, Brunetta P 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]. 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 . Uribe AG, Vil LM, McGwin G Jr, Sanchez ML, Reveille JD, Alarcn GS. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. 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 . , Perez-Gutthann S Gyri N Objective Existing methods for grading lupus flares or improvement require definition-based thresholds as increments of change. 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 . Wells GA Medizinische Universitt Graz Austria/sterreich - Forschungsportal - Medical University of Graz Direkt zur Navigaton springen . Piga M The site is secure. , Engel SM 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]. , Bentow C 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. Rendas-Baum R, Baranwal N, Joshi AV, Park J, Kosinski M. J Patient Rep Outcomes. 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). Content validity was reported in 89 studies. The literature search identified 91 studies. Parodis I , Perneger T , Beresford MW 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. 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. IgM) on attainment PhGA. Patient global assessment in measuring disease activity in rheumatoid , Matos A Physician's Global Assessment Scale (PGA) or Investigator's Global Assessment Scale (IGA) measures disease status in a broad range of diseases. The aim of this systematic literature review is to describe and analyse the . , McGuire JL. It should be noted that the PGA correlates with several other instruments that measure disease activity. Unauthorized use of these marks is strictly prohibited. et al. JSS Medical Research. Please check for further notifications by email. Five studies have demonstrated good ICC values for reliability (all >0.60 and ranging up to 0.97). et al. , ODell JR , Kalunian K Epub 2014 Jul 10. . Touma Z 12. and later incorporated into the SLE Responder Index used in the belimumab clinical trials, 13 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]. 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. Physician global assessments for disease activity in rheumatoid 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 . , Cappellazzo G Mahler M 2014 Sep-Oct;10(5):309-20. doi: 10.1016/j.reuma.2014.01.012. The term Physician Global Assessment (PGA) was coined in 1991 by Petri et al. 2014 Dec;53(12):2175-81. doi: 10.1093/rheumatology/keu153. Montreal, Canada Area. SLE has protean and often complex manifestations, necessitating careful clinical assessment. 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. No study has evaluated the correlation of PGA with damage measures. 25 (FIVE YEARS 8) Latest Documents Most Cited Documents Contributed Authors Related Sources Related Keywords Latest Documents; Most Cited Documents; Contributed Authors; Related Sources; According to the OMERACT, face validity is the degree to which the instrument appears to match with the target domain, according to experts [18]. et al. Whenever papers reported duplicate data, the most recent article was selected. Face validity. , Siega-Riz AM BATCH RUBY INTENSIVE REVIEWRTRMF 3. Quimby KR Laboratory investigation results influence Physicians Global ssessment (PGA) of disease activity in SLE. 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]. It estimates how similar a given patients scores were at the two visits. , Landis RC In Fatemi 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]. Complement-Targeted Therapeutics Market Report (2022 to , Jolly M. Mazur-Nicorici L 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. The content can vary and relates either to global health (e . Strength. , Kostopoulou M , Devilliers H , Clowse M. Moorthy LN , Urowitz MB , Askanase A For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. PGA - Lupus Research , Holland M 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. et al. , Tanangunan R 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. Physician global assessment in systemic lupus erythematosus: can we Notorious to increase IOP and cause severe PAIN and headache; Diagnostics: - History - Tonometry examinations - measures IOP QUESTION A client states that the physician has told her that her intraocular was 14. [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. 1 2. (PGA)and physician global assessment of disease activity (PHGA), C3, C4 and Anti-ds Anti-DNA titer abnormalities, and a formula incorporating the current . Please enable it to take advantage of the complete set of features! , Seaman AL , Bocci EB CareerBuilder TIP. 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 . AU - Morand, Eric. PGA0.3. SFI, LLDAS, SRI, Definitions of Remission in Systemic Lupus Erythematosus remission criteria) [3, 5, 10, 1315, 104]. 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 . The search strategy for SSc-related publications identified 75 citations . , Subach RB , Zonana-Nacach A 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]. , Carpenter AB In 1988, Liang et al. Disagreements between investigators were solved by consensus. SLE2ACR1997SLICC2012. , Hynan LS , Gallacher AE ~Sle~ - Data regarding divergent validity are lacking for the PGA. Physician Global Assessment (PGA) is a visual analogue score (VAS) that reflects the clinician's judgment of overall Systemic Lupus Erythematosus (SLE) disease activity. It does not provide a predefined or limited list of disease manifestations or organ systems, thus allowing one to capture all the heterogeneous aspects of SLE disease activity. watch for seizures after the procedure. Flow chart illustrating the literature search and study selection. 