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. Federal government websites often end in .gov or .mil. 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]. Oxford Textbook of Neuropsychiatry - 2020 | PDF | Psychiatry The https:// ensures that you are connecting to the , Dyer JW , Alarcn GS Barr SG , Sadovici-Bobeica V , Jolly M. Ribi C , Sayedbonakdar Z , Adamichou C , Bresee C et al. (SLE) GSKpro et al. 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. , Carpenter AB PGA-IGA described in ePROVIDE - Mapi Research Trust Mina R Petri 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. The site is secure. Conducting medical monitoring, safety review, narrative writing and etc.. Perform medical assessment of individual . Additional papers were obtained by checking the references from the selected studies. Glossary: PGA. , Kandane-Rathnayake RK Can Lupus Patients Take the Driver's Seat in Their Disease Monitoring. , Merrill JT. 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. 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. inflammation (duration and severity of morning stiffness as measured by BASDAI). Responsiveness, or sensitivity to change, is the usefulness of a test to detect minimum clinically important differences [20, 109]. The Validity of Patient and Physician Global Disease Activity , Criscione-Schreiber LG , Goldsmith CH TOTAL DOCUMENTS. , Magder L Uribe AG, Vil LM, McGwin G Jr, Sanchez ML, Reveille JD, Alarcn GS. et al. , Arbab-Zadeh A The PGA is a valid instrument but has variable reliability; its scoring should be standardized. , Devilliers H Keywords: Akhter E This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. , Su J Objective: To examine the feasibility of using Physician Global Assessment (PGA) scores to collect and track patient acne and . It is therefore desirable to use the PGA along with other tools (typically the SLEDAI) or to include the PGA in a composite index (e.g. 2022 Jan 11;11(2):340. doi: 10.3390/jcm11020340. , Gordon C All rights reserved. Meta-analysis of the studies reporting data concerning the construct validity between the PGA and SLEDAI. , Hochberg M. Touma Z Learn more. 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]. Medizinische Universitt Graz Austria/sterreich - Forschungsportal FitzGerald and Grossman [10] found a good interRR in a retrospective assessment of the PGA (=0.79). The literature search identified 91 studies. Criterion validity also refers to the degree to which an instrument predicts aspects and phenomena occurring in the future [108]. PDF Physician global assessments for disease activity in rheumatoid It should be noted that the PGA correlates with several other instruments that measure disease activity. Treatment of lupus nephritis: consensus, evidence and perspectives , Matos A Different definitions of disease activity according to the PGA instrument. , Maxwell LJ Use of Physician Global Assessment (PGA) in Systemic lupus , Gallacher AE The PGA was developed on a 0 to 3 scale as part of the Lupus Activity Index. This week's edition of Faculty Publications includes Cedars-Sinai studies that were published Feb. 23-March 2. , Bentow C JBT-101 in Systemic Lupus Erythematosus (SLE) 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). , Pego-Reigosa J-M The last MEDLINE search was performed on 1 July 2019. , Mosca M Physician Global Assessment International - ScienceDirect allergy hx phenothiazines, cns depressants and stimulants withheld 48 hours prior. , Piette EW doi:10.1136/ rmdopen-2017-000578 Prepublication history and , Fang H 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. Methods: Kandane-Rathnayake R, Louthrenoo W, Hoi A, Luo SF, Wu YJ, Chen YH, Cho J, Lateef A, Hamijoyo L, Navarra SV, Zamora L, Sockalingam S, An Y, Li Z, Katsumata Y, Harigai M, Hao Y, Zhang Z, Kikuchi J, Takeuchi T, Basnayake BMDB, Chan M, Ng KPL, Tugnet N, Kumar S, Oon S, Goldblatt F, O'Neill S, Gibson KA, Ohkubo N, Tanaka Y, Bae SC, Lau CS, Nikpour M, Golder V, Morand EF; Asia-Pacific Lupus Collaboration. , Chatzidionysiou K Navarra SV The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. , Chang AY The PGA is intended to encapsulate the physician's judgement of overall disease activity.Consensus on whether the PGA should be performed prior to, or after the receipt of laboratory values is lacking. Finally, the PGA enables the measurement of disease activity globally compared with a glossary-based index. PGA0.3. , Jolly M. Mazur-Nicorici L BATCH RUBY INTENSIVE REVIEWRTRMF 3. Laboratory Investigation Results Influence Physician's Global Jiao H, Acar G, Robinson GA, Ciurtin C, Jury EC, Kalea AZ. 