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. . Copay AG , Jolly M. Ribi C Introduction Physician global assessments of disease activity (medical doctor (MD) globals) are important outcomes. Methods This SLR was conducted by two independent reviewers in accordance with the PRISMA statement. , Siega-Riz AM 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. Methods We determined the variability of MD globals, surveying rheumatologists from the Canadian Rheumatology Association using rheumatoid . Supervise the development of junior medical affairs staff . Rendas-Baum R, Baranwal N, Joshi AV, Park J, Kosinski M. J Patient Rep Outcomes. et al. Visual analogue scales (VAS) allow rapid, continuous scaling of disease severity. The SRI is a validated SLE disease activity instrument used to detect clinically meaningful improvement of disease in SLE clinical trials. , Chizzolini C 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. et al. et al. 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]. Objective: PGA - Lupus Research Convergent validity is fulfilled indirectly in studies where the PGA is used as the gold standard to assess the construct validity of other indices. BICLA is a validated composite global measure of SLE disease activity including SLEDAI-2K, CLASI-A, OCS dosage reduction, and patient-reported outcomes. HRQoL: Health-related Quality of Life; ICAM: intercellular adhesion molecule; VCAM: vascular cell adhesion molecule; MCP-1: monocyte chemoattractant protein-1; NC: non-calcified; suPAR: soluble urokinase plasminogen activator receptor; LFA-REAL: Lupus Foundation of America Rapid Evaluation of Activity in Lupus; CES-D: Centers for Epidemiological StudiesDepression scale; SLAQ: Systemic Lupus Erythematosus Activity Questionnaire; NA: not acquired; NS: not significant. 8600 Rockville Pike et al. Clinical composite measures of disease activity and damage used to evaluate patients with systemic lupus erythematosus: A systematic literature review. Lai J-S 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. , Bonithon-Kopp C The intrarater reliability (intraRR) is the ability to provide consistent scores in a stable population by the same assessor over time. 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. ECG - correct answer no sleep the night before, meals allowed, no stimulants/tranquilizers for 24-48 hours before. Epub 2014 Jul 10. Oxford University Press is a department of the University of Oxford. Prinsen CAC official website and that any information you provide is encrypted et al. Schlencker A, Messer L, Ardizzone M, Blaison G, Hinschberger O, Dahan E, Sordet C, Walther J, Dory A, Gonzalez M, Kleinlogel S, Bramont-Nachman A, Barrand L, Payen-Revol I, Sibilia J, Martin T, Arnaud L. Lupus Sci Med. sharing sensitive information, make sure youre on a federal physician's global assessment (PGA) of disease activity in SLE. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. , Navarra SV , Bertsias G et al. 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 PGA is a well accepted and commonly used scale for evaluating treatment response in clinical trials both in adults and children. Use of Physician Global Assessment (PGA) in Systemic lupus , Kalunian K 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. Fatigue is independently associated with disease activity assessed using the Physician Global Assessment but not the SLEDAI in patients with systemic lupus erythematosus. Physician global assessment in systemic lupus erythematosus: can we , Giannakou I 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 . The assessment of disease activity in SLE is particularly challenging. OBJECTIVE The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. , Magder L , Saad-Magalhes C , Kraag GR , Kiani AN , Gomez A , Merrill JT. , Sadovici-Bobeica V 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]. et al. , Bocci EB Sullivan KE (SLE) GSKpro 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. , Nguyen SC Strength. , Flower C , Engel SM Fanouriakis A At a glance: Common scores used in rheumatology Physician Global Assessment International Standardisation COnsensus in One study showed a significant ability of the PGA in distinguishing between patients (P<0.0001) and observers (P<0.0001), but not between visits [79]. 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). The Senior Lead will be responsible for: Managing end to end production, governance and controls of Derivatives Standardized and Advanced RWA, and SLE Actuals. , Urowitz MB , Esdaile JM. Gladman DD The pooled correlation coefficient (95% CI) is given both for the fixed effects model and the random effects model. Disclaimer. , Koutsoviti S , Urowitz MB. Disagreements between investigators were solved by consensus. , Kandane-Rathnayake RK At least 1 issue from each virtual tour. , Farewell V 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). , Rodrigues M 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. SELENA SLEDAI4. 