A good responsiveness for PGA was shown in eight studies. et al. Exagen's products are used for therapeutic drug monitoring of hydroxychloroquine in whole blood and methotrexate polyglutamates, risk assessment testing, anti-TNF monitoring to individualize therapy and optimize dosing, and others. Thanou A, Chakravarty E, James JA, Merrill JT. , Magder L , Magder L Provide oversight to Shared Services Derivatives team supporting RWA operations and production. The last MEDLINE search was performed on 1 July 2019. Learn more. TOTAL DOCUMENTS. , Chizzolini C et al. [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. Despite the need for new treatments in CLE . , Allen E Oxford Textbook of. Published by Oxford University Press on behalf of the British Society for Rheumatology. 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. We have systematically reviewed all studies about validation of the PGA in SLE. , Rodrigues M , Mohan C. Jolly M 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). SLE or at an SLE site, but only if the injury requires treatment by a licensed medical doctor. 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. , Nelson S The other authors have declared no conflicts of interest. 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. 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). , Smiley A. Askanase AD To discriminate between the severity of flares, the PGA was incorporated in a composite index: the SFI [10] (Table1). 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. 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. et al. , Urowitz MB. Before 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]. 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]. , Magder LS 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. Results: All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients age. BILAGAB . A PGA 2 correlated with a risk of pregnancy loss (29% vs 8%, P=0.005) [49]. , Gomez A van Vollenhoven R et al. 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. , Longenecker JC BICLA is a validated composite global measure of SLE disease activity including SLEDAI-2K, CLASI-A, OCS dosage reduction, and patient-reported outcomes. Unable to load your collection due to an error, Unable to load your delegates due to an error. This may be explored through convergent and divergent validity. Touma Z This important heterogeneity in the anchoring of the PGA prevented us from performing a meta-analysis of reliability data. 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]. Ward et al. , Chakravarty E may be asked to hyperventilate 3-4 min and watch a bright flashing light. , McGwin G According to the OMERACT, face validity is the degree to which the instrument appears to match with the target domain, according to experts [18]. 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. A good correlation was considered for a value >0.60. PGA is a simple instrument and the result is easily understood. 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. 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]. , Su J Feasibility is the ease of application of the instrument of measure in its intended setting [106]. , Altman DG 'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study. , Askanase A Construct validity is the degree to which the PGA relates to other instruments that measure the same concept [18]. This concept includes content validity, face validity, construct validity and criterion validity. Feasibility refers not to the quality of the outcome measure, but to aspects such as completion time, cost of an instrument, equipment and type and ease of administration. Arthritis Res Ther. Sullivan KE Thousand Oaks. The literature search identified 91 studies. OBJECTIVE The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. Navarra SV [8] suggested that the PGA should account for objective examination, laboratory results and what patients report. , Sjwall C. Strand V Content validity pertains to the degree to which the instrument measures all facets of a construct of interest [20]: this property is satisfied if the PGA is considered able to measure all aspects of disease activity in SLE in a comprehensive way. [35], the PGA correlated, although moderately, with the need for treatment change (r=0.46, P<0.01). , Ho LY , Beresford MW Liang MH The PGA intraRR was assessed in three studies [10, 68, 94] and ranged from 0.55 [68] to 0.88 [10]. physician global assessment Recently Published Documents. , Ibaez D 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. Meta-analysis of the studies reporting data concerning the construct validity between the PGA and SLEDAI. Prinsen CAC . , Jolly M. Ribi C 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). Laboratory investigation results influence Physicians Global ssessment (PGA) of disease activity in SLE. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. , Petri MA Parodis I , Jolly M. Mok CC It is unclear when or with what justification the physician global assessment of disease status (PhGA) was first used to assess patients with systemic . et al. et al. et al. et al. , Lerman RH 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. However, it was used as a single outcome measure only in two studies [49, 100], while in the majority the PGA was scored together with another instrument (typically the SLEDAI) [2, 9, 11, 12, 21, 24, 30, 32, 34, 3740, 44, 45, 48, 49, 55, 58, 59, 61, 63, 64, 66, 67, 74, 75, 80, 82, 86, 8995, 103]. Disclaimer. 1 2. RN-BSN HOLISTIC HEALTH ASSESSMENT ACROSS THE LIFESPAN (NURS 3315) Sociology of Social Problems (SOC213) , Goldsmith CH AU - Louthrenoo, Worawit. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. , Bertsias G Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index. , Khamashta MA Criterion validity data reporting correlation coefficients between PGA and quality of life measures, laboratory markers and miscellaneous. , Giannakou I , Sadovici-Bobeica V Construct validity was demonstrated by a good correlation (r0.50) between the PGA with the SLEDAI (12 studies), SLAM (4 studies), LAI, BILAG and ECLAM (2 studies each). National Library of Medicine A Comprehensive Digest of Research Publications From Cedars-Sinai Investigators. A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.67-0.98). 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. Myelogram - correct answer NPO for 4-6 hours. , Bouter LM doi: 10.1136/rmdopen-2022-002395. Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus: the PISCOS study . et al. Diet and Systemic Lupus Erythematosus (SLE): From Supplementation to Intervention. All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients' age. AU - Morand, Eric. 2021 Apr 8;5(1):33. doi: 10.1186/s41687-021-00298-x. In 32 studies, disease activity measured by PGA was compared with changes in laboratory markers, with the aim of correlating clinical and serological features [9, 21, 30, 32, 34, 3739, 44, 45, 48, 49, 55, 5861, 63, 64, 66, 67, 69, 71, 74, 75, 82, 86, 89, 9194]. Mok CC Some may be a consequence of therapy and others may be . 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 . 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). , Kandane-Rathnayake RK Physician's Global Assessment (PGA) score 1.0 on a 0 to 3 visual analog scale. 12. and later incorporated into the SLE Responder Index used in the belimumab clinical trials, 13 These results enabled its use as a gold standard for assessing flare and defining flare severity in several studies [21, 67, 88]. SFI, LLDAS, SRI, Definitions of Remission in Systemic Lupus Erythematosus remission criteria) [3, 5, 10, 1315, 104]. , Hennis A. Jesus D The PGA is a well accepted and commonly used scale for evaluating treatment response in clinical trials both in adults and children. 2. This systematic literature review was conducted by two independent reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The Physician Global Assessment (PGA) is a frequently used co-primary end point in psoriasis clinical trials. SLE2ACR1997SLICC2012. (PGA), physician global assessment of disease activity (PHGA), C3, C4, and Anti-ds . 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. Wells GA The sensitivity to change was estimated to be the smallest for the SLEDAI; the standardized response means were 0.48 when the physician global assessment was used as the standard and 0.01 when the patient global assessment was used . Objectives Remission in systemic lupus erythematosus (SLE) is defined through a combination of 'clinical SLE Disease Activity Index (cSLEDAI)=0', 'physician's global assessment (PGA) <0.5 .

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