Gandhi N Retrieved papers were selected with no limitation on the year of publication, language or patients age. Reviews and case series with fewer than five patients were excluded. 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). Moher D Construct validity. , Bentow C Please check for further notifications by email. , Maxwell LJ Background/Purpose: The Physician Global Assessment (PGA) is a frequently-used outcome measure in Systemic Lupus Erythematosus (SLE). The quantification of reliability is expressed by a correlation coefficient. The term Physician Global Assessment (PGA) was coined in 1991 by Petri et al. , Petri MA , Sadovici-Bobeica V The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. Results: FOIA , Jnsen A , Borghoff K Touma Z et al. X 20 sentence examples within Physician Global Assessment. Mahler M 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). Fatigue is independently associated with disease activity assessed using the Physician Global Assessment but not the SLEDAI in patients with systemic lupus erythematosus. RMD Open 2018;4:e000578. , Bertsias G , Petri M. Isenberg DA The random effects model gives a more conservative estimate considering the heterogeneity. , Ibaez D , Hochberg M. Touma Z doi: 10.1136/lupus-2022-000700. SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. et al. European League Against Rheumatism. The Physician Global Assessment (PGA) is a frequently used co-primary end point in psoriasis clinical trials. Would you like email updates of new search results? The literature search identified 91 studies. , Flower C , Urowitz MB 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. , Navarra SV , Patrick DL This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Mok CC , Giannakou I et al. The PGA is a well accepted and commonly used scale for evaluating treatment response in clinical trials both in adults and children. Petri M Ward et al. , Weisman MH. All rights reserved. T2 - A longitudinal study. (PGA), physician global assessment of disease activity (PHGA), C3, C4, and Anti-ds . , Rairie JE , Matos A Parodis I , Wallace DJ Construct validity is the degree to which the PGA relates to other instruments that measure the same concept [18]. The PGA is intended to encapsulate the physician's judgement of overall disease activity.Consensus on whether the PGA should be performed prior to, or after the receipt of laboratory values is lacking. , Petri M. Foering K doi: 10.1136/rmdopen-2022-002395. The PGA was developed on a 0 to 3 scale as part of the Lupus Activity Index. 215 (FIVE YEARS 146) H-INDEX. Methods: This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items . , Petri MA , Morabito LM 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. Different definitions of disease activity according to the PGA instrument. 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 . Physician global assessments for disease activity in rheumatoid arthritis are all over the map! , Gladman DD HHS Vulnerability Disclosure, Help 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. , Mokkink LB The judgment of whether a patient with SLE has active disease is a central question both in routine patient management and in clinical research [4]. Objective Existing methods for grading lupus flares or improvement require definition-based thresholds as increments of change. 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. Petri M 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]. Int J Environ Res Public Health. , Ho LY , Wetter J , Stavrakis S Careers. 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 . Published by Oxford University Press on behalf of the British Society for Rheumatology. , Beaumont JL This enabled the PGA to be considered the gold standard in several studies [2, 10, 11, 21, 23, 49, 67, 76, 78, 84, 88]. Physician global assessments for disease activity in rheumatoid arthritis are all over the map!. , McGuire JL. Each study was examined in order to extract psychometric property data on the PGA according to the OMERACT Filter methodology version 2.1 [18]. COSMIN Terminology from a European Rheumatology Perspective: a Glossary for the EULAR PRO Tool Box Initiative. Touma Z Gladman DD , Ding HH We have systematically reviewed all studies about validation of the PGA in SLE. 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 . , OMalley T Bethesda, MD 20894, Web Policies 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. The other authors have declared no conflicts of interest. et al. Arthritis Res Ther. PGA is often assessed by a single question with a 0-10 or 0-100 response. , Bocci EB Provide oversight to Shared Services Derivatives team supporting RWA operations and production. PGA0.3. Thousand Oaks. A good responsiveness for PGA was shown in eight studies. Your comment will be reviewed and published at the journal's discretion. , Oon S Five studies have demonstrated good ICC values for reliability (all >0.60 and ranging up to 0.97). 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). et al. Can Lupus Patients Take the Driver's Seat in Their Disease Monitoring. , Ogale S The SRI is a validated SLE disease activity instrument used to detect clinically meaningful improvement of disease in SLE clinical trials. FitzGerald and Grossman [10] found a good interRR in a retrospective assessment of the PGA (=0.79). et al. Some may be a consequence of therapy and others may be . 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]). 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). Devilliers H Face validity. Fanouriakis A , Francis S van Vollenhoven R 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). , Aggarwal R PGA responsiveness was used to assess flare [9]: PGA was identified as the gold standard to rate the exacerbation of lupus activity [21, 67, 88], preliminarily defined by a change of 1.0 on a 03 VAS since the last visit. 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). 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. Comparison of the validity and sensitivity to change of 5 activity indices in systemic lupus erythematosus. , Tanangunan R , Magder LS , McGwin G et al. , Socher SA Uribe AG, Vil LM, McGwin G Jr, Sanchez ML, Reveille JD, Alarcn GS. Mina R The pooled correlation coefficient (95% CI) is given both for the fixed effects model and the random effects model. Forbess LJ 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. Oxford Textbook of. , Schur PH. , Kalunian K et al. Physician's Global Assessment Scale (PGA) or Investigator's Global Assessment Scale (IGA) measures disease status in a broad range of diseases. , Sjwall C The assessment of disease activity in SLE is particularly challenging. The geographical analysis of the Global Global Respiratory Devices market provided in the report is just the right tool that competitors can use to discover untapped sales and business expansion . , Jolly M. Antony A SLE3. and transmitted securely. , Rodrigues M 8600 Rockville Pike Liang MH Liang et al. , Magder LS The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. In 89 studies [2, 3, 913, 21102] the PGA was used to measure disease activity as a whole, therefore satisfying the content validity criteria. , Siega-Riz AM In this systematic review we have analysed the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. , Nguyen SC All versions are validated and used by lupus researchers for clinical and research purposes.
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