The PGA is a well accepted and commonly used scale for evaluating treatment response in clinical trials both in adults and children. 25 (FIVE YEARS 8) Latest Documents Most Cited Documents Contributed Authors Related Sources Related Keywords Latest Documents; Most Cited Documents; Contributed Authors; Related Sources; , Mina R Wells GA , Bertsias G A total of 91 articles were included in the study (Fig. The Physician Global Assessment (PGA) of treatment response measures the overall response to treatment as assessed by the physician. Would you like email updates of new search results? van Vollenhoven R , Hochberg M. Wallace DJ We have systematically reviewed all studies about validation of the PGA in SLE. , Gladman DD Federal government websites often end in .gov or .mil. It estimates how similar a given patients scores were at the two visits. , Mohan C. Giangreco D , Urowitz MB 2022 Mar 14;24(1):70. doi: 10.1186/s13075-022-02756-3. , Navarra SV , Roberts WN . Vashisht P 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]. , Arora S disease activity). A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.67-0.98). [84] expressed the sensitivity in PGA scoring with the standardized response mean (SRM), demonstrating a very large effect size (ES=2.23) [110]. OBJECTIVE The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. The Author(s) 2020. , Francis S Content validity was reported in 89 studies. , Weisman MH. , Maxwell LJ Touma Z Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. 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. This may be explored through convergent and divergent validity. AU - Kasitanon, Nuntana. , Raeisi A 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). This site needs JavaScript to work properly. Results: It should be noted that the PGA correlates with several other instruments that measure disease activity. 12. and later incorporated into the SLE Responder Index used in the belimumab clinical trials, 13 et al. 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. The Systemic Lupus Activity Measure-revised, the Mexican Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and a modified SLEDAI-2K are adequate instruments to measure disease activity in systemic lupus erythematosus. Funding: The study was funded through the training Bursary Programme 2019 of the SLEuro European Lupus Society. Merrill JT et al. 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. , Pilkington C Oxford University Press is a department of the University of Oxford. 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). Unable to load your collection due to an error, Unable to load your delegates due to an error. Objective: The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. 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. , Koutsoviti S Mahler M , Jolly M. Mok CC 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. 2022 Sep;8(2):e002395. Introduction Physician global assessments of disease activity (medical doctor (MD) globals) are important outcomes. , Klein-Gitelman MS . This scoring modality was used for the SRI [3]. Barr SG Medizinische Universitt Graz Austria/sterreich - Forschungsportal - Medical University of Graz Direkt zur Navigaton springen . The Janus kinase (Jak)/signal transducer and activating protein (STAT) pathways mediate the intracellular signaling of cytokines in a wide spectrum of cellular processes. , Suriano A 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. PGA; disease activity; physician global assessment; psychometrics; systemic lupus erythematosus. 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]. Liang et al. 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. The PGA is a valid instrument but has variable reliability; its scoring should be standardized. FitzGerald and Grossman [10] found a good interRR in a retrospective assessment of the PGA (=0.79). sharing sensitive information, make sure youre on a federal 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. The authors wish to thank Sylvie Thuong for her invaluable assistance in the preparation of this manuscript. X 20 Physician Global Assessment 10.1136/lupus-2019-lsm.176 . 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. Objective: watch for seizures after the procedure. Castrejn I, Ra-Figueroa I, Rosario MP, Carmona L. Reumatol Clin. , Mosca M 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. Cloud, mobility, security, and more. The other authors have declared no conflicts of interest. physician global assessment Recently Published Documents. 8600 Rockville Pike Petri M , Larson MG 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]. , Fang H 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. Ruiz-Irastorza G The literature search identified 91 studies. , Giangreco D To determine longitudinal associations between Physician Global Assessment (PGA) and patient-reported outcomes (PROs) in patients with systemic lupus erythematosus (SLE). et al. , Shinada S Navarra SV , Gladman DD [8] suggested the need for a disease activity instrument that would be valid, reliable and sensitive to change. 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]. 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 . Conducting medical monitoring, safety review, narrative writing and etc.. Perform medical assessment of individual . 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. The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinicians judgement of overall SLE disease activity. , Piette EW , Genovese M 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]. Parodis I The Physician's Global Assessment (PhGA) is a number without unit. , Socher SA , Birmingham DJ The PGA is usually reported by experts as allowing exhaustive coverage of the concept of disease activity in SLE [20, 108]. 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]. PGA0.3. , Stavrakis S Because of its dynamic nature, this disease has an unpredictable natural course leading to high . et al. No study has evaluated the feasibility of the PGA in SLE to date. This button displays the currently selected search type. et al. The PGA was developed on a 0 to 3 scale as part of the Lupus Activity Index. , Jolly M. Antony A Ward et al. , Matos A et al. AU - Kandane-Rathnayake, Rangi. 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 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. 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. Accessibility allergy hx phenothiazines, cns depressants and stimulants withheld 48 hours prior. , Leung HW Feb 2016 - Jan 20182 years. This enabled the PGA to be considered the gold standard in several studies [2, 10, 11, 21, 23, 49, 67, 76, 78, 84, 88]. The https:// ensures that you are connecting to the LECTURE 10: MEDICAL SURGICAL NURSING. , Petri MA According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. However, the PGA allows for the measurement of disease activity in a global way (content validity). Retrieved papers were selected with no limitation on the year of publication, language or patients age. Objective Existing methods for grading lupus flares or improvement require definition-based thresholds as increments of change. In the second column, the definitions were reported according to the VAS used in the study. SLE or at an SLE site, but only if the injury requires treatment by a licensed medical doctor. , Adamichou C JSS Medical Research. IgM) on attainment PhGA. The company serves physicians and patients. 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. CLOSED ANGLE/ ANGLE CLOSURE GLAUCOMA. , Kharboutli M 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 aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. Mokkink LB Schneider M An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA. 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]. , Ko T , Hochberg M. Touma Z 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).
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