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 other authors have declared no conflicts of interest. This may be explored through convergent and divergent validity. The PGA was integrated in composite indices, including the definition of the LLDAS [12, 13, 29, 34, 37, 39, 40] and remission [29, 37] (Table1). X 20 sentence examples within Physician Global Assessment. Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus: the PISCOS study . physician global assessment (pga) - Assesschild Neuropsychiatry OXFORD TEXTBOOKS IN PSYCHIATRY Oxford Textbook of Neuropsychiatry Edited by Niruj Agrawal, Rafey Faruqui, and Mayur Bodani Oxford Textbook of Psychiatry of Intellectual Disability Edited by Sabyasachi Bhaumik and Regi Alexander Oxford Textbook of Inpatient Psychiatry Edited by Alvaro Barrera, Caroline Attard, and Rob Chaplin Oxford Textbook of Attention . , Cella D. van Vollenhoven RF When expanded it provides a list of search options that will switch the search inputs to match the current selection. For permissions, please email: journals.permissions@oup.com. , Wallace DJ 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. (SLE) GSKpro , Mosca M , Aggarwal R The Physician Global Assessment (PGA) of treatment response measures the overall response to treatment as assessed by the physician. The index assesses separately eight organ-based systems. et al. SLE or at an SLE site, but only if the injury requires treatment by a licensed medical doctor. Petri M 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. 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. Brunner HI In most studies, the PGA was assessed by a rheumatologist experienced in SLE care or research and, as already stated, the ICC reliability was different for an untrained physician and a trained investigator [36]. Gladman DD In this systematic review we have analysed the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. Can Lupus Patients Take the Driver's Seat in Their Disease Monitoring. In 16 studies the PGA was used as a mean to assess changes in disease activity after treatment [3, 12, 22, 29, 40, 42, 43, 52, 54, 56, 57, 80, 85, 87, 95, 98, 101]. et al. It operates in Albuquerque, and New Mexico. et al. , Longenecker JC , Wetter J , Flower C Disclosure statement: L.A. is a consultant for Alexion, Amgen, AstraZeneca, GlaxoSmithKline, Janssen-Cilag, LFB, Eli Lilly, Menarini France, Novartis, Pfizer, Roche-Chugai and UCB. , Sadovici-Bobeica V A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.670.98). Moreover, there is uncertainty as to whether the best timing of assessment is prior to or after reviewing laboratory exams [26]. Physician global assessment in systemic lupus erythematosus: Can we , Nelson S , Magder L Would you like email updates of new search results? . 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). allergy hx phenothiazines, cns depressants and stimulants withheld 48 hours prior. , Mohan C. Giangreco D The https:// ensures that you are connecting to the COSMIN Terminology from a European Rheumatology Perspective: a Glossary for the EULAR PRO Tool Box Initiative. , Carpenter AB T1 - Associations between physicians' global assessment of disease activity and patient-reported outcomes in patients with systemic lupus erythematosus. Presence of at least one of the following items of serological evidence of active SLE or biological variables predictive of Type 1 Interferon (IFN-1) high signature (in a Screening sample as measured by central laboratory): Navarra SV Petri M , McGuire JL. Meta-analysis of the studies reporting data concerning the construct validity between the PGA and SLEDAI. Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. PDF Physician s global assessment is often useful in SLE, but not always 2022 Jan 11;11(2):340. doi: 10.3390/jcm11020340. Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index. Use of Physician Global Assessment (PGA) in Systemic lupus - medRxiv Mok CC The Validity of Patient and Physician Global Disease Activity , Tanangunan R In one open-label study [43], the decrease in PGA score was considered the primary endpoint. The following search strategy was used through MEDLINE via PubMed: (((lupus erythematosus, systemic[MeSH Terms] OR (lupus[TIAB] AND erythematosus[TIAB] AND systemic[TIAB]) OR systemic lupus erythematosus[TIAB] OR (systemic[TIAB] AND lupus[TIAB] AND erythematosus[TIAB]))) OR SLE[TIAB]) AND (physician global assessment[TIAB] OR PGA[TIAB]). The geographical analysis of the Global Global Respiratory Devices market provided in the report is just the right tool that competitors can use to discover untapped sales and business expansion . , Petri M. Iaccarino L et al. 'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study. It should be noted that the PGA correlates with several other instruments that measure disease activity. Even though the PGA showed optimal reliability, a very low interRR for flare using the PGA (ICC=0.18) was found in a single study [65] compared with that of the BILAG (ICC=0.54) or SFI (ICC=0.21). 