, Socher SA , Shea BJ , Floris A It operates in Albuquerque, and New Mexico. et al. physician's global assessment (PGA) of disease activity in SLE. Bethesda, MD 20894, Web Policies , Adamichou C 2. Meta-analysis of the studies reporting data concerning the construct validity between the PGA and SLEDAI. , Mosca M The LUMINA (Lupus in Minorities: Nature versus Nurture) study and other trials have offered evidence of a decrease in flares and prolonged life in patients given hydroxychloroquine, making . et al. Different definitions of disease activity according to the PGA instrument. Use of Physician Global Assessment (PGA) in Systemic lupus - medRxiv (PGA)and physician global assessment of disease activity (PHGA), C3, C4 and Anti-ds Anti-DNA titer abnormalities, and a formula incorporating the current . All versions are validated and used by lupus researchers for clinical and research purposes. , Giangreco D Stojan G Conducting medical monitoring, safety review, narrative writing and etc.. Perform medical assessment of individual . 04 Measuring SLE disease activity in 2020: perspectives from clinical Castrejn I, Ra-Figueroa I, Rosario MP, Carmona L. Reumatol Clin. Additional papers were obtained by checking the references from the selected studies. More frequently, responsiveness was assessed by correlating changes in the PGA with changes in other scores [23, 50, 58, 77, 78, 81, 83], finding a significant correlation with variations in the SLEDAI (r=0.390.66) [23, 77, 78], SLAM (0.61) [77], LAI (0.56) [77], patient global assessment (0.37) [77], SRI-50 (0.48) [78] and ESR (P<0.0001) [58], but not with C3, C4, circulating immunocomplexes and prednisone dose [77]. (Open Access) Development and assessment of a computerized index of [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. Associations between physicians' global assessment of disease activity The SRI is a composite instrument comprised of the SELENA-SLE Disease Activity Index [SELENA-SLEDAI], Physician Global Assessment (PGA) and British Isles Lupus Assessment Group (BILAG) 2004. , Guzmn RM SLE or at an SLE site, but only if the injury requires treatment by a licensed medical doctor. , Giannakou I PDF Getting To Know Dr. Derek Shendell, New Safe Schools Project Director The PGA also showed good predictive validity, as it correlated significantly with measures of future outcomes, such as quality of life or laboratory exams, but no study has currently evaluated its correlation with measures of damage. One study showed a significant ability of the PGA in distinguishing between patients (P<0.0001) and observers (P<0.0001), but not between visits [79]. , Pego-Reigosa J-M 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. SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. No study has evaluated the feasibility of the PGA in SLE to date. Nehring J , Devilliers H The Physician Global Assessment (PGA) is a frequently used co-primary end point in psoriasis clinical trials. disease activity). Moreover, a difference between the interRR of the PGA assessed by an untrained physician (0.50.63) and a trained investigator (0.790.81) was found, suggesting the need for PGA scoring training or standardization [36]. A good responsiveness for PGA was shown in eight studies. , ODell JR For permissions, please email: journals.permissions@oup.com. LECTURE 10: MEDICAL SURGICAL NURSING. Mina R The .gov means its official. 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]. The Physician Global Assessment (PGA) has been shown to be a valid, responsive, and feasible instrument to capture disease activity in systemic lupus erythematosus (SLE), but its low reliability further supports the need for a standardisation of its scoring. , Cappellazzo G et al. Annapureddy N , Wallace DJ BICLA responders had fewer lupus-related serious . Medical Cannabis Use by Rheumatology Patients Following Recreational , Tugwell P Construct validity is the degree to which the PGA relates to other instruments that measure the same concept [18]. Physician Global Assessment International Standardisation COnsensus in Mok CC The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinicians judgement of overall SLE disease activity. Learn more. The Validity of Patient and Physician Global Disease Activity The Systemic Lupus Activity Measure-revised, the Mexican Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and a modified SLEDAI-2K are adequate instruments to measure disease activity in systemic lupus erythematosus. Results. Please enable it to take advantage of the complete set of features! Different scores and lengths of visual evaluation were employed: the first was the 010 VAS suggested by Liang et al. Psychometric properties of FACIT-Fatigue in systemic lupus erythematosus: a pooled analysis of three phase 3 randomised, double-blind, parallel-group controlled studies (BLISS-SC, BLISS-52, BLISS-76). et al. In Fatemi et al. et al. , Kraag GR . Over the years, PGA-IGA scales were modified for the purpose of clinical settings and thus present a diversity in the number of response options (4 to 10 points), the response options label and the . 