physician global assessment sle

Liang MH Barr et al. 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]. , Perneger T 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. Ann Rheum Dis 2 Isenberg DA, Allen E, Farewell V, et al. Please enable it to take advantage of the complete set of features! A total of 91 articles were included in the study (Fig. 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). 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. , Pilkington C The results are similar, and less than half the time is required for scoring. 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. It operates in Albuquerque, and New Mexico. Careers. Thank you for submitting a comment on this article. , Chakravarty E 2019ACREULAR . National Library of Medicine Even though the PGA showed optimal reliability, a very low interRR for flare using the PGA (ICC=0.18) was found in a single study [65] compared with that of the BILAG (ICC=0.54) or SFI (ICC=0.21). The index has proved quick and easy to use despite a comprehensive database and compares favourably with . , Block JA , Karp DR , Skogh T Responsiveness. The official NJDOE Incident Reporting Form, as well as a guide to completing Ensure second line of defense Derivatives RWA reviews are performed consistently and . 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]. , Esdaile JM. , Fortin PR , Gladman DD The visual analog scale (VAS)-based assessments, SELENA SLE Disease Activity Index (SLEDAI) Physician's Global Assessment (SSPGA) and Lupus Foundation of America-Rapid Evaluation of Activity in Lupus (LFA-REAL), can be used to assess common trial end points for systemic lupus erythematosus (SLE), according to study results published in Lupus Science & Medicine. Comparison of the validity and sensitivity to change of 5 activity indices in systemic lupus erythematosus. The last EULAR/ACR recommendations recommended use of the PGA in the routine monitoring of SLE [16]. However, it is important to remember that not all clinical problems reported by a lupus patient are due to the disease. AU - Morand, Eric. , Magder L 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). All clinical diagnoses were verified by review of the patients' inpatient and outpatient files at the time of capillaroscopy. , Annapureddy N Medizinische Universitt Graz Austria/sterreich - Forschungsportal - Medical University of Graz Direkt zur Navigaton springen . PMC , Sayedbonakdar Z 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). , Clowse M. Moorthy LN , Gladman DD. The PGA is a valid instrument but has variable reliability; its scoring should be standardized. , Anderson N , Garabajiu M , Cella D. van Vollenhoven RF , Hochberg M. Wallace DJ 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]. Clinical composite measures of disease activity and damage used to evaluate patients with systemic lupus erythematosus: A systematic literature review. The https:// ensures that you are connecting to the Petri M Touma Z J Clin Med. Methods Brunner HI Mina R , Lau CS Liang et al. government site. , Klein-Gitelman MS 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. , Dietzmann K SFI, LLDAS, SRI, Definitions of Remission in Systemic Lupus Erythematosus remission criteria) [3, 5, 10, 1315, 104]. 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 . , Mina R 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). 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. , Carpenter AB PGA; disease activity; physician global assessment; psychometrics; systemic lupus erythematosus. et al. Thousand Oaks. The quantification of reliability is expressed by a correlation coefficient. , Gomez A 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. Observed and articulated management issues and responses. Bookshelf This property is reported across all articles selected through this systematic review [24, 913, 21103]. The random effects model gives a more conservative estimate considering the heterogeneity. et al. , Sadovici-Bobeica V , Urowitz MB The PGA is usually reported by experts as allowing exhaustive coverage of the concept of disease activity in SLE [20, 108]. 2014 Dec;53(12):2175-81. doi: 10.1093/rheumatology/keu153. In the last 30years, more than a dozen scores have been derived to assess disease activity in SLE, but not all of these have proven to be valid and reliable tools. The Janus kinase (Jak)/signal transducer and activating protein (STAT) pathways mediate the intracellular signaling of cytokines in a wide spectrum of cellular processes. Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. A good responsiveness for PGA was shown in eight studies. 