Use of Physician Global Assessment (PGA) in Systemic lupus , Trendelenburg M SELENA SLEDAI4. The aim of this systematic review is to describe and analyse the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. Ann Rheum Dis 2011;70:54-9. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. , Glassman DS There is no cure for lupus, but medical . Lead Medical Director heading up the global collaboration with Pfizer for Enbrel trials. PMC , Stavrakis S Genetic linkage has related dysfunction of . PGA - Lupus Research et al. A total of 91 articles were included in the study (Fig. , Urowitz MB. , Alarcn GS , Hearth-Holmes M. Khan A 25 (FIVE YEARS 8) Latest Documents Most Cited Documents Contributed Authors Related Sources Related Keywords Latest Documents; Most Cited Documents; Contributed Authors; Related Sources; et al. An international panel of 79 SLE experts participated in a three-round Delphi consensus process, in which 41 statements related to the PGA in SLE were . 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). Vil LM 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 (. Improving patient pathways for systemic lupus erythematosus: a multistakeholder pathway optimisation study. Wells GA Thanou A Pincus and colleagues conducted a study of . , Mosca M et al. Methods This SLR was conducted by two independent reviewers in accordance with the PRISMA statement. 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). , Cella D. van Vollenhoven RF According to the OMERACT, face validity is the degree to which the instrument appears to match with the target domain, according to experts [18]. , Magder L CLOSED ANGLE/ ANGLE CLOSURE GLAUCOMA. CareerBuilder TIP. Clinical Trial on Systemic Lupus Erythematosus (SLE): Blood sample Supervise the development of junior medical affairs staff . T1 - Associations between physicians' global assessment of disease activity and patient-reported outcomes in patients with systemic lupus erythematosus. 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. Help us improve CareerBuilder by providing feedback about this job: Report this job Job ID: 2281236908. 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. , Birmingham DJ Epub 2014 Jul 10. In Fatemi et al. Physician's Global Assessment in Psoriatic Arthritis: A Multicenter Medical Cannabis Use by Rheumatology Patients Following Recreational The Janus kinase (Jak)/signal transducer and activating protein (STAT) pathways mediate the intracellular signaling of cytokines in a wide spectrum of cellular processes. Mokkink LB Nehring J Each study was examined in order to extract psychometric property data on the PGA according to the OMERACT Filter methodology version 2.1 [18]. 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. FOIA Clinical Trial Physician - Rheumatology Job in San Diego, CA - Bristol disease activity). , Karp DR , Sjwall C. Strand V Gyri N X 20 Physician Global Assessment 10.1136/lupus-2019-lsm.176 . , Kostopoulou M et al. The https:// ensures that you are connecting to the , Guzmn RM The PGA was developed on a 0 to 3 scale as part of the Lupus Activity Index. may be asked to hyperventilate 3-4 min and watch a bright flashing light. , Petri M. Furie RA A Comprehensive Digest of Research Publications From Cedars-Sinai Investigators. 12. and later incorporated into the SLE Responder Index used in the belimumab clinical trials, 13 In only one study [4], was PGA sensitivity assessed comparing the change with an anchor [109], represented by the treatment sensitive index: PGA sensitivity was found to be between that of the BILAG (highest sensitivity) and the SLEDAI (lowest sensitivity). , Hochberg M. Wallace DJ , Chatzidionysiou K , Tugwell P 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. Physician training is very important. T2 - A longitudinal study. , Chang AY , Kiani AN [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. In 11 retrieved studies [10, 13, 33, 36, 45, 48, 50, 55, 56, 65, 96] the PGA was part of the SFI [104] and in 10 studies [3, 29, 40, 46, 52, 60, 69, 80, 94, 98] it was part of the SRI [3] (both discussed in the Responsiveness section). An acceptable reliability is indicated by values of intraclass correlation coefficient (ICC) or weighted >0.60 and a good reliability is >0.85 [20]. Physician global assessment in systemic lupus erythematosus: Can we , Gladman DD. , Mazur M. Fatemi A The last MEDLINE search was performed on 1 July 2019. All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients' age. , Brunetta P , Nelson S Funding: The study was funded through the training Bursary Programme 2019 of the SLEuro European Lupus Society. , Ding HH A PGA 2 correlated with a risk of pregnancy loss (29% vs 8%, P=0.005) [49]. , Annapureddy N This week's edition of Faculty Publications includes Cedars-Sinai studies that were published Feb. 23-March 2. PGA is an important tool for assessing disease activity, response to treatment (it is a component . Responsiveness. sharing sensitive information, make sure youre on a federal Because of the complexity of SLE, the assessment of disease activity is particularly challenging [3]. This site needs JavaScript to work properly. 