Once two investigators (E.C., M.P.) Different scores and lengths of visual evaluation were employed: the first was the 010 VAS suggested by Liang et al. official website and that any information you provide is encrypted Faculty Publications: Feb. 23-March 2 , Ogale S , Borghoff K Objective: The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. [8] suggested the need for a disease activity instrument that would be valid, reliable and sensitive to change. et al. Your comment will be reviewed and published at the journal's discretion. , Gladman DD et al. MeSH , Alunno A A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.67-0.98). AU - Louthrenoo, Worawit. Background/Purpose: The Physician Global Assessment (PGA) is a frequently-used outcome measure in Systemic Lupus Erythematosus (SLE). Ruiz-Irastorza G [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. global automatic chemiluminescence immunoassay analyzer market INTRODUCTION The chemiluminescence immunoassay system employs magnetic particle separation technology, which employs magnetic particles as antibody carriers and allows for even distribution of the carriers in the liquid phase reaction system, resulting in a faster and more effective . Content validity was reported in 89 studies. , Goldsmith CH The last EULAR/ACR recommendations recommended use of the PGA in the routine monitoring of SLE [16]. Construct validity. TOTAL DOCUMENTS. , Nelson S Reliability was excellent when scored through a pointed scale, such as the Likert scale, that was anchored in unit numbers from 0 (not active) to 7 (most active) (interRR ICC 0.96; intraRR ICC 0.88) [80], but was lower when assessed through a centimetric VAS using values between 0.0 and 3.0 (interRR ICC 0.67; intraRR ICC 0.55) [68]. 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). et al. Clinical Trial on Systemic Lupus Erythematosus (SLE): Blood sample , Gomez A , Petri M 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]. 2021 Apr 8;5(1):33. doi: 10.1186/s41687-021-00298-x. , Khamashta MA 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). et al. This scoring modality was used for the SRI [3]. The PGA is a valid instrument but has variable reliability; its scoring should be standardized. Brunner HI Physician global assessment in systemic lupus erythematosus: can we Global Respiratory Devices Market Size, Growth, Source Analysis, Top , James JA The interRR was assessed in seven studies [4, 10, 11, 36, 65, 68, 94], showing values ranging from 0.67 [68] to 0.96 [94]. Gordon C CLOSED ANGLE/ ANGLE CLOSURE GLAUCOMA. This button displays the currently selected search type. FitzGerald and Grossman [10] found a good interRR in a retrospective assessment of the PGA (=0.79). Physician global assessment in systemic lupus erythematosus: Can we X 20 sentence examples within Physician Global Assessment. Lead Medical Director heading up the global collaboration with Pfizer for Enbrel trials. Devilliers H Physician Global Assessment International Standardisation COnsensus in and transmitted securely. 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. 10- Medical- Surgical- Nursing- Intensive- Review Methods: This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items . , Socher SA et al. The sensitivity to change was estimated to be the smallest for the SLEDAI; the standardized response means were 0.48 when the physician global assessment was used as the standard and 0.01 when the patient global assessment was used . , Merrill JT. Medizinische Universitt Graz Austria/sterreich - Forschungsportal , Terwee CB Pincus and colleagues conducted a study of . [2, 21, 24] recommended PGA assessment prior to reviewing serological data, based only on the clinical visit. Fanouriakis A 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. BILAGAB . Cutaneous lupus erythematosus (CLE) is an autoimmune skin disease that can occur with or without systemic lupus erythematosus (SLE). 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. , Saad-Magalhes C This may be explored through convergent and divergent validity. Despite the need for new treatments in CLE . To increase its reliability, the PGA should be scored by a physician with significant expertise in SLE, with prior knowledge of laboratory results [112], considering the overall disease activity at the time of the visit and comparing it to the last visit in order to assess flares [9]. Systemic lupus erythematosus (SLE) is a multisystem autoimmune rheumatic disease (ARD) characterized by flares and remissions. PGA0.3. Uribe AG, Vil LM, McGwin G Jr, Sanchez ML, Reveille JD, Alarcn GS. 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. , Trendelenburg M Clipboard, Search History, and several other advanced features are temporarily unavailable. et al. , Friebus-Kardash J It operates in Albuquerque, and New Mexico. , Urowitz MB The index assesses separately eight organ-based systems. In the last 30years, more than a dozen scores have been derived to assess disease activity in SLE, but not all of these have proven to be valid and reliable tools. There is no cure for lupus, but medical . Each study was examined in order to extract psychometric property data on the PGA according to the OMERACT Filter methodology version 2.1 [18]. 215 (FIVE YEARS 146) H-INDEX. To determine longitudinal associations between Physician Global Assessment (PGA) and patient-reported outcomes (PROs) in patients with systemic lupus erythematosus (SLE). 