physician global assessment sle

Face validity was reported in all the articles retrieved in which the PGA was used alone or as part of composite indices (Systemic Responder Index, Safety of Estrogen in Lupus Erythematosus National Assessment Flare Index, Lupus Low Disease Activity State, Definitions of Remission in Systemic Lupus Erythematosus criteria). government site. et al. Cloud, mobility, security, and more. Construct validity was demonstrated by a good correlation (r0.50) between the PGA with the SLEDAI (12 studies), SLAM (4 studies), LAI, BILAG and ECLAM (2 studies each). Measurement properties of the PGA were analysed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) terminology [19]. , Bouter LM Moher D However, it was used as a single outcome measure only in two studies [49, 100], while in the majority the PGA was scored together with another instrument (typically the SLEDAI) [2, 9, 11, 12, 21, 24, 30, 32, 34, 3740, 44, 45, 48, 49, 55, 58, 59, 61, 63, 64, 66, 67, 74, 75, 80, 82, 86, 8995, 103]. , Allen E Results: 2022 Jan 11;11(2):340. doi: 10.3390/jcm11020340. et al. , Hochberg M. Wallace DJ et al. 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. , Hynan LS Criterion validity. Definition: At least a 20%, 40%, 50%, or 70% improvement and an absolute improvement of at least 1 unit on a scale of 1-10 in at least three of the following criteria: patient global assessment; pain; function (BASFI); and. The judgment of whether a patient with SLE has active disease is a central question both in routine patient management and in clinical research [4]. , Kalunian K Epub 2014 Apr 11. , Petri M. Thanou A 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 . According to the OMERACT, face validity is the degree to which the instrument appears to match with the target domain, according to experts [18]. A PGA >1 was predictive of polymorphic light cutaneous eruption (P=0.02) [59] and correlated negatively with LLDAS attainment [37]. , Lerman RH et al. physician's global assessment (PGA) of disease activity in SLE. Face validity. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. The aim of this systematic literature review is to describe and analyse the . Reliability. Construct validity. , Alunno A Piga M 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. Published by Oxford University Press on behalf of the British Society for Rheumatology. Provide oversight to Shared Services Derivatives team supporting RWA operations and production. , Jolly M. Ribi C Tel: 03 88 12 84 74; Fax: 03 88 12 82 90; E-mail: Measuring disease activity in adults with systemic lupus erythematosus: the challenges of administrative burden and responsiveness to patient concerns in clinical research, Patterns of disease activity in systemic lupus erythematosus, Novel evidence-based systemic lupus erythematosus responder index, Reliability and validity of six systems for the clinical assessment of disease activity in systemic lupus erythematosus, Failure to achieve lupus low disease activity state (LLDAS) six months after diagnosis is associated with early damage accrual in Caucasian patients with systemic lupus erythematosus, Treatment target in newly diagnosed systemic lupus erythematosus, 10 most important contemporary challenges in the management of SLE, Measurement of systemic lupus erythematosus activity in clinical research, Definition, incidence, and clinical description of flare in systemic lupus erythematosus. If you have a published paper from this period that does not appear on this list, please contact Sue Marone, who will add it to next week's collection. et al. Physician global assessments for disease activity in rheumatoid arthritis are all over the map! et al. The index assesses separately eight organ-based systems. , Urowitz MB. IgM) on attainment PhGA. , Borghoff K The official NJDOE Incident Reporting Form, as well as a guide to completing , Maxwell LJ , Gomez A , Engleman EG A good responsiveness for PGA was shown in eight studies. Physician's Global Assessment (PGA) score 1.0 on a 0 to 3 visual analog scale. Castrejn I, Ra-Figueroa I, Rosario MP, Carmona L. Reumatol Clin. Patient-Reported Outcomes in Systemic Lupus Erythematosus. , Pilkington C 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 . Epub 2014 Jul 10. 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. Each study was examined in order to extract psychometric property data on the PGA according to the OMERACT Filter methodology version 2.1 [18]. et al. , Sadovici-Bobeica V , Brunetta P 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. These results enabled its use as a gold standard for assessing flare and defining flare severity in several studies [21, 67, 88]. Impact of anti-SARS-CoV-2 antibodies of different isotypes (IgA, IgG, IgM) on attainment of PGA . , ODell JR 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. Can Lupus Patients Take the Driver's Seat in Their Disease Monitoring. TOTAL DOCUMENTS. 2019ACREULAR . Assessing disease activity in rheumatic diseases such as systemic lupus erythematosus (SLE) is vital for effective treatment. A new tool -- the Lupus Activity Scoring Tool (LAST) - has been proposed to join the ranks of current disease activity indices. Thus the development of a comprehensive index for assessing disease activity still represents one of the most important challenges in SLE [7]. Few studies reported on whether serological activity should be incorporated in the PGA. 1 2. , Tetzlaff J Elisabetta Chessa, Matteo Piga, Alberto Floris, Herv Devilliers, Alberto Cauli, Laurent Arnaud, Use of Physician Global Assessment in systemic lupus erythematosus: a systematic review of its psychometric properties, Rheumatology, Volume 59, Issue 12, December 2020, Pages 36223632, https://doi.org/10.1093/rheumatology/keaa383. PGA is often assessed by a single question with a 0-10 or 0-100 response. , Farewell V , Gordon C , Zonana-Nacach A 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]. Pincus and colleagues conducted a study of . 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]. , Buyon J , Mokkink LB Correspondence to: Laurent Arnaud, Service de Rhumatologie, Centre National de Rfrence des Maladies Autoimmunes et Systmiques Rares, Hpital de Hautepierre, 1 Avenue Molire BP 83049, 67098 Strasbourg Cedex, France. Mokkink LB Systemic lupus erythematosus (SLE), is the most common type of lupus. Content validity was reported in 89 studies. , Schirmbeck LA In a post-hoc analysis of phase 3 belimumab trials, improvements and no worsening in the PGA were greater among SRI responders vs SRI non-responders (P<0.001) [52]. Barr SG Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of multifactorial origin that can affect any organ or organ system, resulting in a broad spectrum of clinical manifestations ranging from dermatological involvement to multi-organ failure with episodes of relapses and remissions. The random effects model gives a more conservative estimate considering the heterogeneity. Lead Medical Director heading up the global collaboration with Pfizer for Enbrel trials. , Chang AY Construct validity is the degree to which the PGA relates to other instruments that measure the same concept [18]. Ruiz-Irastorza G , Wallace DJ . Navarra SV Would you like email updates of new search results? 