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Table 3 Sensitivity of PGA to change in disease activity and comparison with other measures of disease

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

Study group Study details Main findings
Kaneko et al. 2014 [46] Prospective study
Newly diagnosed RA
75 patients
Discordance between PGA and EGA
PGA more sensitive for indicating progressive joint destruction and functional impairment when compared with EGA
Discrepancy directed toward a worse assessment by patients
Pope et al. 2009 [52] Prospective study of a large clinical practice
225 RA patients
MID estimates for: (1) HAQ-DI improvement and worsening using PGA anchor; and (2) pain using a patient-reported pain anchor.
MID scores for HAQ-DI in clinical practice were smaller than those seen in clinical trials
MID scores were influenced by baseline HRQOL scores and may be influenced by disease duration
MID changes were different for worsening (usually needing a larger value) than for improving
MID for deterioration was much less than for improvement in patients with more pain and impairment in physical function
Wells et al. 2008 [31] Randomized controlled trial comparing abatacept (n = 258) with placebo (n = 133) in anti-TNF poor respondents (ATTAIN study)
Evaluation of the responsiveness of PROs in RA patients
PGA had larger relative percentage improvement with treatment (24 %) than the generic quality of life outcomes SF-36 domains and component scores (range 8–21 %)
PGA was more efficient than TJC in detecting a treatment effect
PGA was found to be in close proximity to the ESR, physician global assessment and the PROs pain assessment, HAQ, bodily pain and physical component score in terms of the standardized response means
Lassere et al. 2001 [53] Literature review on reliability for different classes of RA measures The SDD for the PGA (as well as for SJC, TJC, and pain) was found to be large and it had poor reliability compared to multi-item measures of physical and psychological function and radiologic measures
Ward 1994 [54] Prospective study
24 RA patients
Determination of the relative accuracy and sensitivity to change of 14 measures commonly used to assess arthritis activity
High correlation between EGA, PGA, and pain scores
The PGA along with other measures of disease severity have been shown to be more sensitive to change than laboratory measures (ESR)
  1. EGA estimator global assessment, ESR erythrocyte sedimentation rate, HAQ-DI Health Assessment Questionnaire-Disability Index, HRQOL Health Related Quality of Life, MID minimally important difference, PGA patient global assessment, SDD smallest detectable difference, SF-36 36-item Short Form Health Survey, SJC swollen joint count, TJC tender joint count, TNF tumor necrosis factor