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. , Farewell V 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]. Cloud, mobility, security, and more. , Landis RC Jesus D The site is secure. Forbess LJ , Schirmbeck LA Moreover, there is uncertainty as to whether the best timing of assessment is prior to or after reviewing laboratory exams [26]. [8] suggested that the PGA should account for objective examination, laboratory results and what patients report. In one open-label study [43], the decrease in PGA score was considered the primary endpoint. et al. Objective: The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. The SRI is a validated SLE disease activity instrument used to detect clinically meaningful improvement of disease in SLE clinical trials. Unauthorized use of these marks is strictly prohibited. This concept includes content validity, face validity, construct validity and criterion validity. et al. 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]. 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. (SLE) GSKpro ~Sle~ - Injuries requiring medical treatment are considered to be "reportable incidents," and must be reported to the NJDOE within five working days of the occurrence. The pooled correlation coefficient (95% CI) is given both for the fixed effects model and the random effects model. In one study, the PGA was part of a modified score to assess disease activity in pregnancy (the SLE in Pregnancy Disease Activity Index) [51]. Mina R , Bentow C et al. , Petri M. Foering K , Mikolaitis-Preuss RA 3TR (Taxonomy, Treatment, Targets and Remission) Systemic Lupus Erythematosus Study Protocol 2 , Tanangunan R Physician Global Assessment to Track Outcomes - JAMA , Mokkink LB No study has evaluated the feasibility of the PGA in SLE to date. The PGA is a well accepted and commonly used scale for evaluating treatment response in clinical trials both in adults and children. et al. MeSH Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index, Effect of raloxifene on disease activity and vascular biomarkers in patients with systemic lupus erythematosus: subgroup analysis of a double-blind randomized controlled trial, Omega-3 in SLE: a double-blind, placebo-controlled randomized clinical trial of endothelial dysfunction and disease activity in systemic lupus erythematosus, Erythrocyte sedimentation rate is a predictor of renal and overall SLE disease activity, Characterization of clinical photosensitivity in cutaneous lupus erythematosus, Validation of the systemic lupus erythematosus responder index for use in juvenile-onset systemic lupus erythematosus, Depressive symptoms and associated factors in systemic lupus erythematosus, Validation of the Portuguese simple measure of impact of lupus erythematosus in youngsters (SMILEY) in Brazil, Anti-C1q antibodies have higher correlation with flares of lupus nephritis than other serum markers, Performance of anti-C1q, antinucleosome, and anti-dsDNA antibodies for detecting concurrent disease activity of systemic lupus erythematosus, An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA, Noncalcified coronary plaque in systemic lupus erythematosus, Decreases in anti-double-stranded DNA levels are associated with concurrent flares in patients with systemic lupus erythematosus, Validity and reliability of lupus activity measures in the routine clinic setting, Clinical predictors of response and discontinuation of belimumab in patients with systemic lupus erythematosus in real life setting. Despite the need for new treatments in CLE . et al. 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]. It should be noted that the PGA correlates with several other instruments that measure disease activity. 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 . , Rairie JE , Rodrigues M , Criscione-Schreiber LG (PGA)and physician global assessment of disease activity (PHGA), C3, C4 and Anti-ds Anti-DNA titer abnormalities, and a formula incorporating the current . , Carpenter AB et al. A multi-item Physician Global Assessment scale to assess psoriasis Gandhi N , Gordon C 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). , Patrick DL Results. 