physician global assessment sle

Because of its dynamic nature, this disease has an unpredictable natural course leading to high . 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. Because of the complexity of SLE, the assessment of disease activity is particularly challenging [3]. Changes in the PGA correlated with changes of other disease activity indices (SLEDAI, SLAM, LAI, patient global assessment), laboratory exams (ESR), patient-reported outcomes (Lupus Impact Tracker) [23, 50, 58, 77, 78, 81, 83] and response to treatment [4]. , Karp DR 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). The Physician's Global Assessment (PhGA) is a number without unit. et al. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. 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. 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). AU - Morand, Eric. 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. , Sengupta M Visual analogue scales (VAS) allow rapid, continuous scaling of disease severity. Parodis I 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). Reliability. LECTURE 10: MEDICAL SURGICAL NURSING. Int J Environ Res Public Health. , Weisman MH. This suggests that the role of the PGA is limited for disease activity assessment when used as a single instrument. , Kalunian K 2014 - 20184 years. et al. Montreal, Canada Area. Wells GA , Magder LS 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. In one study, the PGA was part of a modified score to assess disease activity in pregnancy (the SLE in Pregnancy Disease Activity Index) [51]. 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. Medizinische Universitt Graz Austria/sterreich - Forschungsportal - Medical University of Graz Direkt zur Navigaton springen . , Allen E Kiani AN Chaigne B The Physician Global Assessment (PGA) is a frequently used co-primary end point in psoriasis clinical trials. Please check for further notifications by email. The aim of this systematic literature review is to describe and analyse the . , Kiani AN The Physician Global Assessment (PGA) is an important tool for assessing disease activity in lupus. Conclusion: SELENA SLEDAI4. Management of systemic lupus erythematosus (SLE) often depends on disease severity and disease manifestations, [] although hydroxychloroquine has a central role for long-term treatment in all SLE patients. Liang MH Methods We determined the variability of MD globals, surveying rheumatologists from the Canadian Rheumatology Association using rheumatoid . Enocsson H et al. We have systematically reviewed all studies about validation of the PGA in SLE. et al. Published by Oxford University Press on behalf of the British Society for Rheumatology. HHS Vulnerability Disclosure, Help , Nelson S , Petri MA , Giangreco D et al. Deconstruction of the safety of estrogen in lupus erythematosus national assessment-systemic lupus erythematosus disease activity index flare index. 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). 12. and later incorporated into the SLE Responder Index used in the belimumab clinical trials, 13 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. , Mohan C. Jolly M Before , Criscione-Schreiber LG Results. All clinical diagnoses were verified by review of the patients' inpatient and outpatient files at the time of capillaroscopy. , Kraag GR http://oml.eular.org/glossary (31 January. Matthew Turk,1,2 Janet E Pope1,2 To cite: turk M, Pope Je. 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 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]). 1 2. Accessibility , Altman DG , Block JA Responsiveness. 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 . 2022 Sep 20;19(19):11895. doi: 10.3390/ijerph191911895. , Patrick DL , Ding HH Psychometric properties data were analysed according to the OMERACT Filter methodology version 2.1. 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. 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]. Would you like email updates of new search results? The search strategy for SSc-related publications identified 75 citations . X 20 sentence examples within Physician Global Assessment. In the second column, the definitions were reported according to the VAS used in the study. Annapureddy N , Urowitz MB According to the authors, this difference was probably due to the greater familiarity of the physicians with the BILAG-2004 index. , Smiley A. Askanase AD Touma Z allergy hx phenothiazines, cns depressants and stimulants withheld 48 hours prior. AU - Kasitanon, Nuntana. It operates in Albuquerque, and New Mexico. The correlation with the SLEDAI was determined in 12 studies (Fig. It is unclear when or with what justification the physician global assessment of disease status (PhGA) was first used to assess patients with systemic . Bookshelf This scoring modality was used for the SRI [3]. CLOSED ANGLE/ ANGLE CLOSURE GLAUCOMA. Rheumatology (Oxford). 'Not at target': prevalence and consequences of inadequate disease control in systemic lupus erythematosus-a multinational observational cohort study. Once two investigators (E.C., M.P.) 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. Laboratory investigation results influence Physicians Global ssessment (PGA) of disease activity in SLE. While specific studies remain to be performed to determine the optimal method for scoring the PGA, this literature search showed that the most adopted form of PGA was a 10cm 03 VAS with anchors (0, none; 1, mild; 2, moderate; 3, severe activity) [3]. 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. 