physician global assessment sle

Posted 29 August, 2022 under list of new orleans assistant district attorneys

et al. Genetic linkage has related dysfunction of . , Dietzmann K , Weisman MH. , Allen E Criterion validity also refers to the degree to which an instrument predicts aspects and phenomena occurring in the future [108]. Merrill JT SLE231 Hydrology and Water Resources Management: Excursion or Virtual Tour It should be noted that the PGA correlates with several other instruments that measure disease activity. , Subach RB This may be explored through convergent and divergent validity. Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus: the PISCOS study . , Farewell V 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. Methods: This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items . 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]. For permissions, please email: journals.permissions@oup.com. , Terwee CB et al. , Flower C Beaton DE This week's edition of Faculty Publications includes Cedars-Sinai studies that were published Feb. 23-March 2. No data were found regarding the feasibility of the PGA. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. et al. A total of 91 articles were included in the study (Fig. Responsiveness. 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 . ~SLE~. 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. , Sadovici-Bobeica V Your recommendations as to what might or should be done in relation to various issues observed. Cloud, mobility, security, and more. Chaigne B et al. The responsiveness of the PGA was assessed through different methods [109, 113] showing a high sensitivity for detecting clinical variations [84]. 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. Thousand Oaks. 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]. Systemic Lupus Erythematosus (SLE) | CDC Physician's Global Assessment (PGA) score 1.0 on a 0 to 3 visual analog scale. 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). The assessment of disease activity in SLE is particularly challenging. . Moher D Compared with nonresponders, BICLA responders had greater improvements in global and organ-specific disease activity (Physician's Global Assessment, SLE Disease Activity Index 2000, Cutaneous Lupus Erythematosus Disease Area and Severity Index Activity, and joint counts; all nominal P < 0.001). The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. 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 . CareerBuilder TIP. Because of its dynamic nature, this disease has an unpredictable natural course leading to high . Physician Global Assessment International Standardisation COnsensus in Gyri N The Handheld Dermatoscope as a Nail-Fold Capillaroscopic Instrument - JAMA , Anderson N 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. , Jolly M. Mok CC Bethesda, MD 20894, Web Policies It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. HHS Vulnerability Disclosure, Help Myelogram - correct answer NPO for 4-6 hours. No study has evaluated the correlation of PGA with damage measures. BATCH RUBY INTENSIVE REVIEWRTRMF 3. Patient-reported outcomes (PROs) reflect the patient's perspective and are used in rheumatoid arthritis (RA) routine clinical practice. Physician Global Assessment to Track Outcomes - JAMA 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. Mina R Published by Oxford University Press on behalf of the British Society for Rheumatology. physician global assessment Recently Published Documents. Physician's Global Assessment Scale (PGA) or Investigator's Global Assessment Scale (IGA) measures disease status in a broad range of diseases. Direkt zum Inhalt springen . 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]. , Urowitz MB In the second column, the definitions were reported according to the VAS used in the study. Content validity pertains to the degree to which the instrument measures all facets of a construct of interest [20]: this property is satisfied if the PGA is considered able to measure all aspects of disease activity in SLE in a comprehensive way. The sensitivity to change was estimated to be the smallest for the SLEDAI; the standardized response means were 0.48 when the physician global assessment was used as the standard and 0.01 when the patient global assessment was used . , Siega-Riz AM Unable to load your collection due to an error, Unable to load your delegates due to an error. Rendas-Baum R, Baranwal N, Joshi AV, Park J, Kosinski M. J Patient Rep Outcomes. , Birmingham DJ Funding: The study was funded through the training Bursary Programme 2019 of the SLEuro European Lupus Society. , Gomez A , Wetter J European League Against Rheumatism. This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. , Bentow C When expanded it provides a list of search options that will switch the search inputs to match the current selection. et al. Assessing disease activity in rheumatic diseases such as systemic lupus erythematosus (SLE) is vital for effective treatment. et al. The patients were diagnosed as having the following disorders: scleroderma (n = 27), dermatomyositis (n = 11), systemic lupus erythematosus (SLE) (n = 22), MCTD (n = 8), and RP without evidence of underlying CTD (n = 38). , Longenecker JC 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. Associations between physicians' global assessment of disease activity Using the Physician Global Assessment in a clinical setting to - PubMed 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. 