, Taghavi-Zadeh S Physician's Global Assessment Scale (PGA) or Investigator's Global Assessment Scale (IGA) measures disease status in a broad range of diseases. Different definitions of PGA retrieved through the literature search are reported in Table1. Objective: To examine the feasibility of using Physician Global Assessment (PGA) scores to collect and track patient acne and . Convergent validity is fulfilled indirectly in studies where the PGA is used as the gold standard to assess the construct validity of other indices. 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). Clinical composite measures of disease activity and damage used to evaluate patients with systemic lupus erythematosus: A systematic literature review. Construct validity was demonstrated by a good correlation (r 0.50) between the PGA with the SLEDAI (12 studies), SLAM (4 studies), LAI, BILAG and ECLAM (2 studies each). The OMERACT defines an instrument as an outcome measure if it passes the three pillars of evidence: truth (that refers to validity), discrimination (that includes reliability and responsiveness) and feasibility. To increase its reliability, the PGA should be scored by a physician with significant expertise in SLE, with prior knowledge of laboratory results [112], considering the overall disease activity at the time of the visit and comparing it to the last visit in order to assess flares [9]. Annapureddy N In 89 studies [2, 3, 913, 21102] the PGA was used to measure disease activity as a whole, therefore satisfying the content validity criteria. Brunner HI , Su J Physician's Global Assessment (PGA) score 1.0 on a 0 to 3 visual analog scale. Help us improve CareerBuilder by providing feedback about this job: Report this job Job ID: 2281236908. Prinsen CAC [8] suggested the need for a disease activity instrument that would be valid, reliable and sensitive to change. Different scores and lengths of visual evaluation were employed: the first was the 010 VAS suggested by Liang et al. Once two investigators (E.C., M.P.) Face validity. Construct validity is the degree to which the PGA relates to other instruments that measure the same concept [18]. Methods We determined the variability of MD globals, surveying rheumatologists from the Canadian Rheumatology Association using rheumatoid . Gandhi N , Andreoli L A difference between the interRR of the PGA assessed by an untrained physician (ICC=0.50.63) or a trained investigator (ICC=0.790.81) was found [36]. , Ko T TOTAL DOCUMENTS. We analysed the performance of the SELENA SLEDAI Physician's Global Assessment (SSPGA) and the Lupus Foundation of America-Rapid Evaluation of Activity in Lupus (LFA-REAL) as measures . Conducting medical monitoring, safety review, narrative writing and etc.. Perform medical assessment of individual . , Sengupta M 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. , Karp DR Visual analogue scales (VAS) allow rapid, continuous scaling of disease severity. However, it is important to remember that not all clinical problems reported by a lupus patient are due to the disease. , Seaman AL Int J Environ Res Public Health. Keywords: et al. , Kostopoulou M , Ravelli A 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). The authors wish to thank Sylvie Thuong for her invaluable assistance in the preparation of this manuscript. , Khamashta MA 215 (FIVE YEARS 146) H-INDEX. . A good correlation was considered for a value >0.60. , Annapureddy N Impact of anti-SARS-CoV-2 antibodies of different isotypes (IgA, IgG, IgM) on attainment of PGA . Methods It estimates how similar a given patients scores were at the two visits. , Chan KL This important heterogeneity in the anchoring of the PGA prevented us from performing a meta-analysis of reliability data. Matthew Turk,1,2 Janet E Pope1,2 To cite: turk M, Pope Je. Arriens C In 1988, Liang et al. Results: Physician global assessments for disease activity in rheumatoid arthritis are all over the map!. 2014 Sep-Oct;10(5):309-20. doi: 10.1016/j.reuma.2014.01.012. et al. Clipboard, Search History, and several other advanced features are temporarily unavailable. , Urowitz MB. JSS Medical Research. doi: 10.1136/rmdopen-2022-002395. 2022 Sep 20;19(19):11895. doi: 10.3390/ijerph191911895. 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. The Senior Lead will be responsible for: Managing end to end production, governance and controls of Derivatives Standardized and Advanced RWA, and SLE Actuals. Ann Rheum Dis 2 Isenberg DA, Allen E, Farewell V, et al. , Guzmn RM , Mikolaitis-Preuss RA The https:// ensures that you are connecting to the et al. Diet and Systemic Lupus Erythematosus (SLE): From Supplementation to Intervention. This may be explored through convergent and divergent validity. Touma Z Merrill JT and transmitted securely. 