12. and later incorporated into the SLE Responder Index used in the belimumab clinical trials, 13 Disagreements between investigators were solved by consensus. et al. , OMalley T , Perneger T Published by Oxford University Press on behalf of the British Society for Rheumatology. SLE has protean and often complex manifestations, necessitating careful clinical assessment. 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. In the absence of a well-recognized gold standard for disease activity, criterion validity of the PGA is established when it correlates with a measure that the author of the study defined a priori as the gold standard. , Tugwell P Liang MH , Smiley A. Askanase AD PGA; disease activity; physician global assessment; psychometrics; systemic lupus erythematosus. Epub 2014 Apr 11. , Bresee C Improving patient pathways for systemic lupus erythematosus: a multistakeholder pathway optimisation study. 2022 Sep 20;19(19):11895. doi: 10.3390/ijerph191911895. , Siega-Riz AM Fatigue is independently associated with disease activity assessed using the Physician Global Assessment but not the SLEDAI in patients with systemic lupus erythematosus. Cloud, mobility, security, and more. HHS Vulnerability Disclosure, Help , Kostopoulou M The visual analog scale (VAS)-based assessments, SELENA SLE Disease Activity Index (SLEDAI) Physician's Global Assessment (SSPGA) and Lupus Foundation of America-Rapid Evaluation of Activity in Lupus (LFA-REAL), can be used to assess common trial end points for systemic lupus erythematosus (SLE), according to study results published in Lupus Science & Medicine. , Mazur M. Fatemi A , Zonana-Nacach A et al. et al. The PGA was introduced in 1998 by a US Food and Drug Administration panel as the preferred tool to assess and record the severity of disease in clinical studies, and typically rates a patient's disease from 'clear' to 'severe' or 'very severe' [1, 2]. disease activity). , Sjwall C. Strand V Exagen's products are used for therapeutic drug monitoring of hydroxychloroquine in whole blood and methotrexate polyglutamates, risk assessment testing, anti-TNF monitoring to individualize therapy and optimize dosing, and others. SLE3. Ward et al. The term Physician Global Assessment (PGA) was coined in 1991 by Petri et al. , Klein-Gitelman MS , Arbab-Zadeh A Ensure second line of defense Derivatives RWA reviews are performed consistently and . , Brunetta P 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. BILAGAB . , Petri M. Thanou A , Su J The PGA is a valid instrument but has variable reliability; its scoring should be standardized. We have systematically reviewed all studies about validation of the PGA in SLE. RN-BSN HOLISTIC HEALTH ASSESSMENT ACROSS THE LIFESPAN (NURS 3315) Sociology of Social Problems (SOC213) 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. , Mokkink LB PGA0.3. Criterion validity. Patient-Reported Outcomes in Systemic Lupus Erythematosus. et al. , Glassman DS , Mina R , Hochberg M. Touma Z This site needs JavaScript to work properly. Manzi S 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]. The aim of this systematic literature review is to describe and analyse the . 2022 Mar 14;24(1):70. doi: 10.1186/s13075-022-02756-3. ATI Comprehensive Predictor Exam 2019 (180 Q & A, Verified and 100 At least 1 issue from each virtual tour. Systemic lupus erythematosus (SLE) is a multisystem autoimmune rheumatic disease (ARD) characterized by flares and remissions. Enocsson H 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. , Rairie JE Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, Instrument selection using the OMERACT filter 2.1: the OMERACT methodology, The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes, Health measurement scales: a practical guide to their development and use, A decrease in complement is associated with increased renal and hematologic activity in patients with systemic lupus erythematosus, Efficacy and safety of methotrexate in articular and cutaneous manifestations of systemic lupus erythematosus, Performance of SLEDAI-2K to detect a clinically meaningful change in SLE disease activity: a 36-month prospective cohort study of 334 patients, Disease activity patterns over time in patients with SLE: analysis of the Hopkins Lupus Cohort, Comparison of the systemic lupus erythematosus activity questionnaire and the systemic lupus erythematosus disease activity index in a black Barbadian population, A pilot study to determine the optimal timing of the Physician Global Assessment (PGA) in patients with systemic lupus erythematosus, Preliminary test of the LFA rapid evaluation of activity in lupus (LFA-REAL): an efficient outcome measure correlates with validated