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). Scoring systemic lupus erythematosus (SLE) disease activity with simple JBT-101 in Systemic Lupus Erythematosus (SLE) Bookshelf (PGA) scoring of disease activity in systemic lupus erythematosus (SLE). Sullivan KE Vil LM T2 - A longitudinal study. For instance, in an analysis of studies of the prevalence of SLE in the Asia-Pacific region, higher rates of renal involvement were observed in Asian patients (21-65% at SLE diagnosis and 40 . Reliability. Criterion validity. ~Sle~ - et al. Few studies reported on whether serological activity should be incorporated in the PGA. et al. 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This site needs JavaScript to work properly. , Buyon J Objective: The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. , Urowitz MB Exagen Diagnostics Inc (XGN) - Product Pipeline Analysis, 2022 Update Nevertheless, despite the fact that the PGA was considered the reference in 39 studies involving other indices, it was used as the sole instrument in only 2 of them. , Petri M. Furie RA Different definitions of PGA retrieved through the literature search are reported in Table1. The PGA was developed on a 0 to 3 scale as part of the Lupus Activity Index. The assessment of PGA responsiveness was performed in 10 studies [4, 23, 50, 58, 7779, 81, 83, 84] using different methods [110]. SELENA SLEDAI4. , Fortin PR et al. [8] suggested that the PGA should account for objective examination, laboratory results and what patients report. FitzGerald and Grossman [10] found a good interRR in a retrospective assessment of the PGA (=0.79). Supporting the face validity property, PGA was defined the gold standard in 11 studies [2, 10, 11, 21, 23, 49, 67, 76, 78, 84, 88] and in 32 it was used as the reference to which other activity scores were compared, such as the SLEDAI [4, 10, 13, 25, 27, 28, 31, 33, 35, 36, 41, 46, 47, 50, 51, 53, 62, 65, 68, 72, 73, 76, 81, 9699], BILAG [4, 27, 35, 36, 46, 65, 72, 73, 81, 98], SLAM [4, 72, 76, 99], LAI [68, 88], patient global assessment [81, 83, 84] and ECLAM [35]. . Assessing disease activity in rheumatic diseases such as systemic lupus erythematosus (SLE) is vital for effective treatment. Dynabook PX1900E-1NCA, PROTECTIVE SLE (PX1900E-1NCA) et al. et al. J Clin Med. et al. Methods The SRI is a validated SLE disease activity instrument used to detect clinically meaningful improvement of disease in SLE clinical trials. 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). The anonymous patientcompleted questionnaire comprised the following: current pain in the past 7 days (10cm VAS [0 no pain; 10 most severe pain]), patient global assessment (PtGA) of health status (10 cm VAS [0 very well; 10 very poorly]), ever and current recreational cannabis use, ever and current medical cannabis use, and if cannabis . Lai J-S However, the PGA allows for the measurement of disease activity in a global way (content validity). , Ogale S A difference between the interRR of the PGA assessed by an untrained physician (ICC=0.50.63) or a trained investigator (ICC=0.790.81) was found [36]. Rheumatology (Oxford). Immune Disorders, Deficiency, Etc - Key Points to Review: Initiation of Arthritis Res Ther. Ward et al. The company serves physicians and patients. X 20 sentence examples within Physician Global Assessment. http://oml.eular.org/glossary (31 January. Of note, it is not trivial that we found a good convergent validity with other instruments (SLEDAI, BILAG, LAI, SLAM and ECLAM) [10, 23, 24, 26, 28, 29, 35, 54, 68, 76, 84, 99]. MD globals may vary based on their age, gender, practice setting and experience (number of patients seen per year and years in practice). Physician global assessment in systemic lupus erythematosus: Can we 215 (FIVE YEARS 146) H-INDEX. 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). PDF Physician Global Assessment International Standardisation COnsensus in . Laboratory Investigation Results Influence Physician's Global SLE231 Hydrology and Water Resources Management: Excursion or Virtual Tour Parodis I Once two investigators (E.C., M.P.) Global Automatic Chemiluminescence Immunoassay Analyzer Market 2023 The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). FOIA AU - Morand, Eric. Systemic lupus erythematosus (SLE), is the most common type of lupus. Treatment of lupus nephritis: consensus, evidence and perspectives , Jolly M. Mok CC Physician's Global Assessment Scale (PGA) or Investigator's Global Assessment Scale (IGA) measures disease status in a broad range of diseases. , Chizzolini C . Importance: In dermatology, the development of objective, standardized quality measures that can be used in a clinical setting is important to be able to respond to the needs of payers and credentialing and licensure bodies and to demonstrate dermatologic value. Management of systemic lupus erythematosus (SLE) often depends on disease severity and disease manifestations, [] although hydroxychloroquine has a central role for long-term treatment in all SLE patients. Some may be a consequence of therapy and others may be . , Urowitz MB. , Sjwall C. Strand V It estimates how similar a given patients scores were at the two visits. Barr SG 'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study. Use of Physician Global Assessment (PGA) in Systemic lupus Physician training is very important. , Liberati A , Aggarwal R Thanou A, Chakravarty E, James JA, Merrill JT. 