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]. T1 - Associations between physicians' global assessment of disease activity and patient-reported outcomes in patients with systemic lupus erythematosus. , McGuire JL. For permissions, please email: journals.permissions@oup.com. et al. In this systematic review we have analysed the measurement properties of the PGA, including the validity, reliability, responsiveness and feasibility. et al. , Petri M. Thanou A , Perneger T , Pego-Reigosa J-M BICLA responders had fewer lupus-related serious . , Sjwall C. Strand V Systemic lupus erythematosus (SLE), is the most common type of lupus. (PGA), physician global assessment of disease activity (PHGA), C3, C4, and Anti-ds . , Mazur M. Fatemi A , Fortin PR 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]. , Longenecker JC sharing sensitive information, make sure youre on a federal (PGA) scoring of disease activity in systemic lupus erythematosus (SLE). Objective Existing methods for grading lupus flares or improvement require definition-based thresholds as increments of change. , Alunno A COSMIN Terminology from a European Rheumatology Perspective: a Glossary for the EULAR PRO Tool Box Initiative. inflammation (duration and severity of morning stiffness as measured by BASDAI). Physician Global Assessment (PGA) is a visual analogue score (VAS) that reflects the clinician's judgment of overall Systemic Lupus Erythematosus (SLE) disease activity. , Adamichou C , Gallacher AE 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]. Jesus D MeSH . , Su J Provide oversight to Shared Services Derivatives team supporting RWA operations and production. , Schirmbeck LA 2014 Dec;53(12):2175-81. doi: 10.1093/rheumatology/keu153. , Voskuyl A This property is reported across all articles selected through this systematic review [24, 913, 21103]. , Navarra SV 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. Thanou A Improving patient pathways for systemic lupus erythematosus: a multistakeholder pathway optimisation study. Gladman DD Introduction Physician global assessments of disease activity (medical doctor (MD) globals) are important outcomes. 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. , Kostopoulou M In two studies, the PGA-VAS was used to assess concepts other than disease activity: disease severity [4] and patients compliance with treatments [103]. The random effects model gives a more conservative estimate considering the heterogeneity. Learn more. For permissions, please email: journals.permissions@oup.com, This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (. Quimby KR Flow chart illustrating the literature search and study selection. Objective: The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. 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. This enabled the PGA to be considered the gold standard in several studies [2, 10, 11, 21, 23, 49, 67, 76, 78, 84, 88]. et al. 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 . , Engle E , Sayedbonakdar Z Prinsen CAC , Taghavi-Zadeh S Different definitions of disease activity according to the PGA instrument. Criterion validity also refers to the degree to which an instrument predicts aspects and phenomena occurring in the future [108]. The SRI is a validated SLE disease activity instrument used to detect clinically meaningful improvement of disease in SLE clinical trials. Oxford Textbook of. 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. , Jolly M. Mazur-Nicorici L , Ogale S et al. Content validity was reported in 89 studies. Thus the development of a comprehensive index for assessing disease activity still represents one of the most important challenges in SLE [7]. , ODell JR It was published in 1977 and was initially designed for the measurement of self-assessed pain in rheumatoid arthritis although it has since been used to evaluate RA more globally. [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. All articles published through 1 July 2019 in PubMed were screened, with no limitation on year of publication, language or patients age. Petri M The site is secure. The literature search identified 93 articles, and 12 additional articles were retrieved from the reference list of those publications. SLE3. , Askanase A doi: 10.1136/lupus-2022-000700. Observed and articulated management issues and responses. et al. Assessing disease activity in rheumatic diseases such as systemic lupus erythematosus (SLE) is vital for effective treatment. , Henriques C Systemic lupus erythematosus (SLE) is a multisystem autoimmune rheumatic disease (ARD) characterized by flares and remissions. Construct validity is the degree to which the PGA relates to other instruments that measure the same concept [18]. , Lau CS , Petri M , Alarcn GS 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. 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]. RN-BSN HOLISTIC HEALTH ASSESSMENT ACROSS THE LIFESPAN (NURS 3315) Sociology of Social Problems (SOC213) et al. Methods: 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). This button displays the currently selected search type. 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. , Shea BJ Physician Global Assessment International Standardisation COnsensus in Systemic Lupus Erythematosus: the PISCOS study . At least 1 issue from each virtual tour. Unauthorized use of these marks is strictly prohibited. . A high variability in scales was found, causing a wide range of reliability (intraclass correlation coefficient 0.670.98). Methods This SLR was conducted by two independent reviewers in accordance with the PRISMA statement. , Seaman AL A good correlation was considered for a value >0.60. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. , Terwee CB Despite the need for new treatments in CLE . Direkt zum Inhalt springen . According to the OMERACT, face validity is the degree to which the instrument appears to match with the target domain, according to experts [18]. 