instruments, Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity, Clinical SLEDAI-2K zero may be a pragmatic outcome measure in SLE studies, Erythrocyte-bound C4d in combination with complement and autoantibody status for the monitoring of SLE, Validation of SIMPLE index for lupus disease activity, Performance characteristics of different anti-double-stranded DNA antibody assays in the monitoring of systemic lupus erythematosus, Psychometric properties of MDHAQ/RAPID3 in patients with systemic lupus erythematosus, Therapeutic adherence in patients with systemic lupus erythematosus: a cross-sectional study, Sensitivity analyses of four systemic lupus erythematosus disease activity indices in predicting the treatment changes in consecutive visits: a longitudinal study, Comparison of the lupus foundation of America-rapid evaluation of activity in lupus to more complex disease activity instruments as evaluated by clinical investigators or real-world clinicians, Lupus low disease activity state is associated with a decrease in damage progression in Caucasian patients with SLE, but overlaps with remission, Impact of disease activity on health-related quality of life in systemic lupus erythematosusa cross-sectional analysis of the Swiss Systemic Lupus Erythematosus Cohort Study (SSCS), Association of the lupus low disease activity state (LLDAS) with health-related quality of life in a multinational prospective study, Smoking and pre-existing organ damage reduce the efficacy of belimumab in systemic lupus erythematosus, Cross-cultural validation of Lupus Impact Tracker in five European clinical practice settings, Failure of a systemic lupus erythematosus response index developed from clinical trial data: lessons examined and learned, Belimumab for the treatment of recalcitrant cutaneous lupus, Progression of noncalcified and calcified coronary plaque by CT angiography in SLE, Impact of heart rate variability, a marker for cardiac health, on lupus disease activity, The lupus impact tracker is responsive to changes in clinical activity measured by the systemic lupus erythematosus responder index, Validation of the Lupus Impact Tracker in an Australian patient cohort, Axl, ferritin, IGFBP2 and TNFR2 as biomarkers in systemic lupus erythematosus, Lupus anticoagulant, disease activity and low complement in the first trimester are predictive of pregnancy loss, Lupus Impact Tracker is responsive to physician and patient assessed changes in systemic lupus erythematosus, Predictors of pregnancy outcomes in patients with lupus: a cohort study, Clinical, laboratory and health-related quality of life correlates of Systemic Lupus Erythematosus Responder Index response: a post hoc analysis of the phase 3 belimumab trials, Validation of the LupusPRO in Chinese patients from Hong Kong with systemic lupus erythematosus, The Swiss Systemic lupus erythematosus Cohort Study (SSCS)cross-sectional analysis of clinical characteristics and treatments across different medical disciplines in Switzerland, How should lupus flares be measured? Physician Global Assessment International Standardisation COnsensus in http://oml.eular.org/glossary (31 January. , Anderson N Methods: Physician's Global Assessment in Psoriatic Arthritis: A Multicenter The authors wish to thank Sylvie Thuong for her invaluable assistance in the preparation of this manuscript. Content validity. Myelogram - correct answer NPO for 4-6 hours. Content validity was reported in 89 studies. HRQoL: Health-related Quality of Life; ICAM: intercellular adhesion molecule; VCAM: vascular cell adhesion molecule; MCP-1: monocyte chemoattractant protein-1; NC: non-calcified; suPAR: soluble urokinase plasminogen activator receptor; LFA-REAL: Lupus Foundation of America Rapid Evaluation of Activity in Lupus; CES-D: Centers for Epidemiological StudiesDepression scale; SLAQ: Systemic Lupus Erythematosus Activity Questionnaire; NA: not acquired; NS: not significant. 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. 10- Medical- Surgical- Nursing- Intensive- Review According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. 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). Moher D Vashisht P On stratifying the results by individual clinician, values ranged from 0.61 to 0.90, except for those reported by . Retrieved papers were selected with no limitation on the year of publication, language or patients age. , Jolly M. Ribi C , Emamikia S , Hochberg M. Wallace DJ , James JA Mokkink LB Visual Analog Scale Assessments Can Reliably Assess Disease Severity in SLE van Vollenhoven R [2, 21, 24] recommended PGA assessment prior to reviewing serological data, based only on the clinical visit. Truth refers to whether the measure provided by the scores is able to measure what was intended [18]. Construct validity. The search strategy for SSc-related publications identified 75 citations . Physician Global Assessment to Track Outcomes - JAMA