2014 - 20184 years. Objective Physician's global assessment (PGA) of disease activity is a major determinant of therapeutic decision making. Gladman DD Trusted for over 30 years to provide and transform technology into complete solutions that advance the value of IT. et al. 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 a valid, responsive and feasible instrument, though its reliability was impacted by the scale adopted, suggesting the major need for standardization of its scoring. , Magder L 04 Measuring SLE disease activity in 2020: perspectives from clinical , Skogh T In 32 studies, disease activity measured by PGA was compared with changes in laboratory markers, with the aim of correlating clinical and serological features [9, 21, 30, 32, 34, 3739, 44, 45, 48, 49, 55, 5861, 63, 64, 66, 67, 69, 71, 74, 75, 82, 86, 89, 9194]. In 1988, Liang et al. , Jolly M. Mok CC Because of its dynamic nature, this disease has an unpredictable natural course leading to high . Vil LM , Fortin PR , Cappellazzo G Comparison of the validity and sensitivity to change of 5 activity indices in systemic lupus erythematosus. Mayara Torres Silva de Oliveira, MD, MBA on LinkedIn: #medicinanuclear Finally, the PGA enables the measurement of disease activity globally compared with a glossary-based index. et al. , Schur PH. In 89 studies [2, 3, 913, 21102] the PGA was used to measure disease activity as a whole, therefore satisfying the content validity criteria. et al. , Mohan C. Jolly M We have systematically reviewed all studies about validation of the PGA in SLE. , Hochberg M. Touma Z PGA-IGA described in ePROVIDE - Mapi Research Trust Systemic Lupus Erythematosus (SLE) Treatment & Management - Medscape , Petri MA , Wallace DJ Reliability measures the reproducibility of the instrument: it refers to the degree of agreement between different observers (interrater) and in the same observer over time (intrarater). Physician's Global Assessment in Psoriatic Arthritis: A Multicenter , Gladman DD Dynabook PX1900E-1NCA, PROTECTIVE SLE (PX1900E-1NCA) A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines [17], searching for articles reporting on the use of PGA in SLE. Flow chart illustrating the literature search and study selection. Federal government websites often end in .gov or .mil. PDF Physician global assessments for disease activity in rheumatoid Intoduction to X 20 - Physician Global Assessment , Zonana-Nacach A et al. The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. Patient-Reported Outcomes in Systemic Lupus Erythematosus. Systemic Lupus Erythematosus and Lupus Nephritis - Epidemiology PGA responsiveness was used to assess flare [9]: PGA was identified as the gold standard to rate the exacerbation of lupus activity [21, 67, 88], preliminarily defined by a change of 1.0 on a 03 VAS since the last visit. , Perneger T Criterion validity. PDF Use of Physician Global Assessment (PGA) in Systemic lupus - medRxiv They proposed a physician global score on a 10cm visual analogue scale (VAS) to be used as a gold standard to compare six disease activity instruments [4]. , Klein-Gitelman MS Oxford University Press is a department of the University of Oxford. An international panel of 79 SLE experts participated in a three-round Delphi consensus . , Matos A A PGA 2 correlated with a risk of pregnancy loss (29% vs 8%, P=0.005) [49]. National Library of Medicine Aranow C , Shea BJ Gandhi N Responsiveness. , Chan KL Face validity. This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. 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]. 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. AU - Morand, Eric. Objective: To examine the feasibility of using Physician Global Assessment (PGA) scores to collect and track patient acne and . et al. Introduction Physician global assessments of disease activity (medical doctor (MD) globals) are important outcomes. All rights reserved. It estimates how similar a given patients scores were at the two visits. The other authors have declared no conflicts of interest. Unauthorized use of these marks is strictly prohibited. , Anderson N BATCH RUBY INTENSIVE REVIEWRTRMF 3. , Magder LS Associations between physicians' global assessment of disease activity This site needs JavaScript to work properly. , Matos A In two studies, the PGA-VAS was used to assess concepts other than disease activity: disease severity [4] and patients compliance with treatments [103]. Bookshelf HHS Vulnerability Disclosure, Help No data were found regarding the feasibility of the PGA. , Tetzlaff J All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients age. 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. et al. et al. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. Please enable it to take advantage of the complete set of features! (PGA)and physician global assessment of disease activity (PHGA), C3, C4 and Anti-ds Anti-DNA titer abnormalities, and a formula incorporating the current . , Jnsen A Using the Physician Global Assessment in a clinical setting to - PubMed 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 . Results: physician global assessment Recently Published Documents. , Dyer JW 2022 Sep;8(2):e002395. Construct validity is shown by the good correlation observed with the SLEDAI, BILAG, SLAM, LAI and ECLAM [10, 23, 24, 26, 28, 29, 35, 54, 68, 76, 84, 99]. Criterion validity also refers to the degree to which an instrument predicts aspects and phenomena occurring in the future [108]. The site is secure. Navarra SV Visual Analog Scale Assessments Can Reliably Assess Disease Severity in SLE Impact of anti-SARS-CoV-2 antibodies of different isotypes (IgA, IgG, IgM) on attainment of PGA . 