PGA is an important tool for assessing disease activity, response to treatment (it is a component . IgM) on attainment PhGA. 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. , Seaman AL , Jnsen A 04 Measuring SLE disease activity in 2020: perspectives from clinical Mahler M , Su J To discriminate between the severity of flares, the PGA was incorporated in a composite index: the SFI [10] (Table1). PDF Physician global assessments for disease activity in rheumatoid , Perez-Gutthann S , Saad-Magalhes C Associations between physicians' global assessment of disease activity government site. , Piette EW , Trendelenburg M 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). Brunner HI 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 . Objective Existing methods for grading lupus flares or improvement require definition-based thresholds as increments of change. , Arbab-Zadeh A In two studies, the PGA-VAS was used to assess concepts other than disease activity: disease severity [4] and patients compliance with treatments [103]. et al. Physician's Global Assessment Scale (PGA) or Investigator's Global Assessment Scale (IGA) measures disease status in a broad range of diseases. , Bertsias G The pooled correlation coefficient (95% CI) is given both for the fixed effects model and the random effects model. RMD Open 2018;4:e000578. 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 . , Hearth-Holmes M. Khan A We have systematically reviewed all studies about validation of the PGA in SLE. Clinical composite measures of disease activity and damage used to evaluate patients with systemic lupus erythematosus: A systematic literature review. , Engleman EG Criterion validity. Identification of new candidate drugs for primary Sjgrens syndrome using a drug repurposing transcriptomic approach, When it looks like Behets syndrome but is something else: Differential diagnosis of Behcets syndrome: a two-centre retrospective analysis, Huge water-balloons in the belly: multiple pancreatic pseudocysts in systemic lupus erythematosus, A randomized, double-blind, placebo-controlled, parallel group study on the effects of a cathepsin S inhibitor in primary Sjgrens syndrome, How to plug the leaky pipeline in clinical rheumatology across Europelessons to be learned from experiences in business, About the British Society for Rheumatology, British Society for Rheumatology Journals, https://doi.org/10.1093/rheumatology/keaa383, https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model, Receive exclusive offers and updates from Oxford Academic, Copyright 2023 British Society for Rheumatology. Chaigne B 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). . It was published in 1977 and was initially designed for the measurement of self-assessed pain in rheumatoid arthritis although it has since been used to evaluate RA more globally. Clinical Trial Physician - Rheumatology Job in San Diego, CA - Bristol SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. 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]. ATI Comprehensive Predictor Exam 2019 (180 Q & A, Verified and 100 This button displays the currently selected search type. AU - Kandane-Rathnayake, Rangi. 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). , Larson MG Navarra SV When expanded it provides a list of search options that will switch the search inputs to match the current selection. Moreover, there is uncertainty as to whether the best timing of assessment is prior to or after reviewing laboratory exams [26]. MD globals may vary based on their age, gender, practice setting and experience (number of patients seen per year and years in practice). Reviews and case series with fewer than five patients were excluded. Unauthorized use of these marks is strictly prohibited. , Landis RC Gyri N 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]. , Flower C Schneider M et al. , Chan KL A good responsiveness for PGA was shown in eight studies. 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. Disclosure statement: L.A. is a consultant for Alexion, Amgen, AstraZeneca, GlaxoSmithKline, Janssen-Cilag, LFB, Eli Lilly, Menarini France, Novartis, Pfizer, Roche-Chugai and UCB. PMC et al. This suggests that the role of the PGA is limited for disease activity assessment when used as a single instrument. Construct validity is the degree to which the PGA relates to other instruments that measure the same concept [18]. , Devilliers H , Borghoff K OBJECTIVE The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. Face validity is satisfied when the instrument is considered able to capture what it should capture (i.e. , Gomez A At a glance: Common scores used in rheumatology The index has proved quick and easy to use despite a comprehensive database and compares favourably with . , Petri M. Furie RA , Kraag GR The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinicians judgement of overall SLE disease activity. , Engel SM et al. [PDF] Use of Physician Global Assessment in systemic lupus 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). Copay AG et al. (PGA) scoring of disease activity in systemic lupus erythematosus (SLE). Bookshelf , Karp DR , Petri MA Assessing disease activity in rheumatic diseases such as systemic lupus erythematosus (SLE) is vital for effective treatment. To increase its reliability, the PGA should be scored by a physician with significant expertise in SLE, with prior knowledge of laboratory results [112], considering the overall disease activity at the time of the visit and comparing it to the last visit in order to assess flares [9]. van Vollenhoven R , Gladman DD. The last MEDLINE search was performed on 1 July 2019. et al. , Askanase A et al. , Ibanez D The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. A new tool -- the Lupus Activity Scoring Tool (LAST) - has been proposed to join the ranks of current disease activity indices. , Magder L 2022 Mar 14;24(1):70. doi: 10.1186/s13075-022-02756-3. Liang MH To determine longitudinal associations between Physician Global Assessment (PGA) and patient-reported outcomes (PROs) in patients with systemic lupus erythematosus (SLE). Ward et al. et al. et al. et al. 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. Face validity. et al. A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.670.98). All rights reserved. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. They participate in physiologic and inflammatory cascades and have become a major focus of research, yielding novel therapies for immune-mediated inflammatory diseases (IMID). ~SLE~. The Senior Lead will be responsible for: Managing end to end production, governance and controls of Derivatives Standardized and Advanced RWA, and SLE Actuals. , Chatzidionysiou K Cloud, mobility, security, and more. 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 . physician global assessment Latest Research Papers | ScienceGate European League Against Rheumatism. , Petri M. Foering K 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. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. Pain assessment: An alternative measure - hcplive.com Systemic lupus erythematosus (SLE), is the most common type of lupus. Global Automatic Chemiluminescence Immunoassay Analyzer Market 2023 Karol DE The content can vary and relates either to global health (e . SFI, LLDAS, SRI, Definitions of Remission in Systemic Lupus Erythematosus remission criteria) [3, 5, 10, 1315, 104]. 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. et al. Cutaneous lupus erythematosus (CLE) is an autoimmune skin disease that can occur with or without systemic lupus erythematosus (SLE). et al. 1 2. , Birmingham DJ CareerBuilder TIP. RN-BSN HOLISTIC HEALTH ASSESSMENT ACROSS THE LIFESPAN (NURS 3315) Sociology of Social Problems (SOC213) , Kalunian K 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. An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA. 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]. , Klein-Gitelman MS et al. The Handheld Dermatoscope as a Nail-Fold Capillaroscopic Instrument - JAMA The authors wish to thank Sylvie Thuong for her invaluable assistance in the preparation of this manuscript. The responsiveness of the PGA was assessed through different methods [109, 113] showing a high sensitivity for detecting clinical variations [84]. . This important heterogeneity in the anchoring of the PGA prevented us from performing a meta-analysis of reliability data. The aim of this systematic review is to describe and analyse the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. Physician Global Assessment to Track Outcomes - JAMA , Cella D. van Vollenhoven RF Patient and Physician Global Assessments of Disease Status in Systemic Funding: The study was funded through the training Bursary Programme 2019 of the SLEuro European Lupus Society. AU - Kasitanon, Nuntana. , Ko T , Chakravarty E SELENA SLEDAI4. , Petri M. Iaccarino L [8] suggested that the PGA should account for objective examination, laboratory results and what patients report. Fanouriakis A Content validity. 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.
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