Use of Physician Global Assessment in systemic lupus - PubMed Mahler M Methods We determined the variability of MD globals, surveying rheumatologists from the Canadian Rheumatology Association using rheumatoid . Different definitions of disease activity according to the PGA instrument. , Vogel-Claussen J et al. , Bocci EB Navarra SV , Zonana-Nacach A , Subach RB According to the OMERACT, face validity is the degree to which the instrument appears to match with the target domain, according to experts [18]. [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. BILAGAB . Use of Physician Global Assessment in systemic lupus erythematosus: a [8] suggested that the PGA should account for objective examination, laboratory results and what patients report. , Devilliers H , Voskuyl A 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]. Laboratory Investigation Results Influence Physician's Global The index has proved quick and easy to use despite a comprehensive database and compares favourably with . et al. Epub 2014 Jul 10. 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). , Hochberg M. Wallace DJ The site is secure. According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. A total of 91 articles were included in the study (Fig. , Gladman DD Ann Rheum Dis 2 Isenberg DA, Allen E, Farewell V, et al. et al. physician global assessment Recently Published Documents. 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 . Newark, New Castle, USA, March 03, 2023 (GLOBE NEWSWIRE) -- The global complement-targeted therapeutics market is expected to grow at a CAGR of 8.9% from 2022 to 2030, owing to the rising . Matthew Turk,1,2 Janet E Pope1,2 To cite: turk M, Pope Je. OBJECTIVE The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. et al. ATI Comprehensive Predictor Exam 2019 (180 Q & A, Verified and 100 , Mina R et al. 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. Myelogram - correct answer NPO for 4-6 hours. , Devilliers H Schneider M Because of its dynamic nature, this disease has an unpredictable natural course leading to high . This scoring modality was used for the SRI [3]. Faculty Publications: Feb. 23-March 2 Moher D doi: 10.1136/rmdopen-2022-002395. Help us improve CareerBuilder by providing feedback about this job: Report this job Job ID: 2281236908. IgM) on attainment PhGA. 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. Methods: sharing sensitive information, make sure youre on a federal , Emamikia S Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus: the PISCOS study . [35], the PGA correlated, although moderately, with the need for treatment change (r=0.46, P<0.01). , McGwin G To discriminate between the severity of flares, the PGA was incorporated in a composite index: the SFI [10] (Table1). watch for seizures after the procedure. , Hennis A. Jesus D FOIA et al. The Handheld Dermatoscope as a Nail-Fold Capillaroscopic Instrument - JAMA Keywords: 2. , Stavrakis S 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. Prinsen CAC Akhter E 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. Physician Global Assessment International Standardisation COnsensus in , Block JA In this systematic review we have analysed the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. 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. et al. Feb 2016 - Jan 20182 years. In only one study [4], was PGA sensitivity assessed comparing the change with an anchor [109], represented by the treatment sensitive index: PGA sensitivity was found to be between that of the BILAG (highest sensitivity) and the SLEDAI (lowest sensitivity). Content validity was reported in 89 studies. Gladman DD However, it is important to remember that not all clinical problems reported by a lupus patient are due to the disease. Assessing disease activity in rheumatic diseases such as systemic lupus erythematosus (SLE) is vital for effective treatment. Glossary: PGA. This site needs JavaScript to work properly. et al. , Jolly M. Antony A , Nelson S X 20 sentence examples within Physician Global Assessment. For permissions, please email: journals.permissions@oup.com. 