physician global assessment sle

What Does It Mean to Be a British Isles Lupus Assessment Group-Based , Guzmn RM Mayara Torres Silva de Oliveira, MD, MBA on LinkedIn: #medicinanuclear Myelogram - correct answer NPO for 4-6 hours. Systemic lupus erythematosus (SLE), is the most common type of lupus. The SELENA-SLEDAI assesses systemic lupus erythematosus (SLE) disease activity and categorizes mild/moderate or severe flares based on changes in the SLEDAI score, the Physician's Global Assessment (PGA), medication use (prednisone, Nonsteroidal anti-inflammatory drugs, Plaquenil, major immunosuppressives), other disease activity criteria, and . , Hambleton IR et al. Content validity. Thanou A, Chakravarty E, James JA, Merrill JT. All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients age. , Nelson S et al. 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. et al. 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. Moreover, there is uncertainty as to whether the best timing of assessment is prior to or after reviewing laboratory exams [26]. , Floris A The Janus kinase (Jak)/signal transducer and activating protein (STAT) pathways mediate the intracellular signaling of cytokines in a wide spectrum of cellular processes. 10- Medical- Surgical- Nursing- Intensive- Review We have systematically reviewed all studies about validation of the PGA in SLE. , Perez-Gutthann S 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. et al. A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.670.98). Published by Oxford University Press on behalf of the British Society for Rheumatology. 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. [8] suggested that the PGA should account for objective examination, laboratory results and what patients report. Construct validity. Lai J-S Touma Z 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 . Help us improve CareerBuilder by providing feedback about this job: Report this job Job ID: 2281236908. 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 . Prinsen CAC Mina R A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.67-0.98). Wells GA 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. Accessibility 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]. Gladman DD Scoring systemic lupus erythematosus (SLE) disease activity with simple . , Longenecker JC Liang MH 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. Physician global assessments for disease activity in rheumatoid arthritis are all over the map! The Physician's Global Assessment (PhGA) is a number without unit. The PGA intraRR was assessed in three studies [10, 68, 94] and ranged from 0.55 [68] to 0.88 [10]. Karol DE PGA; disease activity; physician global assessment; psychometrics; systemic lupus erythematosus. , Sato JO FitzGerald and Grossman [10] found a good interRR in a retrospective assessment of the PGA (=0.79). , Urowitz MB The Physician Global Assessment (PGA) is a frequently used co-primary end point in psoriasis clinical trials. 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). , McGuire JL. The last MEDLINE search was performed on 1 July 2019. , Petri MA The following search strategy was used through MEDLINE via PubMed: (((lupus erythematosus, systemic[MeSH Terms] OR (lupus[TIAB] AND erythematosus[TIAB] AND systemic[TIAB]) OR systemic lupus erythematosus[TIAB] OR (systemic[TIAB] AND lupus[TIAB] AND erythematosus[TIAB]))) OR SLE[TIAB]) AND (physician global assessment[TIAB] OR PGA[TIAB]). Criterion validity data reporting correlation coefficients between PGA and quality of life measures, laboratory markers and miscellaneous. 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]. Eudy AM Petri M 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. , Urowitz MB 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 assesses separately eight organ-based systems. Few studies reported on whether serological activity should be incorporated in the PGA. They participate in physiologic and inflammatory cascades and have become a major focus of research, yielding novel therapies for immune-mediated inflammatory diseases (IMID). , Schur PH. Fanouriakis A Thus the development of a comprehensive index for assessing disease activity still represents one of the most important challenges in SLE [7]. , James JA 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]. , Sjwall C. Strand V The authors wish to thank Sylvie Thuong for her invaluable assistance in the preparation of this manuscript. (PGA) scoring of disease activity in systemic lupus erythematosus (SLE). This potentially disfiguring disease can have significant impact on patient's quality of life (QoL) and is often refractory to many first- and second-line therapies. FOIA et al. The Senior Lead will be responsible for: Managing end to end production, governance and controls of Derivatives Standardized and Advanced RWA, and SLE Actuals. 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]. Exagen Diagnostics Inc (XGN) - Product Pipeline Analysis, 2022 Update Patient-reported outcomes (PROs) reflect the patient's perspective and are used in rheumatoid arthritis (RA) routine clinical practice. [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. , Shea BJ All rights reserved. Use of Physician Global Assessment (PGA) in Systemic lupus Physician's global assessment is often useful in SLE - ResearchGate 2022 Sep 20;19(19):11895. doi: 10.3390/ijerph191911895. , Kalunian K Criterion validity was assessed exploring the PGA correlation with quality of life measurements, biomarker levels and treatment changes in 28 studies, while no study has evaluated correlation with damage. The company serves physicians and patients. Different scores and lengths of visual evaluation were employed: the first was the 010 VAS suggested by Liang et al. independently selected the articles, initially on the basis of titles and abstracts, then, if necessary, on the full texts, an eligibility assessment was performed independently in a blinded standardized manner. , Goldsmith CH 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. et al. