physician global assessment sle
physician global assessment sle
At a glance: Common scores used in rheumatology Gordon C T1 - Associations between physicians' global assessment of disease activity and patient-reported outcomes in patients with systemic lupus erythematosus. 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). Thanou A There is no cure for lupus, but medical . The Physician Global Assessment (PGA) has been shown to be a valid, responsive, and feasible instrument to capture disease activity in systemic lupus erythematosus (SLE), but its low reliability further supports the need for a standardisation of its scoring. The Author(s) 2020. , Wetter J A 21-numbered circle visual analog scale (VAS) may be a desirable alternative to the traditional 10-cm horizontal line for pain and patient global estimate on a Multidimensional Health Assessment Questionnaire (MDHAQ). 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. PGA is a simple instrument and the result is easily understood. In this systematic review we have analysed the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. 2014 - 20184 years. Of note, the literature search revealed heterogeneous definitions of physician assessment of disease activity other than the PGA (physician global assessment [4, 70, 73], physician overall assessment [85]). Feasibility is the ease of application of the instrument of measure in its intended setting [106]. Responsiveness. According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. Jesus D , Sayedbonakdar Z et al. Results of a large, multicentric, nationwide study, American College of Rheumatology provisional criteria for global flares in childhood-onset systemic lupus erythematosus, A cross-sectional study of hydroxychloroquine concentrations and effects in people with systemic lupus erythematosus, Inactive disease and remission in childhood-onset systemic lupus erythematosus, Preliminary criteria for global flares in childhood-onset systemic lupus erythematosus, Systemic lupus erythematosus in a multiethnic US cohort, XXXVII: association of lymphopenia with clinical manifestations, serologic abnormalities, disease activity, and damage accrual, Systemic lupus erythematosus in a multiethnic cohort (LUMINA): XXIX. , Hochberg M. Wallace DJ et al. 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. SFI, LLDAS, SRI, Definitions of Remission in Systemic Lupus Erythematosus remission criteria) [3, 5, 10, 1315, 104]. Medical Cannabis Use by Rheumatology Patients Following Recreational Systemic Lupus Erythematosus (SLE) Treatment & Management - Medscape This scoring modality was used for the SRI [3]. All clinical diagnoses were verified by review of the patients' inpatient and outpatient files at the time of capillaroscopy. 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 content can vary and relates either to global health (e . Patient global assessment in measuring disease activity in rheumatoid Ensure second line of defense Derivatives RWA reviews are performed consistently and . It estimates how similar a given patients scores were at the two visits. , Clowse M. Moorthy LN ATI Comprehensive Predictor Exam 2019 (180 Q & A, Verified and 100 Reliability measures the reproducibility of the instrument: it refers to the degree of agreement between different observers (interrater) and in the same observer over time (intrarater). Data regarding divergent validity are lacking for the PGA. When expanded it provides a list of search options that will switch the search inputs to match the current selection. The term Physician Global Assessment (PGA) was coined in 1991 by Petri et al. The quantification of reliability is expressed by a correlation coefficient. 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 https:// ensures that you are connecting to the , Bonithon-Kopp C , Mosca M The index assesses separately eight organ-based systems. , Mokkink LB BATCH RUBY INTENSIVE REVIEWRTRMF 3. Brunner HI Construct validity was recognized in 21 studies [2, 10, 11, 23, 24, 2629, 35, 47, 52, 54, 65, 68, 76, 84, 88, 92, 99, 101]. All rights reserved. Objective: The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. , Sadovici-Bobeica V This enabled the PGA to be considered the gold standard in several studies [2, 10, 11, 21, 23, 49, 67, 76, 78, 84, 88]. PGA-IGA described in ePROVIDE - Mapi Research Trust Methods: This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items . Use of Physician Global Assessment in systemic lupus erythematosus: a , Petri M. Furie RA Objective: Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. Akhter E 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. 