physician global assessment sle

AU - Morand, Eric. et al. Can Lupus Patients Take the Driver's Seat in Their Disease Monitoring. All versions are validated and used by lupus researchers for clinical and research purposes. Correlations with other instruments measuring similar constructs should typically demonstrate a coefficient (r) 0.50 [106]. 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]. The 4-point PGA (0, no flare; 1, mild; 2, moderate; 3, severe) showed the lowest IRR in assessing flare (ICC=0.18) compared with the BILAG-2004 (ICC=0.54) and SFI (ICC=0.21) [65]. Face validity is satisfied when the instrument is considered able to capture what it should capture (i.e. 2014 Sep-Oct;10(5):309-20. doi: 10.1016/j.reuma.2014.01.012. 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]. [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. Thus the development of a comprehensive index for assessing disease activity still represents one of the most important challenges in SLE [7]. HHS Vulnerability Disclosure, Help http://oml.eular.org/glossary (31 January. Federal government websites often end in .gov or .mil. , Devilliers H 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]. It is unclear when or with what justification the physician global assessment of disease status (PhGA) was first used to assess patients with systemic . The PGA is a well accepted and commonly used scale for evaluating treatment response in clinical trials both in adults and children. 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 . Petri M , Tugwell P In conclusion, the PGA was demonstrated to be a valid, responsive and feasible instrument, but its reliability was strongly impacted by the scale adopted, suggesting the need for standardization in its scoring. 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. , ODell JR , Mokkink LB The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinicians judgement of overall SLE disease activity. , Annapureddy N Physician global assessments for disease activity in rheumatoid arthritis are all over the map! 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]). et al. 2022 Sep;8(2):e002395. 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. 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 . Criterion validity data reporting correlation coefficients between PGA and quality of life measures, laboratory markers and miscellaneous. et al. , Magder LS et al. 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. 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. , Friebus-Kardash J Content validity was reported in 89 studies. 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]. A new tool -- the Lupus Activity Scoring Tool (LAST) - has been proposed to join the ranks of current disease activity indices. AU - Louthrenoo, Worawit. , Kosinski M 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). Genetic linkage has related dysfunction of . , Kharboutli M The index has proved quick and easy to use despite a comprehensive database and compares favourably with . This scoring modality was used for the SRI [3]. Responsiveness. No data were found regarding the feasibility of the PGA. 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. FOIA PGA0.3. . , Andreoli L The other authors have declared no conflicts of interest. 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. Parodis I , Chakravarty E , Clowse M. Moorthy LN A PGA 2 correlated with a risk of pregnancy loss (29% vs 8%, P=0.005) [49]. , Lerman RH PGA is often assessed by a single question with a 0-10 or 0-100 response. , Merrill JT. 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). The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. 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). 8600 Rockville Pike However, the PGA allows for the measurement of disease activity in a global way (content validity). , Genovese M It estimates how similar a given patients scores were at the two visits. 2) [10, 23, 24, 26, 28, 29, 35, 54, 68, 76, 84, 99], with the SLAM in 4 studies (r=0.470.65) [35, 76, 84, 99], with LAI in 2 studies (r=0.640.75) [68, 84], with BILAG in 2 studies (r=0.610.62) [35, 84] and with ECLAM in 2 studies (r=0.580.65) [35, 84]. Chaigne B et al. Criterion validity was assessed exploring the PGA correlation with quality of life measurements, biomarker levels and treatment changes in 28 studies, while no study has evaluated correlation with damage. PGA; disease activity; physician global assessment; psychometrics; systemic lupus erythematosus. Enocsson H Because of its dynamic nature, this disease has an unpredictable natural course leading to high . , Perez-Gutthann S , Khamashta MA (PGA) scoring of disease activity in systemic lupus erythematosus (SLE). Mokkink LB Stojan G Barr SG In the second column, the definitions were reported according to the VAS used in the study. , Klein-Gitelman MS 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. 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. , Mohan C. Jolly M Montreal, Canada Area. Ward et al. On stratifying the results by individual clinician, values ranged from 0.61 to 0.90, except for those reported by . Ann Rheum Dis 2 Isenberg DA, Allen E, Farewell V, et al. , Aggarwal R , Burlingame RW , Bocci EB Your comment will be reviewed and published at the journal's discretion. doi:10.1136/ rmdopen-2017-000578 Prepublication history and doi: 10.1136/rmdopen-2022-002395. 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). 