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Table 2 Major strengths and weaknesses of PGA in RA

From: Patient global assessment in measuring disease activity in rheumatoid arthritis: a review of the literature

Strengths Weaknesses
Practical and feasible to collect: much more easily collected than joint counts, acute phase reactants, or radiographic damage (simple, single-item tool) Heterogeneity in concept (i.e., global health versus disease activity) and attribution to RA or other co-existing health conditions and wording/phrasing, all leading to possible heterogeneity in the responses
No cost, non-invasive and self-administered Heterogeneous phrasing of the time-frame (today, last week, etc.) applied to PGA
May summarize all aspects of disease important to the patient (face validity) Very broad concept leading to interpretation difficulties
Practical and feasible to interpret: easy to score, incorporate in composite scores, and analyze Difficulties of interpretation due to uncertainty regarding attribution to permanent damage related to RA compared to inflammation and disease activity
Good test–retest reliability Difficulties of interpretation due to uncertainty regarding attribution to RA versus non-RA disease, including psychological distress and comorbidities
Good sensitivity to change in clinical trials May be influenced by patient education level
Discordance between PGA and physician assessment: brings in additional information Discordance between PGA and physician assessment: what impact on decision making?