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]. , Sengupta M AB - The Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus (PISCOS) study aimed to obtain an evidence . , Chan KL Jiao H, Acar G, Robinson GA, Ciurtin C, Jury EC, Kalea AZ. Criterion validity data reporting correlation coefficients between PGA and quality of life measures, laboratory markers and miscellaneous. , Magder L , Khamashta MA This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. , Weisman MH. CLOSED ANGLE/ ANGLE CLOSURE GLAUCOMA. Schneider M BICLA responders had fewer lupus-related serious . CareerBuilder TIP. 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. Pain assessment: An alternative measure - hcplive.com 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 . Aranow C Some may be a consequence of therapy and others may be . A good correlation was considered for a value >0.60. , Sato JO , Sjwall C 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). Tel: 03 88 12 84 74; Fax: 03 88 12 82 90; E-mail: Measuring disease activity in adults with systemic lupus erythematosus: the challenges of administrative burden and responsiveness to patient concerns in clinical research, Patterns of disease activity in systemic lupus erythematosus, Novel evidence-based systemic lupus erythematosus responder index, Reliability and validity of six systems for the clinical assessment of disease activity in systemic lupus erythematosus, Failure to achieve lupus low disease activity state (LLDAS) six months after diagnosis is associated with early damage accrual in Caucasian patients with systemic lupus erythematosus, Treatment target in newly diagnosed systemic lupus erythematosus, 10 most important contemporary challenges in the management of SLE, Measurement of systemic lupus erythematosus activity in clinical research, Definition, incidence, and clinical description of flare in systemic lupus erythematosus. 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. Physician's global assessment is often useful in SLE - ResearchGate Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. Moreover, there is uncertainty as to whether the best timing of assessment is prior to or after reviewing laboratory exams [26]. PDF Physician s global assessment is often useful in SLE, but not always , Magder LS et al. Physician global assessment in systemic lupus erythematosus: can we Trusted for over 30 years to provide and transform technology into complete solutions that advance the value of IT. , Chatzidionysiou K Use of Physician Global Assessment in systemic lupus - PubMed Bookshelf Additional papers were obtained by checking the references from the selected studies. Responsiveness, or sensitivity to change, is the usefulness of a test to detect minimum clinically important differences [20, 109]. 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]. , Leung HW A new tool -- the Lupus Activity Scoring Tool (LAST) - has been proposed to join the ranks of current disease activity indices. Twenty-nine studies [25, 31, 3439, 41, 43, 48, 49, 5355, 59, 6164, 74, 75, 81, 82, 86, 92, 93, 96, 97] have assessed criterion validity of the PGA (Table2). HHS Vulnerability Disclosure, Help Cutaneous lupus erythematosus (CLE) is an autoimmune skin disease that can occur with or without systemic lupus erythematosus (SLE). MeSH Castrejn I, Ra-Figueroa I, Rosario MP, Carmona L. Reumatol Clin. Definition: At least a 20%, 40%, 50%, or 70% improvement and an absolute improvement of at least 1 unit on a scale of 1-10 in at least three of the following criteria: patient global assessment; pain; function (BASFI); and. They participate in physiologic and inflammatory cascades and have become a major focus of research, yielding novel therapies for immune-mediated inflammatory diseases (IMID). allergy hx phenothiazines, cns depressants and stimulants withheld 48 hours prior. , Engle E , Tugwell P The official NJDOE Incident Reporting Form, as well as a guide to completing 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. , Stavrakis S , Ko T , Askanase A Criterion validity also refers to the degree to which an instrument predicts aspects and phenomena occurring in the future [108]. Patient and Physician Global Assessments of Disease Status in Systemic et al. , Buyon J 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. 