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. A total of 91 articles were included in the study (Fig. SELENA SLEDAI4. , Brunetta P , Magder L et al. Patient-Reported Outcomes in Systemic Lupus Erythematosus. may be asked to hyperventilate 3-4 min and watch a bright flashing light. Published by Oxford University Press on behalf of the British Society for Rheumatology. [PDF] Use of Physician Global Assessment in systemic lupus Kiani AN Genetic linkage has related dysfunction of . 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 . Petri M IgM) on attainment PhGA. The official NJDOE Incident Reporting Form, as well as a guide to completing , ODell JR The Physician Global Assessment (PGA) is an important tool for assessing disease activity in lupus. , Costenbader K , Skogh T Direkt zum Inhalt springen . ECG - correct answer no sleep the night before, meals allowed, no stimulants/tranquilizers for 24-48 hours before. , Chan KL Use of Physician Global Assessment in systemic lupus - PubMed The aim of this systematic literature review (SLR) is to describe and analyse the psychometric properties of PGA. 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. , Gomez A , Subach RB Lead Medical Director heading up the global collaboration with Pfizer for Enbrel trials. A good responsiveness for PGA was shown in eight studies. , Alunno A , Ding HH Touma Z Finally, the PGA enables the measurement of disease activity globally compared with a glossary-based index. Physician global assessments for disease activity in rheumatoid et al. , Lin M Reliability. 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 . 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. , Petri MA Clipboard, Search History, and several other advanced features are temporarily unavailable. Rheumatology (Oxford). , Weisman MH. The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinicians judgement of overall SLE disease activity. Introduction Physician global assessments of disease activity (medical doctor (MD) globals) are important outcomes. New Tools to Measure Disease Activity in SLE - Rheumatology Network Moher D Can Lupus Patients Take the Driver's Seat in Their Disease Monitoring. , Engel SM Epub 2014 Apr 11. . Physician's Global Assessment (PGA) score 1.0 on a 0 to 3 visual analog scale. JSS Medical Research. If you have a published paper from this period that does not appear on this list, please contact Sue Marone, who will add it to next week's collection. 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. This property is reported across all articles selected through this systematic review [24, 913, 21103]. Physician training is very important. A PGA 2 correlated with a risk of pregnancy loss (29% vs 8%, P=0.005) [49]. Randomized MMF Withdrawal in Systemic Lupus Erythematosus (SLE) - Full , Mosca M No study has evaluated the feasibility of the PGA in SLE to date. , Pego-Reigosa J-M An official website of the United States government. Enocsson H , Cella D. van Vollenhoven RF This may be explored through convergent and divergent validity. et al. 2014 Sep-Oct;10(5):309-20. doi: 10.1016/j.reuma.2014.01.012. Unable to load your collection due to an error, Unable to load your delegates due to an error. , Rodrigues M Assessing disease activity in rheumatic diseases such as systemic lupus erythematosus (SLE) is vital for effective treatment. , Jolly M. Ribi C Patient global assessment in measuring disease activity in rheumatoid 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. et al. Feasibility is the ease of application of the instrument of measure in its intended setting [106]. HHS Vulnerability Disclosure, Help Mahler M antineutrophil cytoplasmic antibody-associated vasculitis (AAV), and systemic lupus erythematosus (SLE). Physician's Global Assessment in Psoriatic Arthritis: A Multicenter Use of Physician Global Assessment (PGA) in Systemic lupus - medRxiv Your recommendations as to what might or should be done in relation to various issues observed. The Author(s) 2020. , Buyon J The quantification of reliability is expressed by a correlation coefficient. Epub 2014 Jul 10. 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. Keywords: The other authors have declared no conflicts of interest. 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. 