physician global assessment sle

, Petri M. Iaccarino L , Wallace DJ , Mokkink LB Stojan G The random effects model gives a more conservative estimate considering the heterogeneity. AU - Kandane-Rathnayake, Rangi. Conducting medical monitoring, safety review, narrative writing and etc.. Perform medical assessment of individual . et al. Enocsson H Manzi S 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. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. 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]. 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. Would you like email updates of new search results? , Petri M. Furie RA , Block JA , Ravelli A Montreal, Canada Area. , Tetzlaff J , Rodrigues M 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. Objective Existing methods for grading lupus flares or improvement require definition-based thresholds as increments of change. , Perneger T Wells GA Face validity. , Matos A PGA is often assessed by a single question with a 0-10 or 0-100 response. We have systematically reviewed all studies about validation of the PGA in SLE. , Glassman DS Measurement properties of the PGA were analysed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) terminology [19]. 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). Patient-Reported Outcomes in Systemic Lupus Erythematosus. [84] expressed the sensitivity in PGA scoring with the standardized response mean (SRM), demonstrating a very large effect size (ES=2.23) [110]. 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. The correlation with the SLEDAI was determined in 12 studies (Fig. 2014 Dec;53(12):2175-81. doi: 10.1093/rheumatology/keu153. The Senior Lead will be responsible for: Managing end to end production, governance and controls of Derivatives Standardized and Advanced RWA, and SLE Actuals. The Physician Global Assessment (PGA) is a frequently used co-primary end point in psoriasis clinical trials. 12. and later incorporated into the SLE Responder Index used in the belimumab clinical trials, 13 The assessment of PGA responsiveness was performed in 10 studies [4, 23, 50, 58, 7779, 81, 83, 84] using different methods [110]. A new tool -- the Lupus Activity Scoring Tool (LAST) - has been proposed to join the ranks of current disease activity indices. Copay AG European League Against Rheumatism. 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). Merrill JT 2022 Jan 11;11(2):340. doi: 10.3390/jcm11020340. 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). , Garabajiu M , Kostopoulou M Ward et al. Ann Rheum Dis 2011;70:54-9. Physician global assessments for disease activity in rheumatoid arthritis are all over the map! , Jolly M. Antony A Content validity was reported in 89 studies. Mina R , Subach RB SLE has protean and often complex manifestations, necessitating careful clinical assessment. SLE3. This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. , James JA Parodis I Currently the lack of standardized scoring, as well as the subjectivity of the physician judgements, can be an important source of heterogeneity, especially in trials. . Mok CC 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. Vil LM 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 . , Borghoff K FitzGerald and Grossman [10] found a good interRR in a retrospective assessment of the PGA (=0.79). 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. , Birmingham DJ , Aggarwal R 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]. , Brunetta P Once two investigators (E.C., M.P.) Int J Environ Res Public Health. Different definitions of disease activity according to the PGA instrument. , Suriano A official website and that any information you provide is encrypted Mokkink LB , Esdaile JM. et al. et al. 'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study. Conclusion: 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. The intrarater reliability (intraRR) is the ability to provide consistent scores in a stable population by the same assessor over time. Objectives Remission in systemic lupus erythematosus (SLE) is defined through a combination of 'clinical SLE Disease Activity Index (cSLEDAI)=0', 'physician's global assessment (PGA) <0.5 . Devilliers H , Skogh T 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. et al. , Bocci EB Injuries requiring medical treatment are considered to be "reportable incidents," and must be reported to the NJDOE within five working days of the occurrence. , Sjwall C , Hennis A. Jesus D Federal government websites often end in .gov or .mil. , Lau CS , Voskuyl A , Vogel-Claussen J 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]. An official website of the United States government. Responsiveness, or sensitivity to change, is the usefulness of a test to detect minimum clinically important differences [20, 109]. The aim of this systematic literature review (SLR) is to describe and analyse the psychometric properties of PGA. 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. Liang et al. Cloud, mobility, security, and more. 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. Liang MH A PGA >1 was predictive of polymorphic light cutaneous eruption (P=0.02) [59] and correlated negatively with LLDAS attainment [37]. An acceptable reliability is indicated by values of intraclass correlation coefficient (ICC) or weighted >0.60 and a good reliability is >0.85 [20]. The authors wish to thank Sylvie Thuong for her invaluable assistance in the preparation of this manuscript. , Engel SM 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. , Kiani AN The PGA intraRR was assessed in three studies [10, 68, 94] and ranged from 0.55 [68] to 0.88 [10]. Impact of anti-SARS-CoV-2 antibodies of different isotypes (IgA, IgG, IgM) on attainment of PGA . Physician's Global Assessment (PGA) score 1.0 on a 0 to 3 visual analog scale. Construct validity was demonstrated by a good correlation (r0.50) between the PGA with the SLEDAI (12 studies), SLAM (4 studies), LAI, BILAG and ECLAM (2 studies each). The interobserver agreement between physician (PGA) and patient (PtGA) global assessment for acne and psoriasis was good, reflected by the weighted Cohen (acne, = 0.68; psoriasis, = 0.70) (eTable in the Supplement). Responsiveness. , Annapureddy N This may be explored through convergent and divergent validity. ~SLE~. , Sato JO , Schirmbeck LA , Adamichou C , Bertsias G Epub 2014 Apr 11. Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index. , Gladman DD To discriminate between the severity of flares, the PGA was incorporated in a composite index: the SFI [10] (Table1). , Tanangunan R 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. No study has evaluated the feasibility of the PGA in SLE to date. 1 2. Mina R Navarra SV SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. , Urowitz MB , Socher SA , Wetter J , Mohan C. Giangreco D 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. , McGuire JL. [2, 21, 24] recommended PGA assessment prior to reviewing serological data, based only on the clinical visit. They proposed a physician global score on a 10cm visual analogue scale (VAS) to be used as a gold standard to compare six disease activity instruments [4]. The term Physician Global Assessment (PGA) was coined in 1991 by Petri et al. 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]. 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 . Fanouriakis A Published by Oxford University Press on behalf of the British Society for Rheumatology. Physician Global Assessment (PGA) is a visual analogue score (VAS) that reflects the clinician's judgment of overall Systemic Lupus Erythematosus (SLE) disease activity. This property is reported across all articles selected through this systematic review [24, 913, 21103]. , Petri MA . Brunner HI This week's edition of Faculty Publications includes Cedars-Sinai studies that were published Feb. 23-March 2. Pincus and colleagues conducted a study of . The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. 25 (FIVE YEARS 8) Latest Documents Most Cited Documents Contributed Authors Related Sources Related Keywords Latest Documents; Most Cited Documents; Contributed Authors; Related Sources; RMD Open 2018;4:e000578. The quantification of reliability is expressed by a correlation coefficient. et al. SLE2ACR1997SLICC2012. Disagreements between investigators were solved by consensus. , Jolly M. Ribi C Ann Rheum Dis 2 Isenberg DA, Allen E, Farewell V, et al. An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA. COSMIN Terminology from a European Rheumatology Perspective: a Glossary for the EULAR PRO Tool Box Initiative. 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). 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]. PMC The PGA is a well accepted and commonly used scale for evaluating treatment response in clinical trials both in adults and children. In this systematic review we have analysed the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. , Oon S , Chatzidionysiou K , Ibanez D 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.

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