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). , Ibanez D may be asked to hyperventilate 3-4 min and watch a bright flashing light. 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. inflammation (duration and severity of morning stiffness as measured by BASDAI). The patients were diagnosed as having the following disorders: scleroderma (n = 27), dermatomyositis (n = 11), systemic lupus erythematosus (SLE) (n = 22), MCTD (n = 8), and RP without evidence of underlying CTD (n = 38). 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]. RN-BSN HOLISTIC HEALTH ASSESSMENT ACROSS THE LIFESPAN (NURS 3315) Sociology of Social Problems (SOC213) Barr et al. National Library of Medicine , Petri M For permissions, please email: journals.permissions@oup.com, This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (. , Holland M Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. Learn more. Moreover, there is uncertainty as to whether the best timing of assessment is prior to or after reviewing laboratory exams [26]. An official website of the United States government. Akhter E Unauthorized use of these marks is strictly prohibited. et al. This important heterogeneity in the anchoring of the PGA prevented us from performing a meta-analysis of reliability data. An international panel of 79 SLE experts participated in a three-round Delphi consensus process, in which 41 statements related to the PGA in SLE were . Eudy AM Different definitions of disease activity according to the PGA instrument. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Clipboard, Search History, and several other advanced features are temporarily unavailable. Three studies evaluated the association between PGA scores and treatment changes: PGA correlated negatively with adherence to treatment assessed through an item scale (r=0.31, P=0.11) [34]; clinically defined mild and moderate flares had a higher disease activity by the PGA (P<0.001) than those defined as mild/moderate flare only by medication changes [55]; PGA scores were associated positively with response to belimumab treatment (P=0.039) [43]. Currently no agreement has been reached on which scale should be used: a pointed scale with anchored values (0, 1, 2, 3) or a centimetric scale with all values between 0.0 and 3.0. There is no cure for lupus, but medical . et al. This scoring modality was used for the SRI [3]. When expanded it provides a list of search options that will switch the search inputs to match the current selection. Objective Physician's global assessment (PGA) of disease activity is a major determinant of therapeutic decision making. 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]. 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. Because of the complexity of SLE, the assessment of disease activity is particularly challenging [3]. The SELENA-SLEDAI assesses systemic lupus erythematosus (SLE) disease activity and categorizes mild/moderate or severe flares based on changes in the SLEDAI score, the Physician's Global Assessment (PGA), medication use (prednisone, Nonsteroidal anti-inflammatory drugs, Plaquenil, major immunosuppressives), other disease activity criteria, and . Oxford Textbook of. Please enable it to take advantage of the complete set of features! , Taghavi-Zadeh S PGA; disease activity; physician global assessment; psychometrics; systemic lupus erythematosus. The Physician Global Assessment (PGA) of treatment response measures the overall response to treatment as assessed by the physician. 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. All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients age. SELENA SLEDAI4. They participate in physiologic and inflammatory cascades and have become a major focus of research, yielding novel therapies for immune-mediated inflammatory diseases (IMID). 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). 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. JSS Medical Research. Vil LM , Mosca M Forbess LJ Currently the lack of standardized scoring, as well as the subjectivity of the physician judgements, can be an important source of heterogeneity, especially in trials. , Flower C The Physician's Global Assessment (PhGA) is a number without unit. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. , Chatzidionysiou K Unable to load your collection due to an error, Unable to load your delegates due to an error. 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. Oxford University Press is a department of the University of Oxford. BILAGAB . , Glassman DS Brunner HI Meta-analysis of the studies reporting data concerning the construct validity between the PGA and SLEDAI. 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. In the second column, the definitions were reported according to the VAS used in the study. , Arora S The last EULAR/ACR recommendations recommended use of the PGA in the routine monitoring of SLE [16]. 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. , Subach RB Construct validity was demonstrated by a good correlation (r 0.50) between the PGA with the SLEDAI (12 studies), SLAM (4 studies), LAI, BILAG and ECLAM (2 studies each). 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 . Patient-reported outcomes (PROs) reflect the patient's perspective and are used in rheumatoid arthritis (RA) routine clinical practice. , Chan KL et al. , Su J AU - Kasitanon, Nuntana. Physician training is very important. Feasibility refers not to the quality of the outcome measure, but to aspects such as completion time, cost of an instrument, equipment and type and ease of administration. , Petri MA All rights reserved. No data were found regarding the feasibility of the PGA. J Clin Med. [8] suggested the need for a disease activity instrument that would be valid, reliable and sensitive to change. 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]. Brunner HI The index has proved quick and easy to use despite a comprehensive database and compares favourably with .

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