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. SLE or at an SLE site, but only if the injury requires treatment by a licensed medical doctor. Oxford University Press is a department of the University of Oxford. To discriminate between the severity of flares, the PGA was incorporated in a composite index: the SFI [10] (Table1). , Gladman DD. Thank you for submitting a comment on this article. The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinicians judgement of overall SLE disease activity. et al. , Shinada S , Chatzidionysiou K Schneider M et al. , Bouter LM A good responsiveness for PGA was shown in eight studies. Please enable it to take advantage of the complete set of features! , Lin M , Bentow C The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Eudy AM Finally, the PGA enables the measurement of disease activity globally compared with a glossary-based index. MD globals may vary based on their age, gender, practice setting and experience (number of patients seen per year and years in practice). , Birmingham DJ 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 Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. In the absence of a consensus, Aranow [26] found a better correlation between the SLEDAI and the PGA when the latter was assessed taking into account laboratory test results. Liang 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. , Arora S 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]. et al. official website and that any information you provide is encrypted . Myelogram - correct answer NPO for 4-6 hours. Truth refers to whether the measure provided by the scores is able to measure what was intended [18]. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. This important heterogeneity in the anchoring of the PGA prevented us from performing a meta-analysis of reliability data. 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. Epub 2014 Jul 10. Touma Z , Mohan C. Giangreco D It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. , Aggarwal R An official website of the United States government. doi: 10.1136/rmdopen-2022-002395. Careers. OBJECTIVE The Physician Global Assessment (PGA) is a visual analogue score that reflects the clinician's judgement of overall SLE disease activity. , Leung HW 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]. , Engleman EG 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 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. The assessment of PGA responsiveness was performed in 10 studies [4, 23, 50, 58, 7779, 81, 83, 84] using different methods [110]. , Petri MA Mok CC et al. The results are similar, and less than half the time is required for scoring. Kandane-Rathnayake R, Louthrenoo W, Hoi A, Luo SF, Wu YJ, Chen YH, Cho J, Lateef A, Hamijoyo L, Navarra SV, Zamora L, Sockalingam S, An Y, Li Z, Katsumata Y, Harigai M, Hao Y, Zhang Z, Kikuchi J, Takeuchi T, Basnayake BMDB, Chan M, Ng KPL, Tugnet N, Kumar S, Oon S, Goldblatt F, O'Neill S, Gibson KA, Ohkubo N, Tanaka Y, Bae SC, Lau CS, Nikpour M, Golder V, Morand EF; Asia-Pacific Lupus Collaboration. Brunner HI The responsiveness of the PGA was assessed through different methods [109, 113] showing a high sensitivity for detecting clinical variations [84]. 2022 May;9(1):e000700. 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. Your comment will be reviewed and published at the journal's discretion. et al. A total of 91 articles were included in the study (Fig. Some may be a consequence of therapy and others may be . (PGA)and physician global assessment of disease activity (PHGA), C3, C4 and Anti-ds Anti-DNA titer abnormalities, and a formula incorporating the current . The pooled correlation coefficient (95% CI) is given both for the fixed effects model and the random effects model. , Emamikia S However, it is important to remember that not all clinical problems reported by a lupus patient are due to the disease. , Garabajiu M Moreover, there is uncertainty as to whether the best timing of assessment is prior to or after reviewing laboratory exams [26]. Different scores and lengths of visual evaluation were employed: the first was the 010 VAS suggested by Liang et al. A new tool -- the Lupus Activity Scoring Tool (LAST) - has been proposed to join the ranks of current disease activity indices. The Author(s) 2020. Can Lupus Patients Take the Driver's Seat in Their Disease Monitoring. Navarra SV 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). , Socher SA , Rodrigues M et al. 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. et al. FOIA This may be explored through convergent and divergent validity. The aim of this systematic literature review is to describe and analyse the psychometric properties of the PGA. PGA is a simple instrument and the result is easily understood. , Perez-Gutthann S All rights reserved. , James JA Devilliers H , Clowse M. Moorthy LN , Magder L Clinical composite measures of disease activity and damage used to evaluate patients with systemic lupus erythematosus: A systematic literature review. Sullivan KE 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). , Chan KL et al. Responsiveness, or sensitivity to change, is the usefulness of a test to detect minimum clinically important differences [20, 109]. 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). 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. The assessment of disease activity in SLE is particularly challenging. , McGwin G Each study was examined in order to extract psychometric property data on the PGA according to the OMERACT Filter methodology version 2.1 [18]. , Devilliers H Merrill JT 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. AU - Kandane-Rathnayake, Rangi. 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. Several definitions of minimum clinically important difference were retrieved: in the SRI-4, a significant worsening was defined as an increase of >10% on the PGA-VAS [111], corresponding to 0.3 points from baseline; Touma et al.