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. A total of 91 articles were included in the study (Fig. 2022 Sep;8(2):e002395. A good responsiveness for PGA was shown in eight studies. How should lupus flares be measured? RN-BSN HOLISTIC HEALTH ASSESSMENT ACROSS THE LIFESPAN (NURS 3315) Sociology of Social Problems (SOC213) [9] for a disease activity index scored on a VAS ranging from 0 to 3, with an increase of 1.0 since the last visit indicating a flare. 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]. et al. government site. , Gordon C inflammation (duration and severity of morning stiffness as measured by BASDAI). 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. , Sjwall C. Strand V , Allen E 2019ACREULAR . Associations between physicians' global assessment of disease activity et al. 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]. In the second column, the definitions were reported according to the VAS used in the study. 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. , Beresford MW 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. Barr SG The OMERACT defines an instrument as an outcome measure if it passes the three pillars of evidence: truth (that refers to validity), discrimination (that includes reliability and responsiveness) and feasibility. , Urowitz MB. Bethesda, MD 20894, Web Policies 2022 Jan 11;11(2):340. doi: 10.3390/jcm11020340. , Ho LY 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]. In 1988, Liang et al. , Petri M. Thanou A , Mazur M. Fatemi A Systemic lupus erythematosus (SLE) is a multisystem autoimmune rheumatic disease (ARD) characterized by flares and remissions. Frontiers | Cutaneous lupus erythematosus disease assessment Touma Z Criterion validity is defined as the degree to which the scores of an instrument adequately reflect the truth in the form of a gold standard [107]. Physician Global Assessment to Track Outcomes - JAMA PMC , Petri MA Oxford University Press is a department of the University of Oxford. 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. Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus: the PISCOS study . , Magder LS J Clin Med. 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. 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]. Forbess LJ physician global assessment (pga) - Assesschild , Adamichou C Using the Physician Global Assessment in a clinical setting to - PubMed et al. Physician global assessment in systemic lupus erythematosus: Can we 2021 Apr 8;5(1):33. doi: 10.1186/s41687-021-00298-x. Whenever papers reported duplicate data, the most recent article was selected. , Patrick DL It is unclear when or with what justification the physician global assessment of disease status (PhGA) was first used to assess patients with systemic . Faculty Publications: Feb. 23-March 2 Methods This SLR was conducted by two independent reviewers in accordance with the PRISMA statement. , Jolly M. Mazur-Nicorici L Clinical Trial Physician - Rheumatology Job in San Diego, CA - Bristol The site is secure. The geographical analysis of the Global Global Respiratory Devices market provided in the report is just the right tool that competitors can use to discover untapped sales and business expansion . AU - Kandane-Rathnayake, Rangi. , Urowitz MB. et al. http://oml.eular.org/glossary (31 January. Keywords: . Oxford Textbook of. Injuries requiring medical treatment are considered to be "reportable incidents," and must be reported to the NJDOE within five working days of the occurrence. In 16 studies the PGA was used as a mean to assess changes in disease activity after treatment [3, 12, 22, 29, 40, 42, 43, 52, 54, 56, 57, 80, 85, 87, 95, 98, 101]. , Alunno A Visual analogue scales (VAS) allow rapid, continuous scaling of disease severity. , Goldsmith CH , Urowitz MB , Lau CS et al. . , Kostopoulou M 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. 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]. , Wallace DJ Systemic Lupus Erythematosus (SLE) | CDC Glossary: PGA. Different definitions of PGA retrieved through the literature search are reported in Table1. 3TR (Taxonomy, Treatment, Targets and Remission) Systemic Lupus , Kraag GR et al. Physician's Global Assessment in Psoriatic Arthritis: A Multicenter , Siega-Riz AM 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). The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. Supervise the development of junior medical affairs staff . SLE or at an SLE site, but only if the injury requires treatment by a licensed medical doctor. , Holland M Correlations with other instruments measuring similar constructs should typically demonstrate a coefficient (r) 0.50 [106]. 