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). , Schur PH. Eudy AM According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. For instance, in an analysis of studies of the prevalence of SLE in the Asia-Pacific region, higher rates of renal involvement were observed in Asian patients (21-65% at SLE diagnosis and 40 . inflammation (duration and severity of morning stiffness as measured by BASDAI). Assessing disease activity in rheumatic diseases such as systemic lupus erythematosus (SLE) is vital for effective treatment. et al. , Petri M. Furie RA 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]. FOIA 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. In one study [25], the PGA of disease activity resulted from the combination of the clinical visit, laboratory markers evaluation and the physicians knowledge of the patient disease history. , Klein-Gitelman MS IgM) on attainment PhGA. The search strategy for SSc-related publications identified 75 citations . Please enable it to take advantage of the complete set of features! The PGA was developed on a 0 to 3 scale as part of the Lupus Activity Index. It operates in Albuquerque, and New Mexico. Vil LM 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). , Petri M RMD Open 2018;4:e000578. et al. , Buyon J , Block JA 2014 Dec;53(12):2175-81. doi: 10.1093/rheumatology/keu153. Supervise the development of junior medical affairs staff . , Piette EW van Vollenhoven R et al. , Jolly M. Mazur-Nicorici L [80] considered worsening as any increase in the PGA from baseline; in the epratuzumab trial [87], a significant improvement was a 20% decrease in the PGA score evaluated after 12months of treatment. , Glassman DS , Adamichou C One study showed a significant ability of the PGA in distinguishing between patients (P<0.0001) and observers (P<0.0001), but not between visits [79]. 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]. 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. et al. Epub 2014 Jul 10. Objective Existing methods for grading lupus flares or improvement require definition-based thresholds as increments of change. CareerBuilder TIP. Epub 2014 Apr 11. Direkt zum Inhalt springen . government site. 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. Psychometric properties of FACIT-Fatigue in systemic lupus erythematosus: a pooled analysis of three phase 3 randomised, double-blind, parallel-group controlled studies (BLISS-SC, BLISS-52, BLISS-76). , Sato JO The correlation with the SLEDAI was determined in 12 studies (Fig. ~SLE~. Accessibility , Costenbader K Funding: The study was funded through the training Bursary Programme 2019 of the SLEuro European Lupus Society. Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index, Effect of raloxifene on disease activity and vascular biomarkers in patients with systemic lupus erythematosus: subgroup analysis of a double-blind randomized controlled trial, Omega-3 in SLE: a double-blind, placebo-controlled randomized clinical trial of endothelial dysfunction and disease activity in systemic lupus erythematosus, Erythrocyte sedimentation rate is a predictor of renal and overall SLE disease activity, Characterization of clinical photosensitivity in cutaneous lupus erythematosus, Validation of the systemic lupus erythematosus responder index for use in juvenile-onset systemic lupus erythematosus, Depressive symptoms and associated factors in systemic lupus erythematosus, Validation of the Portuguese simple measure of impact of lupus erythematosus in youngsters (SMILEY) in Brazil, Anti-C1q antibodies have higher correlation with flares of lupus nephritis than other serum markers, Performance of anti-C1q, antinucleosome, and anti-dsDNA antibodies for detecting concurrent disease activity of systemic lupus erythematosus, An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA, Noncalcified coronary plaque in systemic lupus erythematosus, Decreases in anti-double-stranded DNA levels are associated with concurrent flares in patients with systemic lupus erythematosus, Validity and reliability of lupus activity measures in the routine clinic setting, Clinical predictors of response and discontinuation of belimumab in patients with systemic lupus erythematosus in real life setting. SLE is an immune-mediated multisystemic disease characterized by a wide variability of clinical manifestations and a course frequently subject to unpredictable flares [1, 2]. Published by Oxford University Press on behalf of the British Society for Rheumatology. 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. Objective: Rendas-Baum R, Baranwal N, Joshi AV, Park J, Kosinski M. J Patient Rep Outcomes. 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]. SLE or at an SLE site, but only if the injury requires treatment by a licensed medical doctor. Navarra SV , Engel SM , Gordon C , Urowitz MB The PGA is usually reported by experts as allowing exhaustive coverage of the concept of disease activity in SLE [20, 108]. When expanded it provides a list of search options that will switch the search inputs to match the current selection. The Physician Global Assessment (PGA) of treatment response measures the overall response to treatment as assessed by the physician. The PGA intraRR was assessed in three studies [10, 68, 94] and ranged from 0.55 [68] to 0.88 [10]. PGA is often assessed by a single question with a 0-10 or 0 . They participate in physiologic and inflammatory cascades and have become a major focus of research, yielding novel therapies for immune-mediated inflammatory diseases (IMID). et al. , Lin M et al. Liang MH It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. , Tanangunan R et al. 3TR (Taxonomy, Treatment, Targets and Remission) Systemic Lupus Erythematosus Study Protocol 2 Fanouriakis A et al. 