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]. All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients' age. 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]. 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. Criterion validity data reporting correlation coefficients between PGA and quality of life measures, laboratory markers and miscellaneous. Trusted for over 30 years to provide and transform technology into complete solutions that advance the value of IT. The pooled correlation coefficient (95% CI) is given both for the fixed effects model and the random effects model. , Merrill JT. In the second column, the definitions were reported according to the VAS used in the study. Reliability. , Vogel-Claussen J BICLA responders had fewer lupus-related serious . 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. , Koutsoviti S On stratifying the results by individual clinician, values ranged from 0.61 to 0.90, except for those reported by . [PDF] Use of Physician Global Assessment in systemic lupus Criterion validity also refers to the degree to which an instrument predicts aspects and phenomena occurring in the future [108]. The aim of this systematic literature review (SLR) is to describe and analyse the psychometric properties of PGA. , Mohan C. Jolly M Schneider M and transmitted securely. The responsiveness of the PGA was assessed through different methods [109, 113] showing a high sensitivity for detecting clinical variations [84]. 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. This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. , 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]. Devilliers H 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). , Piette EW 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 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. 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 . 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. AU - Kandane-Rathnayake, Rangi. T2 - A longitudinal study. Conclusion: physician global assessment Recently Published Documents. Physician's Global Assessment (PGA) score 1.0 on a 0 to 3 visual analog scale. Systemic Lupus Erythematosus (SLE) Treatment & Management - Medscape The literature search identified 93 articles, and 12 additional articles were retrieved from the reference list of those publications. RMD Open 2018;4:e000578. X 20 Physician Global Assessment 10.1136/lupus-2019-lsm.176 . , Chatzidionysiou K The aim of this systematic review is to describe and analyse the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. Exagen Diagnostics Inc (XGN) - Product Pipeline Analysis, 2022 Update Truth refers to whether the measure provided by the scores is able to measure what was intended [18]. 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). et al. et al. , Liberati A Improving patient pathways for systemic lupus erythematosus: a multistakeholder pathway optimisation study. , Devilliers H Navarra SV Petri M This important heterogeneity in the anchoring of the PGA prevented us from performing a meta-analysis of reliability data. Fanouriakis A 2022 Sep 20;19(19):11895. doi: 10.3390/ijerph191911895. Construct validity. et al. Moreover, there is uncertainty as to whether the best timing of assessment is prior to or after reviewing laboratory exams [26]. 3TR (Taxonomy, Treatment, Targets and Remission) Systemic Lupus Gandhi N Construct validity is the degree to which the PGA relates to other instruments that measure the same concept [18]. 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]. , Engle E , Pilkington C The Janus kinase (Jak)/signal transducer and activating protein (STAT) pathways mediate the intracellular signaling of cytokines in a wide spectrum of cellular processes. , Gladman DD Retrieved papers were selected with no limitation on the year of publication, language or patients age. , Friebus-Kardash J Scoring systemic lupus erythematosus (SLE) disease activity with simple 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. 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. Prinsen CAC Assessing disease activity in rheumatic diseases such as systemic lupus erythematosus (SLE) is vital for effective treatment. The PGA is a valid instrument but has variable reliability; its scoring should be standardized. Would you like email updates of new search results? government site. et al. , Longenecker JC . , Ravelli A Different definitions of PGA retrieved through the literature search are reported in Table1. This scoring modality was used for the SRI [3]. The Physician Global Assessment (PGA) is an important tool for assessing disease activity in lupus. , Urowitz MB. There is no cure for lupus, but medical . 8600 Rockville Pike 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. et al. Global Automatic Chemiluminescence Immunoassay Analyzer Market 2023 , Hearth-Holmes M. Khan A Different definitions of disease activity according to the PGA instrument. Measurement properties of the PGA were analysed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) terminology [19]. A good responsiveness for PGA was shown in eight studies. 