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The Physician Global Assessment (PGA) is an important tool for assessing disease activity in lupus. These results enabled its use as a gold standard for assessing flare and defining flare severity in several studies [21, 67, 88]. This enabled the PGA to be considered the gold standard in several studies [2, 10, 11, 21, 23, 49, 67, 76, 78, 84, 88]. In one open-label study [43], the decrease in PGA score was considered the primary endpoint. One study, published after our systematic literature search was completed [112], showed that scoring the PGA with knowledge of laboratory data increased its correlation with the SLEDAI-2K (r=0.79) compared with without knowledge of laboratory results (r=0.67). PGA0.3. , Petri M. Furie RA To determine longitudinal associations between Physician Global Assessment (PGA) and patient-reported outcomes (PROs) in patients with systemic lupus erythematosus (SLE). et al. , Altman DG This concept includes content validity, face validity, construct validity and criterion validity. Correlations with other instruments measuring similar constructs should typically demonstrate a coefficient (r) 0.50 [106]. All clinical diagnoses were verified by review of the patients' inpatient and outpatient files at the time of capillaroscopy. Physician's Global Assessment (PGA) score 1.0 on a 0 to 3 visual analog scale. Objective: This property is reported across all articles selected through this systematic review [24, 913, 21103]. According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients age. Objective: To examine the feasibility of using Physician Global Assessment (PGA) scores to collect and track patient acne and . Ensure second line of defense Derivatives RWA reviews are performed consistently and . Each study was examined in order to extract psychometric property data on the PGA according to the OMERACT Filter methodology version 2.1 [18]. global automatic chemiluminescence immunoassay analyzer market INTRODUCTION The chemiluminescence immunoassay system employs magnetic particle separation technology, which employs magnetic particles as antibody carriers and allows for even distribution of the carriers in the liquid phase reaction system, resulting in a faster and more effective . et al. , Urowitz MB. , Giangreco D et al. , Kalunian K . Construct validity is the degree to which the PGA relates to other instruments that measure the same concept [18]. et al. , Gomez A Results. AU - Kandane-Rathnayake, Rangi. The index assesses separately eight organ-based systems. 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). Aranow C , Mokkink LB Thousand Oaks. 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. At least 1 issue from each virtual tour. Ward et al. The aim of this systematic literature review (SLR) is to describe and analyse the psychometric properties of PGA. . 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. 2019ACREULAR . , Roberts WN Some may be a consequence of therapy and others may be . , Wallace DJ It is unclear when or with what justification the physician global assessment of disease status (PhGA) was first used to assess patients with systemic . BICLA responders had fewer lupus-related serious . A PGA >1 was predictive of polymorphic light cutaneous eruption (P=0.02) [59] and correlated negatively with LLDAS attainment [37]. , Bentow C Navarra SV Arthritis Res Ther. Thanou A, Chakravarty E, James JA, Merrill JT. Jiao H, Acar G, Robinson GA, Ciurtin C, Jury EC, Kalea AZ. 2014 Dec;53(12):2175-81. doi: 10.1093/rheumatology/keu153. 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. , Mikolaitis-Preuss RA The following search strategy was used through MEDLINE via PubMed: (((lupus erythematosus, systemic[MeSH Terms] OR (lupus[TIAB] AND erythematosus[TIAB] AND systemic[TIAB]) OR systemic lupus erythematosus[TIAB] OR (systemic[TIAB] AND lupus[TIAB] AND erythematosus[TIAB]))) OR SLE[TIAB]) AND (physician global assessment[TIAB] OR PGA[TIAB]). Trusted for over 30 years to provide and transform technology into complete solutions that advance the value of IT. , Taghavi-Zadeh S Federal government websites often end in .gov or .mil. Prinsen CAC When expanded it provides a list of search options that will switch the search inputs to match the current selection. 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. , Wetter J , Gladman DD Accessibility , Farewell V et al. Methods: This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items . The Physician Global Assessment (PGA) is a frequently used co-primary end point in psoriasis clinical trials. et al. , Francis S , Dyer JW 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). Please check for further notifications by email. Over the years, PGA-IGA scales were modified for the purpose of clinical settings and thus present a diversity in the number of response options (4 to 10 points), the response options label and the . , Urowitz MB. et al. , Mina R [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. , Glassman DS , Mazur M. Fatemi A and transmitted securely. Barr et al. A Comprehensive Digest of Research Publications From Cedars-Sinai Investigators. , Morabito LM All versions are validated and used by lupus researchers for clinical and research purposes. 