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. Your comment will be reviewed and published at the journal's discretion. , Shinada S Physician Global Assessment International - ScienceDirect Schlencker A, Messer L, Ardizzone M, Blaison G, Hinschberger O, Dahan E, Sordet C, Walther J, Dory A, Gonzalez M, Kleinlogel S, Bramont-Nachman A, Barrand L, Payen-Revol I, Sibilia J, Martin T, Arnaud L. Lupus Sci Med. et al. et al. PGA is a valid, responsive and feasible instrument, though its reliability was impacted by the scale adopted, suggesting the major need for standardization of its scoring. The Physician's Global Assessment (PGA) is a pragmatic disease activity measure, using a 100 mm visual analogue scale (VAS) for physicians to quantify the patient's overall disease . , Petri M. Iaccarino L Flow chart illustrating the literature search and study selection. et al. The responsiveness of the PGA was assessed through different methods [109, 113] showing a high sensitivity for detecting clinical variations [84]. Objective: Finally, the PGA enables the measurement of disease activity globally compared with a glossary-based index. The Physician Global Assessment (PGA) is an important tool for assessing disease activity in lupus. , Block JA , Schur PH. A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.67-0.98). A validation study of the SRI for juvenile SLE [60] showed that exclusion of the BILAG or PGA from the SRI did not change the accuracy of the SRI in detecting improvement. 2022 May;9(1):e000700. Akhter E BICLA is a validated composite global measure of SLE disease activity including SLEDAI-2K, CLASI-A, OCS dosage reduction, and patient-reported outcomes. Frontiers | Cutaneous lupus erythematosus disease assessment lupus erythematosus; systemic outcome assessment; qualitative research; healthcare; We read with great interest the recent paper by Aranow et al 1 about the impact of laboratory results on scoring of the Physician Global Assessment (PGA) of disease activity in systemic lupus erythematosus (SLE). , Arbab-Zadeh A Search for other works by this author on: Rheumatology Unit, AOU University Clinic and University of Cagliari, Department of Medical Sciences and Public Health, Cagliari, Italy, Centre Hospitalier Universitaire de Dijon, Hpital Franois-Mitterrand, service de mdecine interne et maladies systmiques (mdecine interne, 2) et Centre dInvestigation Clinique, Service de rhumatologie, Hpitaux Universitaires de Strasbourg, Universit de Strasbourg, Centre National de Rfrence des Maladies Systmiques et Autoimmunes Rares Est Sud-Ouest (RESO). , Perneger T An acceptable reliability is indicated by values of intraclass correlation coefficient (ICC) or weighted >0.60 and a good reliability is >0.85 [20]. , Ibaez D et al. This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. In the second column, the definitions were reported according to the VAS used in the study. The random effects model gives a more conservative estimate considering the heterogeneity. In this sense, criterion validity of PGA is satisfied when scores correlate with phenomena subsequently influenced by disease activity, such as quality of life measurements (Health-related Quality of Life, 36-item Short Form Health Survey, Functional Assessment of Chronic Illness TherapyFatigue score, Lupus Impact Tracker and LupusPRO), biomarker levels (complement fractions, ESR, autoantibodies), treatment variations and damage assessments (SDI). The OMERACT defines an instrument as an outcome measure if it passes the three pillars of evidence: truth (that refers to validity), discrimination (that includes reliability and responsiveness) and feasibility. The Physician's Global Assessment (PhGA) is a number without unit. , Mohan C. Jolly M Touma Z , Bouter LM Schneider M Convergent validity is fulfilled indirectly in studies where the PGA is used as the gold standard to assess the construct validity of other indices. et al. Measurement properties of the PGA were analysed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) terminology [19]. [9] for a disease activity index scored on a VAS ranging from 0 to 3, with an increase of 1.0 since the last visit indicating a flare. Can Lupus Patients Take the Driver's Seat in Their Disease Monitoring. , Gallacher AE 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. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. Content validity was reported in 89 studies. The PGA is a well accepted and commonly used scale for evaluating treatment response in clinical trials both in adults and children. , Magder L Would you like email updates of new search results? , Cella D. van Vollenhoven RF Responsiveness. The aim of this systematic literature review (SLR) is to describe and analyse the psychometric properties of PGA. , Lau CS This suggests that the role of the PGA is limited for disease activity assessment when used as a single instrument. Content validity pertains to the degree to which the instrument measures all facets of a construct of interest [20]: this property is satisfied if the PGA is considered able to measure all aspects of disease activity in SLE in a comprehensive way. , Gayet-Ageron A Myelogram - correct answer NPO for 4-6 hours. Five centres in Great Britain and the Republic of Ireland have collaborated to produce a computerized index of clinical disease activity in systemic lupus erythematosus, based on the principle of the physician's intention to treat. It was published in 1977 and was initially designed for the measurement of self-assessed pain in rheumatoid arthritis although it has since been used to evaluate RA more globally. , Sayedbonakdar Z Use of Physician Global Assessment in systemic lupus - PubMed SLE is an immune-mediated multisystemic disease characterized by a wide variability of clinical manifestations and a course frequently subject to unpredictable flares [1, 2]. Ahmed S. - Managing Director/ Medical Lead - Global Bio-pharma MeSH The responsiveness of the PGA is the ability to detect worthwhile variations in disease activity over time, measuring worsening or improvements in SLE disease status. doi: 10.1136/rmdopen-2022-002395. The Author(s) 2020. Pain assessment: An alternative measure - hcplive.com Systemic Lupus Erythematosus (SLE) Treatment & Management - Medscape All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients age. The other authors have declared no conflicts of interest. In 1988, Liang et al. In one study [25], the PGA of disease activity resulted from the combination of the clinical visit, laboratory markers evaluation and the physicians knowledge of the patient disease history. Forbess LJ , Henriques C In our centre, new tools for the assessment of SLE activity: the Lupus Activity Scoring Tool (LAST) and Clinical Lupus Activity Scoring Tool (C-LAST) were developed and validated. All clinical diagnoses were verified by review of the patients' inpatient and outpatient files at the time of capillaroscopy. Methods: The PGA is a valid instrument but has variable reliability; its scoring should be standardized. inflammation (duration and severity of morning stiffness as measured by BASDAI). The last EULAR/ACR recommendations recommended use of the PGA in the routine monitoring of SLE [16]. Ann Rheum Dis 2 Isenberg DA, Allen E, Farewell V, et al. AU - Kandane-Rathnayake, Rangi. Because of the complexity of SLE, the assessment of disease activity is particularly challenging [3]. TOTAL DOCUMENTS. et al. Measuring disease activity in adults with systemic lupus erythematosus The index assesses separately eight organ-based systems. , Sadovici-Bobeica V , Lerman RH , Hochberg M. Touma Z A total of 91 articles were included in the study (Fig. disease activity in SLE, with the Physician Global Assessment (PGA) being the only one included in the updated EULAR recommendations for the management of SLE.11. et al. et al. Oxford University Press is a department of the University of Oxford. Laboratory investigation results influence Physicians Global ssessment (PGA) of disease activity in SLE. An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA. , Klein-Gitelman MS Medical-Surgical Nursing Clinical Lab (NUR1211L) U.S. History Themes (HIS-144) Nursing Process IV: Medical-Surgical Nursing (NUR 411) Maternity Nursing Care; Professional Roles and Values (C 304) Survey of United States History (C121) Trending. Kiani AN This property is reported across all articles selected through this systematic review [24, 913, 21103]. , Magder LS The content can vary and relates either to global health (e . et al. 2014 - 20184 years. , Wallace DJ Thus the development of a comprehensive index for assessing disease activity still represents one of the most important challenges in SLE [7]. Oxford Textbook of. Clinical Trial Physician - Rheumatology Job in San Diego, CA - Bristol The Handheld Dermatoscope as a Nail-Fold Capillaroscopic Instrument - JAMA They participate in physiologic and inflammatory cascades and have become a major focus of research, yielding novel therapies for immune-mediated inflammatory diseases (IMID). A multi-item Physician Global Assessment scale to assess psoriasis , Kosinski M This week's edition of Faculty Publications includes Cedars-Sinai studies that were published Feb. 23-March 2. Complement-Targeted Therapeutics Market Report (2022 to , Ibanez D et al. Randomized MMF Withdrawal in Systemic Lupus Erythematosus (SLE) - Full