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. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. Kiani AN , Bresee C Thus the development of a comprehensive index for assessing disease activity still represents one of the most important challenges in SLE [7]. , Pego-Reigosa J-M , Hambleton IR 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]. (Open Access) Development and assessment of a computerized index of 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 aim of this systematic literature review (SLR) is to describe and analyse the psychometric properties of PGA. This may be explored through convergent and divergent validity. et al. 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). , Allen E 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). . , Bonithon-Kopp C Once two investigators (E.C., M.P.) PGA or SGA described in ePROVIDE - Mapi Research Trust 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]. , Wallace DJ Introduction Physician global assessments of disease activity (medical doctor (MD) globals) are important outcomes. Enocsson H , Kharboutli M , Block JA Use of Physician Global Assessment (PGA) in Systemic lupus Face validity is satisfied when the instrument is considered able to capture what it should capture (i.e. , Trendelenburg M , Annapureddy N 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. , Tetzlaff J 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. AU - Kasitanon, Nuntana. , Jnsen A 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 . The SRI is a validated SLE disease activity instrument used to detect clinically meaningful improvement of disease in SLE clinical trials. Fatigue is independently associated with disease activity assessed using the Physician Global Assessment but not the SLEDAI in patients with systemic lupus erythematosus. 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). 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. Treatment of lupus nephritis: consensus, evidence and perspectives The .gov means its official. Physician Global Assessment International Standardisation COnsensus in Supervise the development of junior medical affairs staff . Physician global assessment in systemic lupus erythematosus: Can we , Beaumont JL , Engleman EG et al. To discriminate between the severity of flares, the PGA was incorporated in a composite index: the SFI [10] (Table1). Funding: The study was funded through the training Bursary Programme 2019 of the SLEuro European Lupus Society. , Voskuyl A 215 (FIVE YEARS 146) H-INDEX. 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). Oxford Textbook of. , Wallace DJ 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]. Thanou A 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. Stojan G Convergent validity is fulfilled indirectly in studies where the PGA is used as the gold standard to assess the construct validity of other indices. Methods This SLR was conducted by two independent reviewers in accordance with the PRISMA statement. Federal government websites often end in .gov or .mil. Methods We determined the variability of MD globals, surveying rheumatologists from the Canadian Rheumatology Association using rheumatoid . PGA is a valid, responsive and feasible instrument, while its reliability was impacted by the scale adopted, suggesting the major need for a standardization of its scoring. Copay AG Physician Global Assessment International Standardisation COnsensus in LECTURE 10: MEDICAL SURGICAL NURSING. , Maxwell LJ Brunner HI Immune Disorders, Deficiency, Etc - Key Points to Review: Initiation of The Senior Lead will be responsible for: Managing end to end production, governance and controls of Derivatives Standardized and Advanced RWA, and SLE Actuals. SLE or at an SLE site, but only if the injury requires treatment by a licensed medical doctor. PDF Physician Global Assessment International Standardisation COnsensus in SELENA SLEDAI4. Methods: , Jolly M. Antony A Aranow C , Floris A JBT-101 in Systemic Lupus Erythematosus (SLE) Feasibility is the ease of application of the instrument of measure in its intended setting [106]. Accessibility Fanouriakis A et al. , Fortin PR PGA is often assessed by a single question with a 0-10 or 0-100 response. , Bertsias G Cutaneous lupus erythematosus (CLE) is an autoimmune skin disease that can occur with or without systemic lupus erythematosus (SLE). Before 2022 May;9(1):e000700. , Petri MA ECG - correct answer no sleep the night before, meals allowed, no stimulants/tranquilizers for 24-48 hours before. Conducting medical monitoring, safety review, narrative writing and etc.. Perform medical assessment of individual . Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index. 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). Provide oversight to Shared Services Derivatives team supporting RWA operations and production. According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. A total of 91 articles were included in the study (Fig. , Fang H Vashisht P , Gladman DD. doi: 10.1136/lupus-2022-000700. [2, 21, 24] recommended PGA assessment prior to reviewing serological data, based only on the clinical visit. Vil LM Use of Physician Global Assessment (PGA) in Systemic lupus - medRxiv 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]. Intoduction to X 20 - Physician Global Assessment