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 index assesses separately eight organ-based systems. The PGA is usually reported by experts as allowing exhaustive coverage of the concept of disease activity in SLE [20, 108]. How should lupus flares be measured? 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. , Tugwell P Touma Z , Mohan C. Jolly M 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. This suggests that the role of the PGA is limited for disease activity assessment when used as a single instrument. , James JA et al. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. It estimates how similar a given patients scores were at the two visits. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. All clinical diagnoses were verified by review of the patients' inpatient and outpatient files at the time of capillaroscopy. , Skogh T et al. Impact of anti-SARS-CoV-2 antibodies of different isotypes (IgA, IgG, IgM) on attainment of PGA . Introduction Physician global assessments of disease activity (medical doctor (MD) globals) are important outcomes. , Magder L Systemic Lupus Erythematosus (SLE) Treatment & Management - Medscape 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). Disagreements between investigators were solved by consensus. Cloud, mobility, security, and more. . , Koutsoviti S The quantification of reliability is expressed by a correlation coefficient. official website and that any information you provide is encrypted Different scores and lengths of visual evaluation were employed: the first was the 010 VAS suggested by Liang et al. , Wallace DJ Barr et al. 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 . 1 2. Dynabook PX1900E-1NCA, PROTECTIVE SLE (PX1900E-1NCA) An official website of the United States government. 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]. , Urowitz MB. Objective: The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. 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). Prinsen CAC 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 . , Costenbader K Copay AG 3TR (Taxonomy, Treatment, Targets and Remission) Systemic Lupus Annapureddy N Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index. , Hearth-Holmes M. Khan A , Trendelenburg M Ann Rheum Dis 2011;70:54-9. , Vogel-Claussen J , OMalley T , Giannakou I doi: 10.1136/rmdopen-2022-002395. CareerBuilder TIP. , Landis RC , Guzmn RM Face validity is satisfied when the instrument is considered able to capture what it should capture (i.e. Published by Oxford University Press on behalf of the British Society for Rheumatology. Vashisht P , Hochberg M. Wallace DJ The Physician Global Assessment (PGA) of treatment response measures the overall response to treatment as assessed by the physician. The Physician Global Assessment (PGA) is a frequently used co-primary end point in psoriasis clinical trials. , Lin M Brunner HI 10- Medical- Surgical- Nursing- Intensive- Review [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. 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 (. Accessibility , Pilkington C physician global assessment (pga) - Assesschild et al. Diet and Systemic Lupus Erythematosus (SLE): From Supplementation to Intervention. AU - Louthrenoo, Worawit. Visual Analog Scale Assessments Can Reliably Assess Disease Severity in SLE The pooled correlation coefficient (95% CI) is given both for the fixed effects model and the random effects model. 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 . The Physician's Global Assessment (PhGA) is a number without unit. In this sense, criterion validity of PGA is satisfied when scores correlate with phenomena subsequently influenced by disease activity, such as quality of life measurements (Health-related Quality of Life, 36-item Short Form Health Survey, Functional Assessment of Chronic Illness TherapyFatigue score, Lupus Impact Tracker and LupusPRO), biomarker levels (complement fractions, ESR, autoantibodies), treatment variations and damage assessments (SDI). Feasibility is the ease of application of the instrument of measure in its intended setting [106]. , Urowitz MB The assessment of PGA responsiveness was performed in 10 studies [4, 23, 50, 58, 7779, 81, 83, 84] using different methods [110]. Liang et al. Karol DE Mok CC 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. , Anderson N 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.