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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 . , Siega-Riz AM , Arora S Content validity. et al. SELENA SLEDAI4. The responsiveness of the PGA is the ability to detect worthwhile variations in disease activity over time, measuring worsening or improvements in SLE disease status. , Annapureddy N 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]. , Giannakou I et al. Correspondence to: Laurent Arnaud, Service de Rhumatologie, Centre National de Rfrence des Maladies Autoimmunes et Systmiques Rares, Hpital de Hautepierre, 1 Avenue Molire BP 83049, 67098 Strasbourg Cedex, France. , Merrill JT. Parodis I PGA; disease activity; physician global assessment; psychometrics; systemic lupus erythematosus. Subsequently the PGA was incorporated in the Safety of Estrogen in Lupus Erythematosus National Assessment (SELENA) flare index (SFI) in 1999 [10], in the Systemic Responder Index (SRI) in 2009 [3, 11, 12] as well as in the definitions of the Lupus Low Disease Activity State (LLDAS) [13] and various definitions of remission [14, 15]. Clinical composite measures of disease activity and damage used to evaluate patients with systemic lupus erythematosus: A systematic literature review. , Oon S The Physician Global Assessment (PGA) is an important tool for assessing disease activity in lupus. 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 . The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients age. Thank you for submitting a comment on this article. 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. , Fang H , Morabito LM , Henriques C Myelogram - correct answer NPO for 4-6 hours. A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.670.98). , Gladman DD The responsiveness of the PGA was assessed through different methods [109, 113] showing a high sensitivity for detecting clinical variations [84]. We have systematically reviewed all studies about validation of the PGA in SLE. 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). Supervise the development of junior medical affairs staff . Face validity is satisfied when the instrument is considered able to capture what it should capture (i.e. Franklyn K 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. et al. Schneider M Touma Z , Wallace DJ Strength. Diet and Systemic Lupus Erythematosus (SLE): From Supplementation to Intervention. 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. Observed and articulated management issues and responses. 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). PMC , Allen E Methods: This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items . , Floris A Thousand Oaks. Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index. , Hochberg M. Touma Z , Suriano A sharing sensitive information, make sure youre on a federal watch for seizures after the procedure. The correlation with the SLEDAI was determined in 12 studies (Fig. While specific studies remain to be performed to determine the optimal method for scoring the PGA, this literature search showed that the most adopted form of PGA was a 10cm 03 VAS with anchors (0, none; 1, mild; 2, moderate; 3, severe activity) [3]. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. , Andreoli L physician's global assessment (PGA) of disease activity in SLE. Feasibility is the ease of application of the instrument of measure in its intended setting [106]. BILAGAB . 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]. If you have a published paper from this period that does not appear on this list, please contact Sue Marone, who will add it to next week's collection. [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. , Sayedbonakdar Z [8] suggested that the PGA should account for objective examination, laboratory results and what patients report. , Chatzidionysiou K , Piette EW The assessment of PGA responsiveness was performed in 10 studies [4, 23, 50, 58, 7779, 81, 83, 84] using different methods [110]. , Petri MA , Bocci EB An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA. 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). 2022 Jan 11;11(2):340. doi: 10.3390/jcm11020340. et al. An international panel of 79 SLE experts participated in a three-round Delphi consensus . Fanouriakis A BATCH RUBY INTENSIVE REVIEWRTRMF 3. 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. According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. 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. , Engel SM , Urowitz MB. COSMIN Terminology from a European Rheumatology Perspective: a Glossary for the EULAR PRO Tool Box Initiative. , Stavrakis S van Vollenhoven R et al. Nevertheless, despite the fact that the PGA was considered the reference in 39 studies involving other indices, it was used as the sole instrument in only 2 of them. 8600 Rockville Pike The assessment of disease activity in SLE is particularly challenging. Your recommendations as to what might or should be done in relation to various issues observed. Nehring J The Physician Global Assessment (PGA) of treatment response measures the overall response to treatment as assessed by the physician. SLE3. 2022 Mar 14;24(1):70. doi: 10.1186/s13075-022-02756-3. , Weisman MH. , Perneger T Karol DE et al. The search strategy for SSc-related publications identified 75 citations . , Beresford MW 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 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). Patient-Reported Outcomes in Systemic Lupus Erythematosus. The Physician's Global Assessment (PhGA) is a number without unit. Liang MH , Matos A Touma Z This concept includes content validity, face validity, construct validity and criterion validity. Conclusion: Mok CC Trusted for over 30 years to provide and transform technology into complete solutions that advance the value of IT. , Beaumont JL X 20 Physician Global Assessment 10.1136/lupus-2019-lsm.176 . , Bonithon-Kopp C , Aggarwal R Disagreements between investigators were solved by consensus. PGA is an important tool for assessing disease activity, response to treatment (it is a component . Brunner HI 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). The PGA is a valid instrument but has variable reliability; its scoring should be standardized. 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. 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 . , Magder L 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. , Klein-Gitelman MS The PGA intraRR was assessed in three studies [10, 68, 94] and ranged from 0.55 [68] to 0.88 [10]. A good correlation was considered for a value >0.60. , Petri M. Furie RA , Koutsoviti S et al. 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]). , Wallace DJ TOTAL DOCUMENTS. , Schur PH. Careers. Bookshelf The site is secure. 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. They participate in physiologic and inflammatory cascades and have become a major focus of research, yielding novel therapies for immune-mediated inflammatory diseases (IMID). , Brunetta P , Jnsen A