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]. , Patrick DL In the second column, the definitions were reported according to the VAS used in the study. 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]. Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. et al. BATCH RUBY INTENSIVE REVIEWRTRMF 3. , Arbab-Zadeh A Associations between physicians' global assessment of disease activity All rights reserved. [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. 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 . 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 (. Face validity. , Pego-Reigosa J-M Enocsson H Quimby KR 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. , Zonana-Nacach A , Petri M. Isenberg DA , Kosinski M et al. This button displays the currently selected search type. , Hochberg M. Wallace DJ Moher D 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. The OMERACT defines an instrument as an outcome measure if it passes the three pillars of evidence: truth (that refers to validity), discrimination (that includes reliability and responsiveness) and feasibility. 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. , Sayedbonakdar Z Physician Global Assessment International Standardisation COnsensus in et al. Arriens C Gandhi N , Lau CS Content validity. , Borghoff K allergy hx phenothiazines, cns depressants and stimulants withheld 48 hours prior. Ann Rheum Dis 2 Isenberg DA, Allen E, Farewell V, et al. 1 2. Faculty Publications: Feb. 23-March 2 SFI, LLDAS, SRI, Definitions of Remission in Systemic Lupus Erythematosus remission criteria) [3, 5, 10, 1315, 104]. Flow chart illustrating the literature search and study selection. Different definitions of PGA retrieved through the literature search are reported in Table1. However, the PGA allows for the measurement of disease activity in a global way (content validity). , Oon S , Petri MA 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. 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. Scoring systemic lupus erythematosus (SLE) disease activity with simple X 20 Physician Global Assessment 10.1136/lupus-2019-lsm.176 . , Gladman DD. et al. Methods: 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]. Conclusion: , Hearth-Holmes M. Khan A 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. Mayara Torres Silva de Oliveira, MD, MBA on LinkedIn: #medicinanuclear 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. , Aggarwal R Frontiers | Cutaneous lupus erythematosus disease assessment An international panel of 79 SLE experts participated in a three-round Delphi consensus . , Brunetta P et al. Criterion validity also refers to the degree to which an instrument predicts aspects and phenomena occurring in the future [108]. Touma Z PGA is an important tool for assessing disease activity, response to treatment (it is a component . Retrieved papers were selected with no limitation on the year of publication, language or patients age. Feb 2016 - Jan 20182 years. Background/Purpose: The Physician Global Assessment (PGA) is a frequently-used outcome measure in Systemic Lupus Erythematosus (SLE). Systemic Lupus Erythematosus (SLE) Treatment & Management - Medscape When expanded it provides a list of search options that will switch the search inputs to match the current selection. Lead Medical Director heading up the global collaboration with Pfizer for Enbrel trials. physician global assessment Recently Published Documents. TOTAL DOCUMENTS. , Klein-Gitelman MS AU - Kasitanon, Nuntana. et al. Beaton DE et al. Thanou A Uribe AG, Vil LM, McGwin G Jr, Sanchez ML, Reveille JD, Alarcn GS. 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. , Mohan C. Giangreco D 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. According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. , Genovese M , Smiley A. Askanase AD Help us improve CareerBuilder by providing feedback about this job: Report this job Job ID: 2281236908. , Glassman DS 2022 May;9(1):e000700. Petri M The literature search identified 91 studies. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. , Trendelenburg M , Petri MA , Clowse M. Moorthy LN 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]. , Beresford MW It estimates how similar a given patients scores were at the two visits. , Engle E ATI Comprehensive Predictor Exam 2019 (180 Q & A, Verified and 100 Derivatives RWA Production Controller (SA-CCR/SLE) On stratifying the results by individual clinician, values ranged from 0.61 to 0.90, except for those reported by . 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]. , Urowitz MB. Touma Z The Validity of Patient and Physician Global Disease Activity
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