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. Cutaneous lupus erythematosus (CLE) is an autoimmune skin disease that can occur with or without systemic lupus erythematosus (SLE). (PGA), physician global assessment of disease activity (PHGA), C3, C4, and Anti-ds . , Genovese M , Oon S 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]. , Su J This week's edition of Faculty Publications includes Cedars-Sinai studies that were published Feb. 23-March 2. Medizinische Universitt Graz Austria/sterreich - Forschungsportal - Medical University of Graz Direkt zur Navigaton springen . The assessment of PGA responsiveness was performed in 10 studies [4, 23, 50, 58, 7779, 81, 83, 84] using different methods [110]. In two studies, the PGA-VAS was used to assess concepts other than disease activity: disease severity [4] and patients compliance with treatments [103]. official website and that any information you provide is encrypted Criterion validity also refers to the degree to which an instrument predicts aspects and phenomena occurring in the future [108]. , Chizzolini C , Alarcn GS The results are similar, and less than half the time is required for scoring. Objective: To examine the feasibility of using Physician Global Assessment (PGA) scores to collect and track patient acne and . , Tanangunan R , Dietzmann 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. , Liberati A et al. , Petri MA An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA. This suggests that the role of the PGA is limited for disease activity assessment when used as a single instrument. Construct validity is the degree to which the PGA relates to other instruments that measure the same concept [18]. Rheumatology (Oxford). Wells GA Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index. 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]. Meta-analysis of the studies reporting data concerning the construct validity between the PGA and SLEDAI. Liang MH Measuring disease activity in adults with systemic lupus erythematosus , Esdaile JM. 10- Medical- Surgical- Nursing- Intensive- Review 2014 - 20184 years. , Ravelli A Exagen Diagnostics Inc (XGN) - Product Pipeline Analysis, 2022 Update , Brunetta P 3TR (Taxonomy, Treatment, Targets and Remission) Systemic Lupus One study, published after our systematic literature search was completed [112], showed that scoring the PGA with knowledge of laboratory data increased its correlation with the SLEDAI-2K (r=0.79) compared with without knowledge of laboratory results (r=0.67). In the second column, the definitions were reported according to the VAS used in the study. Kiani AN Because of the complexity of SLE, the assessment of disease activity is particularly challenging [3]. 215 (FIVE YEARS 146) H-INDEX. Results: Correlations with other instruments measuring similar constructs should typically demonstrate a coefficient (r) 0.50 [106]. Supervise the development of junior medical affairs staff . Chaigne B , Kandane-Rathnayake RK Complement-Targeted Therapeutics Market Report (2022 to The interrater reliability (interRR) of the PGA is the ability to provide consistent scores in a stable population between two or more physicians who evaluate the disease activity of the same patient. et al. No data were found regarding the feasibility of the PGA. . , Magder L , Rodrigues M , Burlingame RW Gordon C Systemic Lupus Erythematosus (SLE) | CDC All rights reserved. Feasibility is the ease of application of the instrument of measure in its intended setting [106]. 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. A PGA >1 was predictive of polymorphic light cutaneous eruption (P=0.02) [59] and correlated negatively with LLDAS attainment [37]. Direkt zum Inhalt springen . Five studies have demonstrated good ICC values for reliability (all >0.60 and ranging up to 0.97). , Mikolaitis-Preuss RA , Garabajiu M 1), accounting for 49 longitudinal cohort studies, 25 cross-sectional studies, 7 randomized controlled trials, 3 consensus conferences, 4 post-hoc analyses, 2 retrospective studies and 1 case series. et al. 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. , Petri M. Furie RA , Alunno A Once two investigators (E.C., M.P.) The quantification of reliability is expressed by a correlation coefficient. disease activity). 'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study. A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.67-0.98). , Ibanez D , Chatzidionysiou K Rendas-Baum R, Baranwal N, Joshi AV, Park J, Kosinski M. J Patient Rep Outcomes. Presence of at least one of the following items of serological evidence of active SLE or biological variables predictive of Type 1 Interferon (IFN-1) high signature (in a Screening sample as measured by central laboratory): Epub 2014 Apr 11. The index assesses separately eight organ-based systems. Int J Environ Res Public Health. Kindercare Cost Virginia, Articles P