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]. Physician global assessments for disease activity in rheumatoid arthritis are all over the map!. , Ravelli A Despite the need for new treatments in CLE . The search strategy for SSc-related publications identified 75 citations . These results enabled its use as a gold standard for assessing flare and defining flare severity in several studies [21, 67, 88]. All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients' age. Fanouriakis A FitzGerald and Grossman [10] found a good interRR in a retrospective assessment of the PGA (=0.79). 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. This may be explored through convergent and divergent validity. The aim of this systematic review is to describe and analyse the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. Presence of at least one of the following items of serological evidence of active SLE or biological variables predictive of Type 1 Interferon (IFN-1) high signature (in a Screening sample as measured by central laboratory): The PGA is intended to encapsulate the physician's judgement of overall disease activity.Consensus on whether the PGA should be performed prior to, or after the receipt of laboratory values is lacking. Chaigne B 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. doi: 10.1136/lupus-2022-000700. JBT-101 in Systemic Lupus Erythematosus (SLE) doi: 10.1136/rmdopen-2022-002395. , Urowitz MB European League Against Rheumatism. , Cella D. van Vollenhoven RF Kandane-Rathnayake R, Louthrenoo W, Hoi A, Luo SF, Wu YJ, Chen YH, Cho J, Lateef A, Hamijoyo L, Navarra SV, Zamora L, Sockalingam S, An Y, Li Z, Katsumata Y, Harigai M, Hao Y, Zhang Z, Kikuchi J, Takeuchi T, Basnayake BMDB, Chan M, Ng KPL, Tugnet N, Kumar S, Oon S, Goldblatt F, O'Neill S, Gibson KA, Ohkubo N, Tanaka Y, Bae SC, Lau CS, Nikpour M, Golder V, Morand EF; Asia-Pacific Lupus Collaboration. , Roberts WN Comparison of the validity and sensitivity to change of 5 activity indices in systemic lupus erythematosus. OBJECTIVE The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. Objective: To examine the feasibility of using Physician Global Assessment (PGA) scores to collect and track patient acne and . Methods: Please enable it to take advantage of the complete set of features! Background/Purpose: The Physician Global Assessment (PGA) is a frequently-used outcome measure in Systemic Lupus Erythematosus (SLE). , Navarra SV , Zonana-Nacach A Five studies have demonstrated good ICC values for reliability (all >0.60 and ranging up to 0.97). et al. , Nelson S Parodis I Cloud, mobility, security, and more. Your comment will be reviewed and published at the journal's discretion. 3TR (Taxonomy, Treatment, Targets and Remission) Systemic Lupus Erythematosus Study Protocol 2 It does not provide a predefined or limited list of disease manifestations or organ systems, thus allowing one to capture all the heterogeneous aspects of SLE disease activity. et al. Derivatives RWA Production Controller (SA-CCR/SLE) PGA is often assessed by a single question with a 0-10 or 0 . disease activity in SLE, with the Physician Global Assessment (PGA) being the only one included in the updated EULAR recommendations for the management of SLE.11. , Kosinski M , Tanangunan R It operates in Albuquerque, and New Mexico. Face validity. Sullivan KE The aim of this systematic literature review is to describe and analyse the . , Hearth-Holmes M. Khan A According to the OMERACT, face validity is the degree to which the instrument appears to match with the target domain, according to experts [18]. 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 . , Suriano A , Urowitz MB , Arbab-Zadeh A TOTAL DOCUMENTS. , Giannakou I official website and that any information you provide is encrypted 04 Measuring SLE disease activity in 2020: perspectives from clinical Content validity was reported in 89 studies. , Kalunian K This important heterogeneity in the anchoring of the PGA prevented us from performing a meta-analysis of reliability data. et al. et al. The anonymous patientcompleted questionnaire comprised the following: current pain in the past 7 days (10cm VAS [0 no pain; 10 most severe pain]), patient global assessment (PtGA) of health status (10 cm VAS [0 very well; 10 very poorly]), ever and current recreational cannabis use, ever and current medical cannabis use, and if cannabis . Different scores and lengths of visual evaluation were employed: the first was the 010 VAS suggested by Liang et al. 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