Table 5 Discordance between PGA and estimator global assessment and associated factors
Study group | Study description | Patient number (n) | Discordance between PGA and EGA | Factors associated with discordance |
|---|---|---|---|---|
Desthieux et al. 2016 [55] | Systematic literature review and meta-analysis | 11,879 (12 studies) | Frequency of discordance >2.7 cm (weighted mean cutoff): 44.9 % PGA > EGA: 79.1 % PGA < EGA: 20.9 % | Drivers of global assessment: PGA: pain (the most frequent driver of PGA, significant in eight studies [100 % of studies analyzing this driver of PGA]), functional incapacity, fatigue EGA: swollen and tender joint counts, acute phase reactants Drivers of discordance: Depressive symptoms, health literacy |
Davis et al. 2014 [56] | Consecutive RA patients | 127 | Frequency of discordance: PGA > EGA: 16.5 % PGA < EGA: 10.2 % | PGA > EGA: pain, fatigue, HAQ disability, poor health related quality of life on the SF-36 PGA < EGA: higher numbers of swollen joints, positive rheumatoid factor and lower pain; better overall physical and mental health |
Khan et al. 2012 [13] | Patients from the multi-national Quantitative Standard Monitoring of Patients with RA (QUEST-RA) database | 7028 | Mean PGA 4.0 ± 2.7 cm; EGA 2.9 ± 2.4 cm Frequency of discordance >2 cm: PGA > EGA: 30 % PGA < EGA: 6.6 % | PGA > EGA: higher age; higher scores of pain, fatigue, HAQ, and morning stiffness PGA < EGA: higher SJC, TJC, ESR; lower fatigue score |
Barton et al. 2010 [48] | Multi-site observational cohort with RA adults consecutively enrolled from two outpatient clinics in the US | 223 | Mean PGA 4.3 ± 2.6 cm; EGA 3.1 ± 2.1 cm Frequency of discordance >2.5 cm: PGA > EGA: 31 % PGA < EGA: 5 % | PGA > EGA: higher HAQ score; lower SJC; greater depressive symptoms |
Nicolau G et al. 2004 [43] | Single center cohort of RA patients in Brazil | 80 | Frequency of discordance ≥1 cm: PGA > EGA: 44 % PGA < EGA: 28 % Frequency of discordance ≥3 cm PGA > EGA: 24 % PGA < EGA: 9 % | PGA > EGA: higher pain and HAQ scores and tendency for higher number of comorbid conditions |
Studenic et al. [42] | Single center observational cohort of RA patients initiating MTX in Austria | 646 | Mean PGA 3.9 ± 2.7 cm; EGA 2.3 ± 2.1 cm Frequency of discordance ≥0.5 cm: PGA > EGA: 61 % PGA < EGA: 15 % | PGA > EGA: higher pain and lower SJC |