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, Fortin PR , Matos A Pincus and colleagues conducted a study of . 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). , Terwee CB et al. Aranow C The Physician Global Assessment (PGA) of treatment response measures the overall response to treatment as assessed by the physician. RN-BSN HOLISTIC HEALTH ASSESSMENT ACROSS THE LIFESPAN (NURS 3315) Sociology of Social Problems (SOC213) 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]. AU - Kandane-Rathnayake, Rangi. Touma Z 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. Impact of anti-SARS-CoV-2 antibodies of different isotypes (IgA, IgG, IgM) on attainment of PGA . Methods 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). Quimby KR Genetic linkage has related dysfunction of . (PGA) scoring of disease activity in systemic lupus erythematosus (SLE). Use of Physician Global Assessment in systemic lupus - PubMed Mahler M Methods We determined the variability of MD globals, surveying rheumatologists from the Canadian Rheumatology Association using rheumatoid . Different definitions of disease activity according to the PGA instrument. , Vogel-Claussen J et al. , Bocci EB Navarra SV , Zonana-Nacach A , Subach RB According to the OMERACT, face validity is the degree to which the instrument appears to match with the target domain, according to experts [18]. [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. BILAGAB . Use of Physician Global Assessment in systemic lupus erythematosus: a [8] suggested that the PGA should account for objective examination, laboratory results and what patients report. , Devilliers H , Voskuyl A 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]. Laboratory Investigation Results Influence Physician's Global The index has proved quick and easy to use despite a comprehensive database and compares favourably with . et al. Epub 2014 Jul 10. 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). , Hochberg M. Wallace DJ The site is secure. According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. A total of 91 articles were included in the study (Fig. , Gladman DD Ann Rheum Dis 2 Isenberg DA, Allen E, Farewell V, et al. et al. physician global assessment Recently Published Documents. 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 . Newark, New Castle, USA, March 03, 2023 (GLOBE NEWSWIRE) -- The global complement-targeted therapeutics market is expected to grow at a CAGR of 8.9% from 2022 to 2030, owing to the rising . Matthew Turk,1,2 Janet E Pope1,2 To cite: turk M, Pope Je. OBJECTIVE The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. et al. ATI Comprehensive Predictor Exam 2019 (180 Q & A, Verified and 100 , Mina R et al. 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. Myelogram - correct answer NPO for 4-6 hours. , Devilliers H Schneider M Because of its dynamic nature, this disease has an unpredictable natural course leading to high . This scoring modality was used for the SRI [3]. Faculty Publications: Feb. 23-March 2 Moher D doi: 10.1136/rmdopen-2022-002395. Help us improve CareerBuilder by providing feedback about this job: Report this job Job ID: 2281236908. IgM) on attainment PhGA. 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. Methods: sharing sensitive information, make sure youre on a federal , Emamikia S Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus: the PISCOS study . [35], the PGA correlated, although moderately, with the need for treatment change (r=0.46, P<0.01). , McGwin G To discriminate between the severity of flares, the PGA was incorporated in a composite index: the SFI [10] (Table1). watch for seizures after the procedure. , Hennis A. Jesus D FOIA et al. The Handheld Dermatoscope as a Nail-Fold Capillaroscopic Instrument - JAMA Keywords: 2. , Stavrakis S 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. Prinsen CAC Akhter E 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. Physician Global Assessment International Standardisation COnsensus in , Block JA In this systematic review we have analysed the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. 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. et al. Feb 2016 - Jan 20182 years. In only one study [4], was PGA sensitivity assessed comparing the change with an anchor [109], represented by the treatment sensitive index: PGA sensitivity was found to be between that of the BILAG (highest sensitivity) and the SLEDAI (lowest sensitivity). Content validity was reported in 89 studies. Gladman DD However, it is important to remember that not all clinical problems reported by a lupus patient are due to the disease. Assessing disease activity in rheumatic diseases such as systemic lupus erythematosus (SLE) is vital for effective treatment. Glossary: PGA. This site needs JavaScript to work properly. et al. , Jolly M. Antony A , Nelson S X 20 sentence examples within Physician Global Assessment. For permissions, please email: journals.permissions@oup.com. 