title: Patient global assessment in measuring disease activity in rheumatoid arthritis: a review of the literature.
abstract: Patient-reported outcomes (PROs) reflect the patient's perspective and are used in rheumatoid arthritis (RA) routine clinical practice. 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 often assessed by a single question with a 0-10 or 0-100 response. The content can vary and relates either to global health (e.g., how is your health overall) or to disease activity (e.g., how active is your arthritis). The wordings used as anchors, i.e., for the score of 0, 10, or 100 according to the scale used, and the timing (i.e., this day or this week) also vary. The different possible ways of measuring PGA translate into variations in its interpretation and reporting and may impact on measures of disease activity and consequently achievement of treat-to-target goals. Furthermore, although PGA is associated with objective measures of disease activity, it is also associated with other aspects of health, such as psychological distress or comorbidities, which leads to situations of discordance between objective RA assessments and PGA. Focusing on the role of PGA, its use and interpretation in RA, this review explores its validity and correlations with other disease measures and its overall value for research and routine clinical practice.
authors: Department of Rheumatology, Whittington Hospital NHS Trust, London, UK. enikiphorou@gmail.com.
authors: Elena
authors: 0000-0001-6847-3726
authors: E
authors: Nikiphorou
authors: Medical University Vienna, Vienna, Austria.
authors: Helga
authors: H
authors: Radner
authors: Rheumatology Department, Karolinska University Hospital and Department of Medicine, Karolinska Institute, Stockholm, Sweden.|Sorbonne Universités, UPMC University Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS); AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France.
authors: Katerina
authors: K
authors: Chatzidionysiou
authors: Sorbonne Universités, UPMC University Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France.|Department of Patient & Care, Department of Rheumatology, Maastricht, the Netherlands.
authors: Carole
authors: C
authors: Desthieux
authors: Romanian League against Rheumatism, Bucharest, Romania.
authors: Codruta
authors: C
authors: Zabalan
authors: Department of Patient & Care, Maastricht, The Netherlands.|Department of Rheumatology, Maastricht, The Netherlands.
authors: Yvonne
authors: Y
authors: van Eijk-Hustings
authors: Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
authors: William G
authors: WG
authors: Dixon
authors: NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, and Manchester Academic Health Science Centre, Manchester, UK.
authors: Kimme L
authors: KL
authors: Hyrich
authors: Rheumatology Department, Karolinska University Hospital and Department of Medicine, Karolinska Institute, Stockholm, Sweden.|Sorbonne Universités, UPMC University Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS); AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, Paris, France.
authors: Johan
authors: J
authors: Askling
authors: Sorbonne Universités, UPMC University Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France.|Department of Patient & Care, Department of Rheumatology, Maastricht, the Netherlands.
authors: Laure
authors: L
authors: Gossec
mesh_terms: D001172:Arthritis, Rheumatoid; D004185:Disability Evaluation; D006801:Humans; D011594:Psychometrics / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results; D057566:Self Report; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Discordance; Patient global assessment; Rheumatoid arthritis