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). Elevation of erythrocyte sedimentation rate is associated with disease activity and damage accrual, 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, Small changes in outpatients lupus activity are better detected by clinical instruments than by laboratory tests, Development and initial validation of the systemic lupus erythematosus disease activity index 2000 responder index 50, Sensitivity to change of 3 systemic lupus erythematosus disease activity indices: international validation, Systemic Lupus Erythematosus Disease Activity Index 2000 Responder Index 50: sensitivity to response at 6 and 12 months, Validation of the functional assessment of chronic illness therapy-fatigue scale in patients with moderately to severely active systemic lupus erythematosus, participating in a clinical trial, Psychological distress and changes in the activity of systemic lupus erythematosus, The rating scale preference measure as an evaluative measure in systemic lupus erythematosus, Comparison of the validity and sensitivity to change of 5 activity indices in systemic lupus erythematosus, Treatment of systemic lupus erythematosus with dehydroepiandrosterone: 50 patients treated up to 12 months, Soluble urokinase plasminogen activator receptor levels reflect organ damage in systemic lupus erythematosus, Epratuzumab for patients with moderate to severe flaring SLE: health-related quality of life outcomes and corticosteroid use in the randomized controlled ALLEVIATE trials and extension study SL0006, Measuring systemic lupus erythematosus activity during pregnancy: validation of the lupus activity index in pregnancy scale, Autoantibodies against albumin in patients with systemic lupus erythematosus, Association of depression with socioeconomic status, anticardiolipin antibodies, and organ damage in patients with systemic lupus erythematosus: results from the KORNET registry, Placebo-controlled randomized clinical trial of fish oils impact on fatigue, quality of life, and disease activity in systemic lupus erythematosus, Serum free light chains, interferon-alpha, and interleukins in systemic lupus erythematosus, Vitamin D levels in Chinese patients with systemic lupus erythematosus: relationship with disease activity, vascular risk factors and atherosclerosis, Systemic lupus erythematosus disease activity index 2000 responder index-50: a reliable index for measuring improvement in disease activity, Testosterone patches in the management of patients with mild/moderate systemic lupus erythematosus, Turkish LupusPRO: cross-cultural validation study for lupus, Cross-cultural validation of a disease-specific patient-reported outcome measure for lupus in Philippines, Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: a randomised, placebo-controlled, phase 3 trial, Sensitivity and specificity of plasma and urine complement split products as indicators of lupus disease activity, The TNF locus is altered in monocytes from patients with systemic lupus erythematosus, Effect of pregnancy on disease flares in patients with systemic lupus erythematosus, Frequency of lupus flare in pregnancy: the Hopkins Lupus Pregnancy Center experience, Morbidity of systemic lupus erythematosus: role of race and socioeconomic status, Classification and definition of major flares in SLE clinical trials, Efficacy and safety of epratuzumab in patients with moderate/severe active systemic lupus erythematosus: results from EMBLEM, a phase IIb, randomised, double-blind, placebo-controlled, multicentre study, COSMIN guideline for systematic reviews of patient-reported outcome measures, Validity and reliability in social science research, Understanding the minimum clinically important difference: a review of concepts and methods, Statistical significant change versus relevant or important change in (quasi) experimental design: some conceptual and methodological problems in estimating magnitude of intervention-related change in health services research, Minimum important difference between patients with rheumatoid arthritis: the patients perspective, Responsiveness and sensitivity to change of SLE disease activity measures, The Author(s) 2020. Different definitions of disease activity according to the PGA instrument. There is no cure for lupus, but medical . A PGA >1 was predictive of polymorphic light cutaneous eruption (P=0.02) [59] and correlated negatively with LLDAS attainment [37]. [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. , OMalley T AU - Kasitanon, Nuntana. Objective: The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. , Sayedbonakdar Z 2022 Mar 14;24(1):70. doi: 10.1186/s13075-022-02756-3. , Giangreco D , Gladman DD Physician Global Assessment International Standardisation COnsensus in Touma Z 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). 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. Fatigue is independently associated with disease activity assessed using the Physician Global Assessment but not the SLEDAI in patients with systemic lupus erythematosus. Parodis I , Bouter LM 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. Castrejn I, Ra-Figueroa I, Rosario MP, Carmona L. Reumatol Clin. 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). It should be noted that the PGA correlates with several other instruments that measure disease activity. 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]. 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]. Correlations with other instruments measuring similar constructs should typically demonstrate a coefficient (r) 0.50 [106]. (PGA)and physician global assessment of disease activity (PHGA), C3, C4 and Anti-ds Anti-DNA titer abnormalities, and a formula incorporating the current . 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. Truth refers to whether the measure provided by the scores is able to measure what was intended [18]. et al. , Clowse M. Moorthy LN 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. In 89 studies [2, 3, 913, 21102] the PGA was used to measure disease activity as a whole, therefore satisfying the content validity criteria. , Klein-Gitelman MS 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 .