liang et al. 8600 Rockville Pike Reviews and case series with fewer than five patients were excluded. et al. When expanded it provides a list of search options that will switch the search inputs to match the current selection. et al. , Kiani AN The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. Face validity is satisfied when the instrument is considered able to capture what it should capture (i.e. 2022 Mar 14;24(1):70. doi: 10.1186/s13075-022-02756-3. Int J Environ Res Public Health. The site is secure. Copay AG In an epratuzumab trial, the absence of deterioration of the PGA (not >10% worsening) was one of the items to achieve a BILAG-based Composite Lupus Assessment (BICLA) response [105]. et al. (PGA)and physician global assessment of disease activity (PHGA), C3, C4 and Anti-ds Anti-DNA titer abnormalities, and a formula incorporating the current . , Ho LY Compared with nonresponders, BICLA responders had greater improvements in global and organ-specific disease activity (Physician's Global Assessment, SLE Disease Activity Index 2000, Cutaneous Lupus Erythematosus Disease Area and Severity Index Activity, and joint counts; all nominal P < 0.001). Cloud, mobility, security, and more. , Allen E et al. The Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus (PISCOS) study aimed to obtain an evidence-based and expert-based consensus standardisation of the Physician Global Assessment (PGA) scoring of disease activity in systemic lupus erythematosus (SLE). Glossary: PGA. Of note, the literature search revealed heterogeneous definitions of physician assessment of disease activity other than the PGA (physician global assessment [4, 70, 73], physician overall assessment [85]). FOIA , Garabajiu M Gyri N Comparison of the validity and sensitivity to change of 5 activity indices in systemic lupus erythematosus. The results are similar, and less than half the time is required for scoring. [8] and adopted in childhood SLE; the most common tool (the 03 VAS) was developed [68] to capture the concept of flare and is measured on a 3cm VAS in the SRI [3] and a 10cm VAS in the SFI [10, 104], but other scores (02, 04, 05, 07) [11, 53, 78, 80, 86, 87] and lengths (8cm, 15cm) [10, 8284] have also been used. Background: Physician Global Assessment (PGA) is a visual analogue score (VAS) that reflects the clinician's judgment of overall Systemic Lupus Erythematosus (SLE) disease activity. Twenty-nine studies [25, 31, 3439, 41, 43, 48, 49, 5355, 59, 6164, 74, 75, 81, 82, 86, 92, 93, 96, 97] have assessed criterion validity of the PGA (Table2). The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. , Jolly M. Antony A A 21-numbered circle visual analog scale (VAS) may be a desirable alternative to the traditional 10-cm horizontal line for pain and patient global estimate on a Multidimensional Health Assessment Questionnaire (MDHAQ). Higher disease activity is an important predictor of both organ damage and mortality [2] and the attainment of low disease activity is associated with a reduction in early damage [5, 6]. 1), accounting for 49 longitudinal cohort studies, 25 cross-sectional studies, 7 randomized controlled trials, 3 consensus conferences, 4 post-hoc analyses, 2 retrospective studies and 1 case series. Navarra SV , Shinada S Mina R Each study was examined in order to extract psychometric property data on the PGA according to the OMERACT Filter methodology version 2.1 [18]. TOTAL DOCUMENTS. , Landis RC SLE2ACR1997SLICC2012. Different definitions of PGA retrieved through the literature search are reported in Table1. Schneider M Learn more. In 1988, Liang et al. Discrimination refers to whether the score (PGA-VAS) differentiates between situations of interest [18]: discrimination of the PGA measures the ability of the PGA-VAS to report a consistent score where no change in disease activity has occurred (reliability) and to detect a change when a change in disease activity has occurred (sensitivity to change or responsiveness). Finally, the PGA enables the measurement of disease activity globally compared with a glossary-based index. T1 - Associations between physicians' global assessment of disease activity and patient-reported outcomes in patients with systemic lupus erythematosus. Matthew Turk,1,2 Janet E Pope1,2 To cite: turk M, Pope Je. , Burlingame RW A good correlation was considered for a value >0.60. , Sengupta M , Brunetta P Several definitions of minimum clinically important difference were retrieved: in the SRI-4, a significant worsening was defined as an increase of >10% on the PGA-VAS [111], corresponding to 0.3 points from baseline; Touma et al. , Holland M , Engleman EG A total of 91 articles were included in the study (Fig. Background: Physician Global Assessment (PGA) is a visual analogue score (VAS) that reflects the clinician's judgment of overall Systemic Lupus Erythematosus (SLE) disease activity. [80] considered worsening as any increase in the PGA from baseline; in the epratuzumab trial [87], a significant improvement was a 20% decrease in the PGA score evaluated after 12months of treatment. ECG - correct answer no sleep the night before, meals allowed, no stimulants/tranquilizers for 24-48 hours before. , Saad-Magalhes C , Francis S et al. 2014 Dec;53(12):2175-81. doi: 10.1093/rheumatology/keu153. Thousand Oaks. , McGwin G The index assesses separately eight organ-based systems. AU - Kasitanon, Nuntana. [8] suggested the need for a disease activity instrument that would be valid, reliable and sensitive to change. Please enable it to take advantage of the complete set of features! Patient global assessment (PGA) is one of the most widely used PROs in RA practice and research and is included in several composite scores such as the 28-joint Disease Activity Score (DAS28). In the absence of a consensus, Aranow [26] found a better correlation between the SLEDAI and the PGA when the latter was assessed taking into account laboratory test results. 2021 Apr 8;5(1):33. doi: 10.1186/s41687-021-00298-x. , Chatzidionysiou K Responsiveness, or sensitivity to change, is the usefulness of a test to detect minimum clinically important differences [20, 109]. , Henriques C et al. The interrater reliability (interRR) of the PGA is the ability to provide consistent scores in a stable population between two or more physicians who evaluate the disease activity of the same patient. Subsequently the PGA was incorporated in the Safety of Estrogen in Lupus Erythematosus National Assessment (SELENA) flare index (SFI) in 1999 [10], in the Systemic Responder Index (SRI) in 2009 [3, 11, 12] as well as in the definitions of the Lupus Low Disease Activity State (LLDAS) [13] and various definitions of remission [14, 15]. 2. Thanks to this feature, the PGA was included in composite indices with the aim of rating manifestations not included in glossary-based instruments such as the SLEDAI and BILAG [3] or for which a threshold has been defined (cytopenia). , Vogel-Claussen J Reliability. et al. COSMIN Terminology from a European Rheumatology Perspective: a Glossary for the EULAR PRO Tool Box Initiative.
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