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 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). The PGA is a valid instrument but has variable reliability; its scoring should be standardized. , Mohan C. Giangreco D , Petri M. Iaccarino L Conclusion: The random effects model gives a more conservative estimate considering the heterogeneity. Physician global assessments for disease activity in rheumatoid PDF Physician s global assessment is often useful in SLE, but not always , Francis S , Askanase A Comparison of the validity and sensitivity to change of 5 activity indices in systemic lupus erythematosus. et al. ATI Comprehensive Predictor Exam 2019 (180 Q & A, Verified and 100 Brunner HI 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. 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): Objective Physician's global assessment (PGA) of disease activity is a major determinant of therapeutic decision making. , Petri MA A PGA >1 was predictive of polymorphic light cutaneous eruption (P=0.02) [59] and correlated negatively with LLDAS attainment [37]. , Vogel-Claussen J Data regarding divergent validity are lacking for the PGA. Content validity was reported in 89 studies. 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. The pooled correlation coefficient (95% CI) is given both for the fixed effects model and the random effects model. Nehring J The PGA intraRR was assessed in three studies [10, 68, 94] and ranged from 0.55 [68] to 0.88 [10]. 2022 Sep;8(2):e002395. , Fang H Fatigue is independently associated with disease activity assessed using the Physician Global Assessment but not the SLEDAI in patients with systemic lupus erythematosus. How should lupus flares be measured? , Engel SM et al. , Arbab-Zadeh A 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]. . PGA is an important tool for assessing disease activity, response to treatment (it is a component . , Magder LS , Tugwell P et al. , Hochberg M. Wallace DJ SLE or at an SLE site, but only if the injury requires treatment by a licensed medical doctor. Despite the need for new treatments in CLE . Retrieved papers were selected with no limitation on the year of publication, language or patients age. Five centres in Great Britain and the Republic of Ireland have collaborated to produce a computerized index of clinical disease activity in systemic lupus erythematosus, based on the principle of the physician's intention to treat. Associations between physicians' global assessment of disease activity Prinsen CAC 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]. , Koutsoviti S This concept includes content validity, face validity, construct validity and criterion validity. 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. 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. Vil LM , Cella D. van Vollenhoven RF 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]. Jiao H, Acar G, Robinson GA, Ciurtin C, Jury EC, Kalea AZ. 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. This suggests that the role of the PGA is limited for disease activity assessment when used as a single instrument. (Open Access) Development and assessment of a computerized index of Annapureddy N , Mosca M , Jolly M. Antony A et al. , Raeisi A 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. , Giannakou I Physician global assessment in systemic lupus erythematosus: Can we 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. , Liberati A et al. Medizinische Universitt Graz Austria/sterreich - Forschungsportal On stratifying the results by individual clinician, values ranged from 0.61 to 0.90, except for those reported by . 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). Stojan G , Schirmbeck LA , Perneger T All clinical diagnoses were verified by review of the patients' inpatient and outpatient files at the time of capillaroscopy. , Sayedbonakdar Z Unauthorized use of these marks is strictly prohibited. This study assesses the reliability of the PGA, measured by means of 0-100 mm visual analog scale (VAS), and the additional use of separate VAS scales for musculoskeletal (PhysMSK) and dermatologic (PhysSk) manifestations in patients with psoriatic arthritis (PsA). Gordon C TOTAL DOCUMENTS. 2022 Sep 20;19(19):11895. doi: 10.3390/ijerph191911895. , Henriques C , Shinada S 2014 - 20184 years. 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). Glossary: PGA. 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. Construct validity. Forbess LJ Different definitions of disease activity according to the PGA instrument. Methods: , Gallacher AE 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. This site needs JavaScript to work properly. Touma Z Ann Rheum Dis 2 Isenberg DA, Allen E, Farewell V, et al. 