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). A total of 91 articles were included in the study (Fig. , Petri M. Thanou A 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. et al. , Gladman DD SFI, LLDAS, SRI, Definitions of Remission in Systemic Lupus Erythematosus remission criteria) [3, 5, 10, 1315, 104]. , Urowitz MB PGA0.3. Beaton DE AU - Kandane-Rathnayake, Rangi. http://oml.eular.org/glossary (31 January. All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients age. Would you like email updates of new search results? [35], the PGA correlated, although moderately, with the need for treatment change (r=0.46, P<0.01). Your recommendations as to what might or should be done in relation to various issues observed. 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]. A PGA 2 correlated with a risk of pregnancy loss (29% vs 8%, P=0.005) [49]. et al. 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). , Engleman EG et al. Additional papers were obtained by checking the references from the selected studies. Different definitions of disease activity according to the PGA instrument. , Perez-Gutthann S Quimby KR , ODell JR Mokkink LB The literature search identified 91 studies. 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. , Bertsias G 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]. 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. , Goldsmith CH This concept includes content validity, face validity, construct validity and criterion validity. Copay AG , Cappellazzo G Criterion validity data reporting correlation coefficients between PGA and quality of life measures, laboratory markers and miscellaneous. , Jnsen A 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. The Janus kinase (Jak)/signal transducer and activating protein (STAT) pathways mediate the intracellular signaling of cytokines in a wide spectrum of cellular processes. , Saad-Magalhes C , Longenecker JC This suggests that the role of the PGA is limited for disease activity assessment when used as a single instrument. , Zonana-Nacach A Montreal, Canada Area. , Giannakou I , Aggarwal R , Suriano A Oxford Textbook of. , Mina R , Terwee CB Conclusion: Thank you for submitting a comment on this article. SLE3. Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus: the PISCOS study . 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). , Lau CS It does not provide a predefined or limited list of disease manifestations or organ systems, thus allowing one to capture all the heterogeneous aspects of SLE disease activity. , Voskuyl A 2014 - 20184 years. Navarra SV et al. , Chakravarty E T2 - A longitudinal study. , Skogh T Gyri N In the second column, the definitions were reported according to the VAS used in the study. AU - Louthrenoo, Worawit. Mina R 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]. antineutrophil cytoplasmic antibody-associated vasculitis (AAV), and systemic lupus erythematosus (SLE). No study has evaluated the correlation of PGA with damage measures. 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). The last MEDLINE search was performed on 1 July 2019. 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. 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]. 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 . In this systematic review we have analysed the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. et al. , Mohan C. Giangreco D 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]. 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 . SLE2ACR1997SLICC2012. , Gallacher AE , 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). 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). , Askanase A This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. , Oon S In our centre, new tools for the assessment of SLE activity: the Lupus Activity Scoring Tool (LAST) and Clinical Lupus Activity Scoring Tool (C-LAST) were developed and validated. et al. Mahler M et al. Myelogram - correct answer NPO for 4-6 hours. X 20 Physician Global Assessment 10.1136/lupus-2019-lsm.176 . 1 2. HHS Vulnerability Disclosure, Help However, the PGA allows for the measurement of disease activity in a global way (content validity). Moher D et al. 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]. Devilliers H 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. Lai J-S Mok CC sharing sensitive information, make sure youre on a federal , Liberati A , Shea BJ MeSH Methods: BICLA is a validated composite global measure of SLE disease activity including SLEDAI-2K, CLASI-A, OCS dosage reduction, and patient-reported outcomes. et al. Federal government websites often end in .gov or .mil. , Tugwell P , Koutsoviti S , Petri M. Foering K Franklyn K Schneider M , Jolly M. Antony A No data were found regarding the feasibility of the PGA. 