| Name of the Instrument/Tool | Patient global assessment (PGA) | |
| First Description |
|
|
| Year | 1977 |
| Domains | |
| Concept of constructs | Global assessment |
| Population/Disease | Generic |
| Originally developed for | Rheumatoid Arthritis (RA) |
| Other rheumatic diseases where can be applied (only if validated) |
Gout, Psoriatic Arthritis (PsA), Low Back Pain (LBP), Osteoarthritis (OA), Systemic Lupus Erythematosus (SLE), Ankylosing spondylitis (AS), ANCA-associated vasculitis (AAV), Idiopathic Inflammatory Myopathies (IIM) |
| Additional population with no rheumatic diseases |
No |
| Language: Originally published in | English |
| Available in Language | English |
| REFERENCE IDENTIFICATION | |
| Author/s | Scott PJ, Huskisson EC |
| Title | Measurement of functional capacity with visual analogue scales. |
| Journal | Rheumatol Rehabil |
| Year | 1977 |
| Vol | 16 |
| Num | --- |
| Pages | 257–9. |
| Country | UK |
| Language | English |
| Other references of interest | |
| Link | http://www.ncbi.nlm.nih.gov/pubmed/18375533 |
| Brief Description |
Systematic literature review of 109 reports, (45% randomised controlled trials) assessing 63 questionnaires or tools for PROs corresponding to 14 domains of health. Frequently reported domains (and most frequent tools) were: function, 83% (most frequent tool, health assessment questionnaire, HAQ); patient global assessment, 61% (most frequent tool, visual analogue scale, VAS); pain, 56% (VAS); and morning stiffness 27%. This review revealed that PROs are reported with great heterogeneity in RA studies with some domains that are important from the patient’s perspective being infrequently reported. |
| Link | http://www.ncbi.nlm.nih.gov/pubmed/22588741 |
| Brief Description |
A report of selected disease activity measurement instruments in rheumatoid arthritis based on expert panel recommendations for use in the clinical setting and for research. The report includes a description of the instruments along with practical application, a discussion of psychometric properties and a critical appraisal of their overall value to the rheumatology community. |
| Link | http://www.ncbi.nlm.nih.gov/pubmed/23378146 |
| Brief Description |
This study assessed a self-administered questionnaire containing five versions of the 100 mm PG-VAS in 50 patients with RA on biologics. All PG-VAS versions correlated strongly with each other. However, individual scores for each PGA-VAS, had wide limits of agreement and the different phrasing resulted in different DAS28 results (largest difference in DAS28 scores = 0.63). The study highlighted the need for standardizing and validating the PGA. Since DAS28 is a key outcome measure and itself a major influence of clinical decisions relating to eligibility for biologic agents and evaluation of new therapies, such differences stemming from heterogeneity in the phrasing of the PGA need to be eliminated |
| Instrument/Tool Translations References | |
| No other References. | |
| DEVELOPER CONTACT INFORMATION | |
| Correspondence to | no formal development of this tool |
| --- | |
| Address | --- |
| Website | --- |
| Available | --- |
| Links | --- |
| DESCRIPTION OF THE INSTRUMENT | |
| Type Of Measure | VAS, NRS |
| Brief Description |
The Patient Global Assessment is a one sentence numerical or visual rating scale which assesses global opinion. There exist different formulations and those can be adjusted for every disease. The difference lays in whether the global assessment uses the word 'global health' or 'disease activity'.
For more information, refer to Nikiphorou et al., AR&T 2016 |
| Number of Items | 1 |
| Range | 0-10 or 0-100 |
| Responses options/scale |
Yes none (no free text) |
| Developed for | Both |
| PRACTICAL APPLICATION | |
| Method of administration | Online, Self-administered |
| Recommendations to score |
If no numbered scale used, using a ruler, the distance in mm from the left border of the VAS to the point where the patient marked their response on the line, is measured. VAS consisting of circles can be scored by visual inspection without the need for a ruler. |
| Score Interpretation | The level of disease activity increases with increasing score i.e. higher score implies worse disease activity. |
| Cut-off points | Define: 0-100 mm or 0-10cm or very well – very poorly or inactive – very active. Values below 4/10 usually considered low/aceptable |
| Cut-off points applied to | Both |
| Smallest detectable change if described | 26.2 mm Reference link: Uhlig et al., Ann Rheum Dis 2009;68:972-975 |
| Smallest detectable change applied to | Not specified |
| Completion time by the patient | <1 minutes |
| Scoring time by the assessor | <1 minutes |
| Training to score | Not necessary |
| Strengths | Widely used, Easy to use, Useful in clinical practice & research |
| Limitations | --- |
| OTHER COMMENTS | |
| Other Comments |
PGA is widely used, is part of DAS28 in rheumartoid arthritis and is available in many languages but other languages than English have not been published per se and thus are not made available here. For further information on measurement properties, please refer to: Nikiphorou E, et al. Patient global assessment in measuring disease activity in rheumatoid arthritis: a review of the literature. Arthritis Res Ther. 2016;18(1):251. Published 2016 Oct 28. doi:10.1186/s13075-016-1151-6 |