According to the OMERACT, face validity is the degree to which the instrument appears to match with the target domain, according to experts [18]. The site is secure. In the second column, the definitions were reported according to the VAS used in the study. Learn more. , Urowitz MB Published by Oxford University Press on behalf of the British Society for Rheumatology. , ODell JR Franklyn K Discrimination refers to whether the score (PGA-VAS) differentiates between situations of interest [18]: discrimination of the PGA measures the ability of the PGA-VAS to report a consistent score where no change in disease activity has occurred (reliability) and to detect a change when a change in disease activity has occurred (sensitivity to change or responsiveness). Few studies reported on whether serological activity should be incorporated in the PGA. , Longenecker JC , Chang AY Results: 1 2. , Petri M. Iaccarino L Myelogram - correct answer NPO for 4-6 hours. In an epratuzumab trial, the absence of deterioration of the PGA (not >10% worsening) was one of the items to achieve a BILAG-based Composite Lupus Assessment (BICLA) response [105]. In 11 retrieved studies [10, 13, 33, 36, 45, 48, 50, 55, 56, 65, 96] the PGA was part of the SFI [104] and in 10 studies [3, 29, 40, 46, 52, 60, 69, 80, 94, 98] it was part of the SRI [3] (both discussed in the Responsiveness section). Responsiveness. , Lin M , Mohan C. Jolly M Int J Environ Res Public Health. , Maxwell LJ Jiao H, Acar G, Robinson GA, Ciurtin C, Jury EC, Kalea AZ. , James JA A good correlation was considered for a value >0.60. Systemic lupus erythematosus (SLE) is a multisystem autoimmune rheumatic disease (ARD) characterized by flares and remissions. , Wallace DJ , Sato JO , Petri M. Isenberg DA Content validity was reported in 89 studies. , Goldsmith CH 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]. All rights reserved. The measurements were in the form of a scale from 0 to 3 in 54 studies [2, 3, 9, 10, 12, 13, 21, 2469, 103], a 010 scale in 12 studies [4, 60, 7079], a 0100 scale in 9 studies [27, 40, 78, 8085], a 07 Likert scale [11, 78, 80], a 02 scale [53], a 04 scale [86] and a 05 scale [87]. A new tool -- the Lupus Activity Scoring Tool (LAST) - has been proposed to join the ranks of current disease activity indices. , Engleman EG et al. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. 2014 - 20184 years. , Emamikia S However, no precise guidelines exist regarding the optimal use of the PGA in SLE, such as the adequate length of the VAS, the presence of anchored values, the incorporation of laboratory data and the time frame of assessment. 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). A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.67-0.98). The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. Karol DE The LUMINA (Lupus in Minorities: Nature versus Nurture) study and other trials have offered evidence of a decrease in flares and prolonged life in patients given hydroxychloroquine, making . No data were found regarding the feasibility of the PGA. 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. 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]. et al. The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinicians judgement of overall SLE disease activity. , Tanangunan R Finally, the PGA enables the measurement of disease activity globally compared with a glossary-based index. Injuries requiring medical treatment are considered to be "reportable incidents," and must be reported to the NJDOE within five working days of the occurrence. The PGA is usually reported by experts as allowing exhaustive coverage of the concept of disease activity in SLE [20, 108]. This property is reported across all articles selected through this systematic review [24, 913, 21103]. 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. SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. 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. Pincus and colleagues conducted a study of . The PGA is a well accepted and commonly used scale for evaluating treatment response in clinical trials both in adults and children. The company serves physicians and patients. , Socher SA , Gladman DD et al. Arthritis Res Ther. van Vollenhoven R 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 . et al. Different definitions of disease activity according to the PGA instrument. , Askanase A , Giangreco D Enocsson H , Piette EW The PGA is a valid instrument but has variable reliability; its scoring should be standardized. , Pilkington C 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. A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines [17], searching for articles reporting on the use of PGA in SLE. 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. , Khamashta MA 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. Jesus D The random effects model gives a more conservative estimate considering the heterogeneity. , Jolly M. Ribi C For permissions, please email: journals.permissions@oup.com. Clinical composite measures of disease activity and damage used to evaluate patients with systemic lupus erythematosus: A systematic literature review. , Kalunian K , Beresford MW Criterion validity data reporting correlation coefficients between PGA and quality of life measures, laboratory markers and miscellaneous. et al. , Jolly M. Mazur-Nicorici L Liang MH The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. ECG - correct answer no sleep the night before, meals allowed, no stimulants/tranquilizers for 24-48 hours before. SLE3. 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]). Thousand Oaks. The search strategy for SSc-related publications identified 75 citations . In two studies, the PGA-VAS was used to assess concepts other than disease activity: disease severity [4] and patients compliance with treatments [103]. , Kostopoulou M Patient-Reported Outcomes in Systemic Lupus Erythematosus. Physician global assessments for disease activity in rheumatoid arthritis are all over the map! , Giannakou I 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. Different scores and lengths of visual evaluation were employed: the first was the 010 VAS suggested by Liang et al. Epub 2014 Jul 10. , Kandane-Rathnayake RK , Ogale S 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. CLOSED ANGLE/ ANGLE CLOSURE GLAUCOMA. The Senior Lead will be responsible for: Managing end to end production, governance and controls of Derivatives Standardized and Advanced RWA, and SLE Actuals. 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]. Trusted for over 30 years to provide and transform technology into complete solutions that advance the value of IT. T2 - A longitudinal study. Vil LM et al. Thank you for submitting a comment on this article. It operates in Albuquerque, and New Mexico. et al. [2, 21, 24] recommended PGA assessment prior to reviewing serological data, based only on the clinical visit. (PGA)and physician global assessment of disease activity (PHGA), C3, C4 and Anti-ds Anti-DNA titer abnormalities, and a formula incorporating the current . 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. Content validity. In this systematic review we have analysed the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. , Petri M. Furie RA 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].