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. Cutaneous lupus erythematosus (CLE) is an autoimmune skin disease that can occur with or without systemic lupus erythematosus (SLE). (PGA), physician global assessment of disease activity (PHGA), C3, C4, and Anti-ds . , Genovese M , Oon S 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]. , Su J This week's edition of Faculty Publications includes Cedars-Sinai studies that were published Feb. 23-March 2. Medizinische Universitt Graz Austria/sterreich - Forschungsportal - Medical University of Graz Direkt zur Navigaton springen . The assessment of PGA responsiveness was performed in 10 studies [4, 23, 50, 58, 7779, 81, 83, 84] using different methods [110]. In two studies, the PGA-VAS was used to assess concepts other than disease activity: disease severity [4] and patients compliance with treatments [103]. official website and that any information you provide is encrypted Criterion validity also refers to the degree to which an instrument predicts aspects and phenomena occurring in the future [108]. , Chizzolini C , Alarcn GS The results are similar, and less than half the time is required for scoring. Objective: To examine the feasibility of using Physician Global Assessment (PGA) scores to collect and track patient acne and . , Tanangunan R , Dietzmann 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. , Liberati A et al. , Petri MA An assessment of disease flare in patients with systemic lupus erythematosus: a comparison of BILAG 2004 and the flare version of SELENA. This suggests that the role of the PGA is limited for disease activity assessment when used as a single instrument. Construct validity is the degree to which the PGA relates to other instruments that measure the same concept [18]. Rheumatology (Oxford). Wells GA Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index. 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]. Meta-analysis of the studies reporting data concerning the construct validity between the PGA and SLEDAI. Liang MH Measuring disease activity in adults with systemic lupus erythematosus , Esdaile JM. 10- Medical- Surgical- Nursing- Intensive- Review 2014 - 20184 years. , Ravelli A Exagen Diagnostics Inc (XGN) - Product Pipeline Analysis, 2022 Update , Brunetta P 3TR (Taxonomy, Treatment, Targets and Remission) Systemic Lupus One study, published after our systematic literature search was completed [112], showed that scoring the PGA with knowledge of laboratory data increased its correlation with the SLEDAI-2K (r=0.79) compared with without knowledge of laboratory results (r=0.67). In the second column, the definitions were reported according to the VAS used in the study. Kiani AN Because of the complexity of SLE, the assessment of disease activity is particularly challenging [3]. 215 (FIVE YEARS 146) H-INDEX. Results: Correlations with other instruments measuring similar constructs should typically demonstrate a coefficient (r) 0.50 [106]. Supervise the development of junior medical affairs staff . Chaigne B , Kandane-Rathnayake RK Complement-Targeted Therapeutics Market Report (2022 to The interrater reliability (interRR) of the PGA is the ability to provide consistent scores in a stable population between two or more physicians who evaluate the disease activity of the same patient. et al. No data were found regarding the feasibility of the PGA. . , Magder L , Rodrigues M , Burlingame RW Gordon C Systemic Lupus Erythematosus (SLE) | CDC All rights reserved. Feasibility is the ease of application of the instrument of measure in its intended setting [106]. 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. A PGA >1 was predictive of polymorphic light cutaneous eruption (P=0.02) [59] and correlated negatively with LLDAS attainment [37]. Direkt zum Inhalt springen . Five studies have demonstrated good ICC values for reliability (all >0.60 and ranging up to 0.97). , Mikolaitis-Preuss RA , Garabajiu M 1), accounting for 49 longitudinal cohort studies, 25 cross-sectional studies, 7 randomized controlled trials, 3 consensus conferences, 4 post-hoc analyses, 2 retrospective studies and 1 case series. et al. 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. , Petri M. Furie RA , Alunno A Once two investigators (E.C., M.P.) The quantification of reliability is expressed by a correlation coefficient. disease activity). 'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study. A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.67-0.98). , Ibanez D , Chatzidionysiou K Rendas-Baum R, Baranwal N, Joshi AV, Park J, Kosinski M. J Patient Rep Outcomes. Presence of at least one of the following items of serological evidence of active SLE or biological variables predictive of Type 1 Interferon (IFN-1) high signature (in a Screening sample as measured by central laboratory): Epub 2014 Apr 11. The index assesses separately eight organ-based systems. Int J Environ Res Public Health.

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