For permissions, please email: journals.permissions@oup.com. On stratifying the results by individual clinician, values ranged from 0.61 to 0.90, except for those reported by . Thus the development of a comprehensive index for assessing disease activity still represents one of the most important challenges in SLE [7]. 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. , Navarra SV Petri M Mahler M van Vollenhoven R It should be noted that the PGA correlates with several other instruments that measure disease activity. , Karp DR 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). However, it is important to remember that not all clinical problems reported by a lupus patient are due to the disease. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. , Bocci EB The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. Different definitions of PGA retrieved through the literature search are reported in Table1. Fanouriakis A , Mina R antineutrophil cytoplasmic antibody-associated vasculitis (AAV), and systemic lupus erythematosus (SLE). No study has evaluated the correlation of PGA with damage measures. SLE3. 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. , Kalunian K FitzGerald and Grossman [10] found a good interRR in a retrospective assessment of the PGA (=0.79). 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]. In 1988, Liang et al. 2014 Sep-Oct;10(5):309-20. doi: 10.1016/j.reuma.2014.01.012. CareerBuilder TIP. Eudy AM 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. Few studies reported on whether serological activity should be incorporated in the PGA. Systemic lupus erythematosus (SLE), is the most common type of lupus. 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]. et al. , Shea BJ ECG - correct answer no sleep the night before, meals allowed, no stimulants/tranquilizers for 24-48 hours before. lupus erythematosus; systemic outcome assessment; qualitative research; healthcare; We read with great interest the recent paper by Aranow et al 1 about the impact of laboratory results on scoring of the Physician Global Assessment (PGA) of disease activity in systemic lupus erythematosus (SLE). MeSH 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. [84] expressed the sensitivity in PGA scoring with the standardized response mean (SRM), demonstrating a very large effect size (ES=2.23) [110]. Thanou A government site. , Kiani AN The aim of this systematic review is to describe and analyse the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. 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 . The last EULAR/ACR recommendations recommended use of the PGA in the routine monitoring of SLE [16]. 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. (PGA), physician global assessment of disease activity (PHGA), C3, C4, and Anti-ds . 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. LECTURE 10: MEDICAL SURGICAL NURSING. Nehring J 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). [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. Navarra SV Liang et al. Learn more. , Hochberg M. Touma Z BILAGAB . , Siega-Riz AM , Jnsen A , McGwin G Ann Rheum Dis 2011;70:54-9. , Flower C The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Barr et al. 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]. et al. Ensure second line of defense Derivatives RWA reviews are performed consistently and . RN-BSN HOLISTIC HEALTH ASSESSMENT ACROSS THE LIFESPAN (NURS 3315) Sociology of Social Problems (SOC213) , Kharboutli M Sullivan KE The Physician's Global Assessment (PhGA) is a number without unit. The official NJDOE Incident Reporting Form, as well as a guide to completing FOIA Thanks to this feature, the PGA was included in composite indices with the aim of rating manifestations not included in glossary-based instruments such as the SLEDAI and BILAG [3] or for which a threshold has been defined (cytopenia). Physician Global Assessment (PGA) is a visual analogue score (VAS) that reflects the clinician's judgment of overall Systemic Lupus Erythematosus (SLE) disease activity. , Sato JO , Mohan C. Jolly M 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. Myelogram - correct answer NPO for 4-6 hours. The intrarater reliability (intraRR) is the ability to provide consistent scores in a stable population by the same assessor over time. , Ravelli A The https:// ensures that you are connecting to the , Maxwell LJ Five studies have demonstrated good ICC values for reliability (all >0.60 and ranging up to 0.97). A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.67-0.98). 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. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. , Jolly M. Ribi C The PGA was integrated in composite indices, including the definition of the LLDAS [12, 13, 29, 34, 37, 39, 40] and remission [29, 37] (Table1). , Hochberg M. Wallace DJ Disclaimer. Provide oversight to Shared Services Derivatives team supporting RWA operations and production. The aim of this systematic literature review (SLR) is to describe and analyse the psychometric properties of PGA. http://oml.eular.org/glossary (31 January. Introduction Physician global assessments of disease activity (medical doctor (MD) globals) are important outcomes. The interRR was assessed in seven studies [4, 10, 11, 36, 65, 68, 94], showing values ranging from 0.67 [68] to 0.96 [94]. Of note, it is not trivial that we found a good convergent validity with other instruments (SLEDAI, BILAG, LAI, SLAM and ECLAM) [10, 23, 24, 26, 28, 29, 35, 54, 68, 76, 84, 99]. All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients age. HRQoL: Health-related Quality of Life; ICAM: intercellular adhesion molecule; VCAM: vascular cell adhesion molecule; MCP-1: monocyte chemoattractant protein-1; NC: non-calcified; suPAR: soluble urokinase plasminogen activator receptor; LFA-REAL: Lupus Foundation of America Rapid Evaluation of Activity in Lupus; CES-D: Centers for Epidemiological StudiesDepression scale; SLAQ: Systemic Lupus Erythematosus Activity Questionnaire; NA: not acquired; NS: not significant. et al. Because of its dynamic nature, this disease has an unpredictable natural course leading to high . 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. Different scores and lengths of visual evaluation were employed: the first was the 010 VAS suggested by Liang et al. , Raeisi A , Buyon J 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 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 . Your comment will be reviewed and published at the journal's discretion. et al. X 20 sentence examples within Physician Global Assessment. Physician training is very important. . Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. 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. , Weisman MH. Content validity was reported in 89 studies. AU - Louthrenoo, Worawit. A good correlation was considered for a value >0.60. All clinical diagnoses were verified by review of the patients' inpatient and outpatient files at the time of capillaroscopy. et al. et al. Parodis I , Emamikia S , Petri M. Foering K Liang MH 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]. According to the OMERACT, face validity is the degree to which the instrument appears to match with the target domain, according to experts [18]. , Cappellazzo G MD globals may vary based on their age, gender, practice setting and experience (number of patients seen per year and years in practice). 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). Rheumatology (Oxford). 25 (FIVE YEARS 8) Latest Documents Most Cited Documents Contributed Authors Related Sources Related Keywords Latest Documents; Most Cited Documents; Contributed Authors; Related Sources; , Liberati A Despite the need for new treatments in CLE . 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 authors wish to thank Sylvie Thuong for her invaluable assistance in the preparation of this manuscript. , Giangreco D Epub 2014 Apr 11. Careers. Patient-Reported Outcomes in Systemic Lupus Erythematosus. , Pilkington C et al. 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]. 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. An official website of the United States government. 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). AB - The Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus (PISCOS) study aimed to obtain an evidence . 2019ACREULAR . , Devilliers H No data were found regarding the feasibility of the PGA. et al. 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. , Rairie JE Objective: Franklyn K For permissions, please email: journals.permissions@oup.com, This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (. Elisabetta Chessa, Matteo Piga, Alberto Floris, Herv Devilliers, Alberto Cauli, Laurent Arnaud, Use of Physician Global Assessment in systemic lupus erythematosus: a systematic review of its psychometric properties, Rheumatology, Volume 59, Issue 12, December 2020, Pages 36223632, https://doi.org/10.1093/rheumatology/keaa383. 2022 Sep 20;19(19):11895. doi: 10.3390/ijerph191911895. Epub 2014 Jul 10. Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. , Floris A 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). [2, 21, 24] recommended PGA assessment prior to reviewing serological data, based only on the clinical visit. This enabled the PGA to be considered the gold standard in several studies [2, 10, 11, 21, 23, 49, 67, 76, 78, 84, 88]. et al. , Sjwall C. Strand V 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].