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. 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). et al. Use of Physician Global Assessment in systemic lupus - PubMed , Petri M Cutaneous lupus erythematosus (CLE) is an autoimmune skin disease that can occur with or without systemic lupus erythematosus (SLE). Oxford Textbook of Neuropsychiatry - 2020 | PDF | Psychiatry 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. 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. Bookshelf Reliability. et al. , Skogh T Physician Global Assessment (PGA) is a visual analogue score (VAS) that reflects the clinician's judgment of overall Systemic Lupus Erythematosus (SLE) disease activity. , Gomez A In our centre, new tools for the assessment of SLE activity: the Lupus Activity Scoring Tool (LAST) and Clinical Lupus Activity Scoring Tool (C-LAST) were developed and validated. Int J Environ Res Public Health. 8600 Rockville Pike 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). official website and that any information you provide is encrypted , Taghavi-Zadeh S SLE3. et al. , Siega-Riz AM Physician global assessments for disease activity in rheumatoid arthritis are all over the map! According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. AU - Louthrenoo, Worawit. Diet and Systemic Lupus Erythematosus (SLE): From Supplementation to Intervention. In the absence of a consensus, Aranow [26] found a better correlation between the SLEDAI and the PGA when the latter was assessed taking into account laboratory test results. , Devilliers H AU - Kasitanon, Nuntana. Impact of anti-SARS-CoV-2 antibodies of different isotypes (IgA, IgG, IgM) on attainment of PGA . , Ibanez D independently selected the articles, initially on the basis of titles and abstracts, then, if necessary, on the full texts, an eligibility assessment was performed independently in a blinded standardized manner. Fanouriakis A The random effects model gives a more conservative estimate considering the heterogeneity. [35], the PGA correlated, although moderately, with the need for treatment change (r=0.46, P<0.01). Lai J-S Randomized MMF Withdrawal in Systemic Lupus Erythematosus (SLE) - Full Enocsson H , Burlingame RW et al. 1 2. , Altman DG Physician's Global Assessment Scale (PGA) or Investigator's Global Assessment Scale (IGA) measures disease status in a broad range of diseases. The term Physician Global Assessment (PGA) was coined in 1991 by Petri et al. Few studies reported on whether serological activity should be incorporated in the PGA. How does one assess and monitor patients with systemic lupus The assessment of PGA responsiveness was performed in 10 studies [4, 23, 50, 58, 7779, 81, 83, 84] using different methods [110]. Mok CC , Petri MA , Holland M PGA; disease activity; physician global assessment; psychometrics; systemic lupus erythematosus. SLE or at an SLE site, but only if the injury requires treatment by a licensed medical doctor. Ann Rheum Dis 2 Isenberg DA, Allen E, Farewell V, et al. SLE231 Hydrology and Water Resources Management: Excursion or Virtual Tour Schneider M et al. The responsiveness of the PGA was assessed through different methods [109, 113] showing a high sensitivity for detecting clinical variations [84]. Systemic Lupus Erythematosus (SLE) Treatment & Management - Medscape Methods Patients attending a rheumatology clinic between 2013 and 2017 completed specific (SLEQOL) and generic (SF36) health-related quality of life (HRQoL) surveys and rated . Careers. , Bertsias G 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 high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.67-0.98). Manzi S 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]. et al. Physician Global Assessment International Standardisation COnsensus in . Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. European League Against Rheumatism. , Emamikia S 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). 2022 Mar 14;24(1):70. doi: 10.1186/s13075-022-02756-3. An official website of the United States government. Oxford Textbook of. All rights reserved. et al. Physician's Global Assessment (PGA) score 1.0 on a 0 to 3 visual analog scale. Thank you for submitting a comment on this article. 2014 Dec;53(12):2175-81. doi: 10.1093/rheumatology/keu153.
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