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]. (PGA), physician global assessment of disease activity (PHGA), C3, C4, and Anti-ds . , Smiley A. Askanase AD , Nguyen SC Montreal, Canada Area. 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. , Larson MG , Mina R may be asked to hyperventilate 3-4 min and watch a bright flashing light. [PDF] Use of Physician Global Assessment in systemic lupus ATI Comprehensive Predictor Exam 2019 (180 Q & A, Verified and 100 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. , Chatzidionysiou K 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). Diet and Systemic Lupus Erythematosus (SLE): From Supplementation to Intervention. BICLA is a validated composite global measure of SLE disease activity including SLEDAI-2K, CLASI-A, OCS dosage reduction, and patient-reported outcomes. The PGA intraRR was assessed in three studies [10, 68, 94] and ranged from 0.55 [68] to 0.88 [10]. Unable to load your collection due to an error, Unable to load your delegates due to an error. Myelogram - correct answer NPO for 4-6 hours. , Magder L A PGA >1 was predictive of polymorphic light cutaneous eruption (P=0.02) [59] and correlated negatively with LLDAS attainment [37]. , Devilliers H 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]. SLE3. physician's global assessment (PGA) of disease activity in SLE. Forbess LJ In the second column, the definitions were reported according to the VAS used in the study. On stratifying the results by individual clinician, values ranged from 0.61 to 0.90, except for those reported by . Observed and articulated management issues and responses. Wells GA 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). (SLE) GSKpro , Voskuyl A 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. , Lerman RH physician global assessment (pga) - Assesschild , Mazur M. Fatemi A , Morabito LM Methods We determined the variability of MD globals, surveying rheumatologists from the Canadian Rheumatology Association using rheumatoid . Mok CC , Maxwell LJ et al. Some may be a consequence of therapy and others may be . http://oml.eular.org/glossary (31 January. 25 (FIVE YEARS 8) Latest Documents Most Cited Documents Contributed Authors Related Sources Related Keywords Latest Documents; Most Cited Documents; Contributed Authors; Related Sources; This enabled the PGA to be considered the gold standard in several studies [2, 10, 11, 21, 23, 49, 67, 76, 78, 84, 88]. Associations between physicians' global assessment of disease activity Physician global assessments for disease activity in rheumatoid Chaigne B No study has evaluated the feasibility of the PGA in SLE to date. , Hennis A. Jesus D 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]. , Ding HH Quimby KR How does one assess and monitor patients with systemic lupus Different definitions of PGA retrieved through the literature search are reported in Table1. Parodis I Whenever papers reported duplicate data, the most recent article was selected. , Clowse M. Moorthy LN 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. Copay AG 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 . Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus: the PISCOS study . The assessment of PGA responsiveness was performed in 10 studies [4, 23, 50, 58, 7779, 81, 83, 84] using different methods [110]. 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. Laboratory investigation results influence Physicians Global ssessment (PGA) of disease activity in SLE. Patient-reported outcomes (PROs) reflect the patient's perspective and are used in rheumatoid arthritis (RA) routine clinical practice. , Sjwall C. Strand V 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. , Kostopoulou M SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. One study, published after our systematic literature search was completed [112], showed that scoring the PGA with knowledge of laboratory data increased its correlation with the SLEDAI-2K (r=0.79) compared with without knowledge of laboratory results (r=0.67). Physician training is very important. , Arora S Changes in the PGA correlated with changes of other disease activity indices (SLEDAI, SLAM, LAI, patient global assessment), laboratory exams (ESR), patient-reported outcomes (Lupus Impact Tracker) [23, 50, 58, 77, 78, 81, 83] and response to treatment [4]. Touma Z Funding: The study was funded through the training Bursary Programme 2019 of the SLEuro European Lupus Society. , Dietzmann K The measurements were in the form of a scale from 0 to 3 in 54 studies [2, 3, 9, 10, 12, 13, 21, 2469, 103], a 010 scale in 12 studies [4, 60, 7079], a 0100 scale in 9 studies [27, 40, 78, 8085], a 07 Likert scale [11, 78, 80], a 02 scale [53], a 04 scale [86] and a 05 scale [87]. , Genovese M Published by Oxford University Press on behalf of the British Society for Rheumatology. Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. Careers. 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).