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. The other authors have declared no conflicts of interest. Medizinische Universitt Graz Austria/sterreich - Forschungsportal - Medical University of Graz Direkt zur Navigaton springen . Moreover, a difference between the interRR of the PGA assessed by an untrained physician (0.50.63) and a trained investigator (0.790.81) was found, suggesting the need for PGA scoring training or standardization [36]. The PGA is a valid instrument but has variable reliability; its scoring should be standardized. Keywords: , Ravelli A van Vollenhoven R LECTURE 10: MEDICAL SURGICAL NURSING. , Gayet-Ageron A European League Against Rheumatism. disease activity). Content validity was reported in 89 studies. Enocsson H 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]. , Larson MG Castrejn I, Ra-Figueroa I, Rosario MP, Carmona L. Reumatol Clin. Touma Z It operates in Albuquerque, and New Mexico. ECG - correct answer no sleep the night before, meals allowed, no stimulants/tranquilizers for 24-48 hours before. Visual analogue scales (VAS) allow rapid, continuous scaling of disease severity. Methods The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinicians judgement of overall SLE disease activity. , Matos A , Lin M government site. 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. The literature search identified 93 articles, and 12 additional articles were retrieved from the reference list of those publications. No study has evaluated the correlation of PGA with damage measures. watch for seizures after the procedure. 2014 Sep-Oct;10(5):309-20. doi: 10.1016/j.reuma.2014.01.012. Fanouriakis A A prospective cohort study, Validity and reliability of retrospective assessment of disease activity and flare in observational cohorts of lupus patients, A novel lupus activity index accounting for glucocorticoids: SLEDAI-2K glucocorticoid index, Low disease activityirrespective of serologic status at baselineassociated with reduction of corticosteroid dose and number of flares in patients with systemic lupus erythematosus treated with belimumab: a real-life observational study, Definition and initial validation of a lupus low disease activity state (LLDAS), A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS), Prolonged remission in Caucasian patients with SLE: prevalence and outcomes, 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus, PRISMA Group. Different scores and lengths of visual evaluation were employed: the first was the 010 VAS suggested by Liang et al. A PGA 2 correlated with a risk of pregnancy loss (29% vs 8%, P=0.005) [49]. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. 2) [10, 23, 24, 26, 28, 29, 35, 54, 68, 76, 84, 99], with the SLAM in 4 studies (r=0.470.65) [35, 76, 84, 99], with LAI in 2 studies (r=0.640.75) [68, 84], with BILAG in 2 studies (r=0.610.62) [35, 84] and with ECLAM in 2 studies (r=0.580.65) [35, 84]. 8600 Rockville Pike [2, 21, 24] recommended PGA assessment prior to reviewing serological data, based only on the clinical visit. 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. , Arora 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). 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). 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. J Clin Med. , Khamashta MA Brunner HI , Bertsias G However, the PGA allows for the measurement of disease activity in a global way (content validity). The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. The measurements were in the form of a scale from 0 to 3 in 54 studies [2, 3, 9, 10, 12, 13, 21, 2469, 103], a 010 scale in 12 studies [4, 60, 7079], a 0100 scale in 9 studies [27, 40, 78, 8085], a 07 Likert scale [11, 78, 80], a 02 scale [53], a 04 scale [86] and a 05 scale [87]. Construct validity. 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. , Costenbader K All rights reserved. BILAGAB . , Ho LY FOIA Published by Oxford University Press on behalf of the British Society for Rheumatology. Patient-reported outcomes (PROs) reflect the patient's perspective and are used in rheumatoid arthritis (RA) routine clinical practice. Strength. Five studies have demonstrated good ICC values for reliability (all >0.60 and ranging up to 0.97). , Engel SM et al. Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus: the PISCOS study . In the second column, the definitions were reported according to the VAS used in the study. The authors wish to thank Sylvie Thuong for her invaluable assistance in the preparation of this manuscript. 'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study. It estimates how similar a given patients scores were at the two visits. RN-BSN HOLISTIC HEALTH ASSESSMENT ACROSS THE LIFESPAN (NURS 3315) Sociology of Social Problems (SOC213) Pincus and colleagues conducted a study of . 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