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). , Tetzlaff J According to the OMERACT, face validity is the degree to which the instrument appears to match with the target domain, according to experts [18]. , Giangreco D Few studies reported on whether serological activity should be incorporated in the PGA. et al. , Gomez A , Petri M. Iaccarino L Sullivan KE Neuropsychiatry OXFORD TEXTBOOKS IN PSYCHIATRY Oxford Textbook of Neuropsychiatry Edited by Niruj Agrawal, Rafey Faruqui, and Mayur Bodani Oxford Textbook of Psychiatry of Intellectual Disability Edited by Sabyasachi Bhaumik and Regi Alexander Oxford Textbook of Inpatient Psychiatry Edited by Alvaro Barrera, Caroline Attard, and Rob Chaplin Oxford Textbook of Attention . Disagreements between investigators were solved by consensus. The aim of this systematic literature review is to describe and analyse the . , Maxwell LJ may be asked to hyperventilate 3-4 min and watch a bright flashing light. , Kalunian K , Pilkington C This site needs JavaScript to work properly. Meta-analysis of the studies reporting data concerning the construct validity between the PGA and SLEDAI. , Mosca M All clinical diagnoses were verified by review of the patients' inpatient and outpatient files at the time of capillaroscopy. , Navarra SV , Hambleton IR The results are similar, and less than half the time is required for scoring. et al. [8] and adopted in childhood SLE; the most common tool (the 03 VAS) was developed [68] to capture the concept of flare and is measured on a 3cm VAS in the SRI [3] and a 10cm VAS in the SFI [10, 104], but other scores (02, 04, 05, 07) [11, 53, 78, 80, 86, 87] and lengths (8cm, 15cm) [10, 8284] have also been used. Thousand Oaks. , Cella D. van Vollenhoven RF 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 . 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. , Alarcn GS 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. MD globals may vary based on their age, gender, practice setting and experience (number of patients seen per year and years in practice). 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. This button displays the currently selected search type. Ruiz-Irastorza G Genetic linkage has related dysfunction of . Piga M , Altman DG Liang et al. Jesus D PGA is a simple instrument and the result is easily understood. 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. , Matos A Careers. Bethesda, MD 20894, Web Policies Over the years, PGA-IGA scales were modified for the purpose of clinical settings and thus present a diversity in the number of response options (4 to 10 points), the response options label and the . Systemic lupus erythematosus (SLE), is the most common type of lupus. , Ibaez D CLOSED ANGLE/ ANGLE CLOSURE GLAUCOMA. Higher disease activity is an important predictor of both organ damage and mortality [2] and the attainment of low disease activity is associated with a reduction in early damage [5, 6]. , Chatzidionysiou K All rights reserved. Strength. , Bouter LM Please check for further notifications by email. , Burlingame RW The last EULAR/ACR recommendations recommended use of the PGA in the routine monitoring of SLE [16]. . , Wallace DJ SLE has protean and often complex manifestations, necessitating careful clinical assessment. Criterion validity also refers to the degree to which an instrument predicts aspects and phenomena occurring in the future [108]. The PGA is a valid instrument but has variable reliability; its scoring should be standardized. 2022 Mar 14;24(1):70. doi: 10.1186/s13075-022-02756-3. The PISCOS results will allow for increased homogeneity and reliability of PGA ratings in routine clinical practice, definitions of remission and low disease activity, and future SLE trials. Fanouriakis A , Kraag GR , Magder LS 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. , Stavrakis S , Borghoff K , Magder LS , Urowitz MB The official NJDOE Incident Reporting Form, as well as a guide to completing An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA. , Hynan LS The site is secure. Can Lupus Patients Take the Driver's Seat in Their Disease Monitoring. 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. 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. , Patrick DL 12. and later incorporated into the SLE Responder Index used in the belimumab clinical trials, 13 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). The index assesses separately eight organ-based systems. , Genovese M In Fatemi et al. , Lerman RH 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]. Castrejn I, Ra-Figueroa I, Rosario MP, Carmona L. Reumatol Clin. [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. Oxford University Press is a department of the University of Oxford. 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. , Urowitz MB. , Bresee C The 4-point PGA (0, no flare; 1, mild; 2, moderate; 3, severe) showed the lowest IRR in assessing flare (ICC=0.18) compared with the BILAG-2004 (ICC=0.54) and SFI (ICC=0.21) [65].
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