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. Ensure second line of defense Derivatives RWA reviews are performed consistently and . , James JA Eudy AM , Buyon J , Gladman DD 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. et al. Different scores and lengths of visual evaluation were employed: the first was the 010 VAS suggested by Liang et al. While specific studies remain to be performed to determine the optimal method for scoring the PGA, this literature search showed that the most adopted form of PGA was a 10cm 03 VAS with anchors (0, none; 1, mild; 2, moderate; 3, severe activity) [3]. Myelogram - correct answer NPO for 4-6 hours. It operates in Albuquerque, and New Mexico. 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. X 20 sentence examples within Physician Global Assessment. Touma Z , Costenbader K , Subach RB Results of a large, multicentric, nationwide study, American College of Rheumatology provisional criteria for global flares in childhood-onset systemic lupus erythematosus, A cross-sectional study of hydroxychloroquine concentrations and effects in people with systemic lupus erythematosus, Inactive disease and remission in childhood-onset systemic lupus erythematosus, Preliminary criteria for global flares in childhood-onset systemic lupus erythematosus, Systemic lupus erythematosus in a multiethnic US cohort, XXXVII: association of lymphopenia with clinical manifestations, serologic abnormalities, disease activity, and damage accrual, Systemic lupus erythematosus in a multiethnic cohort (LUMINA): XXIX. 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. Int J Environ Res Public Health. , Dietzmann K Provide oversight to Shared Services Derivatives team supporting RWA operations and production. BATCH RUBY INTENSIVE REVIEWRTRMF 3. , Urowitz MB. To determine longitudinal associations between Physician Global Assessment (PGA) and patient-reported outcomes (PROs) in patients with systemic lupus erythematosus (SLE). Please enable it to take advantage of the complete set of features! Akhter E 2014 Dec;53(12):2175-81. doi: 10.1093/rheumatology/keu153. In one open-label study [43], the decrease in PGA score was considered the primary endpoint. The responsiveness of the PGA was assessed through different methods [109, 113] showing a high sensitivity for detecting clinical variations [84]. A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.670.98). 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). , Suriano A , Shea BJ physician's global assessment (PGA) of disease activity in SLE. , Leung HW 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. 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). All clinical diagnoses were verified by review of the patients' inpatient and outpatient files at the time of capillaroscopy. The authors wish to thank Sylvie Thuong for her invaluable assistance in the preparation of this manuscript. 2022 May;9(1):e000700. doi: 10.1136/lupus-2022-000700. et al. , Weisman MH. , Jnsen A An official website of the United States government. Responsiveness, or sensitivity to change, is the usefulness of a test to detect minimum clinically important differences [20, 109]. , Hearth-Holmes M. Khan A There is no cure for lupus, but medical . 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. The literature search identified 91 studies. Mina R Visual analogue scales (VAS) allow rapid, continuous scaling of disease severity. et al. 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). van Vollenhoven R However, it is important to remember that not all clinical problems reported by a lupus patient are due to the disease. The aim of this systematic literature review (SLR) is to describe and analyse the psychometric properties of PGA. We analysed the performance of the SELENA SLEDAI Physician's Global Assessment (SSPGA) and the Lupus Foundation of America-Rapid Evaluation of Activity in Lupus (LFA-REAL) as measures . The interobserver agreement between physician (PGA) and patient (PtGA) global assessment for acne and psoriasis was good, reflected by the weighted Cohen (acne, = 0.68; psoriasis, = 0.70) (eTable in the Supplement). Physician training is very important. 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. No study has evaluated the feasibility of the PGA in SLE to date. Objective: Quimby KR In two studies, the PGA-VAS was used to assess concepts other than disease activity: disease severity [4] and patients compliance with treatments [103]. This is a top barrier, both for treat-to-target management of SLE patients in clinical practice, as well as in clinical trials for new SLE treatments. Vil LM Newark, New Castle, USA, March 03, 2023 (GLOBE NEWSWIRE) -- The global complement-targeted therapeutics market is expected to grow at a CAGR of 8.9% from 2022 to 2030, owing to the rising . 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). Copay AG , Magder L 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). [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. 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). The results are similar, and less than half the time is required for scoring. The pooled correlation coefficient (95% CI) is given both for the fixed effects model and the random effects model. 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). Ruiz-Irastorza G Wells GA et al. Systemic lupus erythematosus (SLE), is the most common type of lupus. At least 1 issue from each virtual tour. 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.

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