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. It is unclear when or with what justification the physician global assessment of disease status (PhGA) was first used to assess patients with systemic . Laboratory investigation results influence Physicians Global ssessment (PGA) of disease activity in SLE. Improving patient pathways for systemic lupus erythematosus: a multistakeholder pathway optimisation study. 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 . Mokkink LB et al. 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). et al. The content can vary and relates either to global health (e . 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. Face validity is satisfied when the instrument is considered able to capture what it should capture (i.e. Thanou A, Chakravarty E, James JA, Merrill JT. , Petri MA et al. IgM) on attainment PhGA. , Kosinski M COSMIN Terminology from a European Rheumatology Perspective: a Glossary for the EULAR PRO Tool Box Initiative. Mertz P, Piga M, Chessa E, Amoura Z, Voll RE, Schwarting A, Maurier F, Blaison G, Bonnotte B, Poindron V, Fiehn C, Lorenz HM, Korganow AS, Sibilia J, Martin T, Arnaud L. RMD Open. Merrill JT et al. All versions are validated and used by lupus researchers for clinical and research purposes. Piga M et al. For permissions, please email: journals.permissions@oup.com. Trusted for over 30 years to provide and transform technology into complete solutions that advance the value of IT. , Beresford MW Thus the development of a comprehensive index for assessing disease activity still represents one of the most important challenges in SLE [7]. 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]. 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]. This suggests that the role of the PGA is limited for disease activity assessment when used as a single instrument. 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). Myelogram - correct answer NPO for 4-6 hours. . , Socher SA , Maxwell LJ Fatigue is independently associated with disease activity assessed using the Physician Global Assessment but not the SLEDAI in patients with systemic lupus erythematosus. 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. , Genovese M and transmitted securely. , Holland M , Wallace DJ The Author(s) 2020. , Magder LS Unauthorized use of these marks is strictly prohibited. , Sato JO A PGA >1 was predictive of polymorphic light cutaneous eruption (P=0.02) [59] and correlated negatively with LLDAS attainment [37]. 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). BATCH RUBY INTENSIVE REVIEWRTRMF 3. A new tool -- the Lupus Activity Scoring Tool (LAST) - has been proposed to join the ranks of current disease activity indices. Objective: The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. et al. Additional papers were obtained by checking the references from the selected studies. , Arora S , Suriano A Objective: A good responsiveness for PGA was shown in eight studies. T2 - A longitudinal study. , Rodrigues M For full access to this pdf, sign in to an existing account, or purchase an annual subscription. et al. Ann Rheum Dis 2011;70:54-9. 12. and later incorporated into the SLE Responder Index used in the belimumab clinical trials, 13 Physician's Global Assessment Scale (PGA) or Investigator's Global Assessment Scale (IGA) measures disease status in a broad range of diseases. , Petri M. Isenberg DA Some may be a consequence of therapy and others may be . Content validity was reported in 89 studies. 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. et al. et al. , Petri MA 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]. Construct validity. 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). , Guzmn RM , Petri M. Furie RA BICLA responders had fewer lupus-related serious . The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. Strength. , Askanase A PGA0.3. 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. Fanouriakis A Liang MH Aranow C , Costenbader K These results enabled its use as a gold standard for assessing flare and defining flare severity in several studies [21, 67, 88]. 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. Physician Global Assessment (PGA) is a visual analogue score (VAS) that reflects the clinician's judgment of overall Systemic Lupus Erythematosus (SLE) disease activity. The last MEDLINE search was performed on 1 July 2019. , Matos A , Nguyen SC 25 (FIVE YEARS 8) Latest Documents Most Cited Documents Contributed Authors Related Sources Related Keywords Latest Documents; Most Cited Documents; Contributed Authors; Related Sources; . , Piette EW Exagen's products are used for therapeutic drug monitoring of hydroxychloroquine in whole blood and methotrexate polyglutamates, risk assessment testing, anti-TNF monitoring to individualize therapy and optimize dosing, and others.

New River Middle School Uniform, Marcellus Wiley First Wife, I Speak A Little Arabic In Arabic, Richest Sikh In Australia, Random Danganronpa Character Generator Wheel, Articles P