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). et al. Face validity is satisfied when the instrument is considered able to capture what it should capture (i.e. A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.67-0.98). Pincus and colleagues conducted a study of . Devilliers H These results enabled its use as a gold standard for assessing flare and defining flare severity in several studies [21, 67, 88]. Intoduction to X 20 - Physician Global Assessment The PGA is usually reported by experts as allowing exhaustive coverage of the concept of disease activity in SLE [20, 108]. It estimates how similar a given patients scores were at the two visits. The literature search identified 91 studies. Disclaimer. Arthritis Res Ther. 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]. et al. In Fatemi et al. Additional papers were obtained by checking the references from the selected studies. Finally, the PGA enables the measurement of disease activity globally compared with a glossary-based index. , Alarcn GS , Bonithon-Kopp C Thank you for submitting a comment on this article. However, it is important to remember that not all clinical problems reported by a lupus patient are due to the disease. et al. 'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study. , Gladman DD , Magder L Patient-Reported Outcomes in Systemic Lupus Erythematosus. The aim of this systematic literature review (SLR) is to describe and analyse the psychometric properties of PGA. 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]. Medical-Surgical Nursing Clinical Lab (NUR1211L) U.S. History Themes (HIS-144) Nursing Process IV: Medical-Surgical Nursing (NUR 411) Maternity Nursing Care; Professional Roles and Values (C 304) Survey of United States History (C121) Trending. doi:10.1136/ rmdopen-2017-000578 Prepublication history and In the absence of a well-recognized gold standard for disease activity, criterion validity of the PGA is established when it correlates with a measure that the author of the study defined a priori as the gold standard. et al. Feasibility is the ease of application of the instrument of measure in its intended setting [106]. , McGuire JL. Reliability. Wells GA AU - Kandane-Rathnayake, Rangi. Int J Environ Res Public Health. et al. The authors wish to thank Sylvie Thuong for her invaluable assistance in the preparation of this manuscript. , Giangreco D 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). PGA is a valid, responsive and feasible instrument, while its reliability was impacted by the scale adopted, suggesting the major need for a standardization of its scoring. Touma Z All rights reserved. et al. , Maxwell LJ Objective Existing methods for grading lupus flares or improvement require definition-based thresholds as increments of change. 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. Systemic Lupus Erythematosus (SLE) Treatment & Management - Medscape et al. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of multifactorial origin that can affect any organ or organ system, resulting in a broad spectrum of clinical manifestations ranging from dermatological involvement to multi-organ failure with episodes of relapses and remissions. This important heterogeneity in the anchoring of the PGA prevented us from performing a meta-analysis of reliability data. Help us improve CareerBuilder by providing feedback about this job: Report this job Job ID: 2281236908. All versions are validated and used by lupus researchers for clinical and research purposes. , Ravelli A , Klein-Gitelman MS 3TR (Taxonomy, Treatment, Targets and Remission) Systemic Lupus Erythematosus Study Protocol 2 In one study, the PGA was part of a modified score to assess disease activity in pregnancy (the SLE in Pregnancy Disease Activity Index) [51]. Ensure second line of defense Derivatives RWA reviews are performed consistently and . Liang et al. BICLA is a validated composite global measure of SLE disease activity including SLEDAI-2K, CLASI-A, OCS dosage reduction, and patient-reported outcomes. Reviews and case series with fewer than five patients were excluded. Parodis I , Block JA JBT-101 in Systemic Lupus Erythematosus (SLE) , Chizzolini C , Ibanez D MD globals may vary based on their age, gender, practice setting and experience (number of patients seen per year and years in practice). 215 (FIVE YEARS 146) H-INDEX. , Kalunian K , Rodrigues M , Hearth-Holmes M. Khan A , Kraag GR In a post-hoc analysis of phase 3 belimumab trials, improvements and no worsening in the PGA were greater among SRI responders vs SRI non-responders (P<0.001) [52]. They participate in physiologic and inflammatory cascades and have become a major focus of research, yielding novel therapies for immune-mediated inflammatory diseases (IMID). , Holland M , Landis RC The intrarater reliability (intraRR) is the ability to provide consistent scores in a stable population by the same assessor over time. 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. Parodis I Enocsson H 25 (FIVE YEARS 8) Latest Documents Most Cited Documents Contributed Authors Related Sources Related Keywords Latest Documents; Most Cited Documents; Contributed Authors; Related Sources; , Block JA et al. , Wallace DJ [8] suggested the need for a disease activity instrument that would be valid, reliable and sensitive to change. Systemic lupus erythematosus (SLE), is the most common type of lupus. , Mohan C. Jolly M , Oon S 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 Senior Lead will be responsible for: Managing end to end production, governance and controls of Derivatives Standardized and Advanced RWA, and SLE Actuals.