Implementation of the Lupus Low Disease Activity State in Pediatric Rheumatology Care: The Role of the Visual Analog Scale
Objective We compared the measurement properties of a traditional physician global assessment of disease activity (PhGA) 10‐cm visual analog scale (PhGA0–10) with that of the three‐point numeric scale (PhGA0–3) in childhood‐onset systemic lupus erythematosus (cSLE) as part of the childhood Lupus Low...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | ACR Open Rheumatology |
| Online Access: | https://doi.org/10.1002/acr2.11737 |
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| author | Ekemini A. Ogbu Anna Carmela P. Sagcal‐Gironella B. Anne Eberhard Jennifer M. Huggins Marisa S. Klein‐Gitelman Karen Onel Chen Chen Bin Huang Hermine I. Brunner |
| author_facet | Ekemini A. Ogbu Anna Carmela P. Sagcal‐Gironella B. Anne Eberhard Jennifer M. Huggins Marisa S. Klein‐Gitelman Karen Onel Chen Chen Bin Huang Hermine I. Brunner |
| author_sort | Ekemini A. Ogbu |
| collection | DOAJ |
| description | Objective We compared the measurement properties of a traditional physician global assessment of disease activity (PhGA) 10‐cm visual analog scale (PhGA0–10) with that of the three‐point numeric scale (PhGA0–3) in childhood‐onset systemic lupus erythematosus (cSLE) as part of the childhood Lupus Low Disease Activity State (cLLDAS). Methods We used a secondary data analysis from a convenience sample of 100 patients with cSLE followed every three months for up to seven visits. Ratings of PhGA0–10, PhGA0–3, parent assessment of patient well‐being (ParGA) (range: 0= very poorly, 10 = very well), disease activity as measured by the SLE disease activity index 2000 (SLEDAI‐2k), Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) SLEDAI, and the British Isles International Lupus Activity Group index (BILAG; A = 9, B = 3, C = 1, D/E = 0) were compared. After linear transformation of PhGA0–10 to a 0 to 3 range (tPhGA0–10), the frequency of PhGA0–3 ≤1 was assessed to estimate the impact of scale type on the scoring of the cLLDAS. Results In 600 visits, the median (range) scores of PhGA0–10, PhGA0–3, SLEDAI‐2k, SELENA‐SLEDAI, and BILAG were 2 (0–10), 1(0–3), 4 (0–28), 4 (0–32), and 2 (0–28), respectively. PhGA0–10 and PhGA0–3 ratings were strong to moderately correlated with (r = 0.73; P < 0.0001) and with more variability for PhGA0–3 ≥2. SELENA‐SLEDAI and SLEDAI‐2k scores were moderately correlated with PhGA0–10 (r = 0.56/0.54; P < 0.0001). ParGA values were weakly correlated with all other measures considered (all r = −0.19 to −0.34). There were 490 of 600 visits with PhGA0−3 ≤1 and 497 of 600 visits with tPhGA0−10 ≤1 (κ (SE) =0.59 (0.04), McNemar P = 0.4). Conclusion PhGA0–3 and PhGA0–10 have comparable measurement properties and yield almost identical cLLDAS rates when used in cSLE. |
| format | Article |
| id | doaj-art-66e5d060a6da4c19aebf08d8ea5842c7 |
| institution | Kabale University |
| issn | 2578-5745 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| series | ACR Open Rheumatology |
| spelling | doaj-art-66e5d060a6da4c19aebf08d8ea5842c72025-02-04T06:21:23ZengWileyACR Open Rheumatology2578-57452025-01-0171n/an/a10.1002/acr2.11737Implementation of the Lupus Low Disease Activity State in Pediatric Rheumatology Care: The Role of the Visual Analog ScaleEkemini A. Ogbu0Anna Carmela P. Sagcal‐Gironella1B. Anne Eberhard2Jennifer M. Huggins3Marisa S. Klein‐Gitelman4Karen Onel5Chen Chen6Bin Huang7Hermine I. Brunner8Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio, and Johns Hopkins University Baltimore MarylandHackensack Meridian School of Medicine Nutley New JerseyCohen Children's Medical Center Northwell, New Hyde Park New YorkCincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine Cincinnati OhioAnn & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine Chicago IllinoisHospital for Special Surgery, Weill Cornell Medicine New York New YorkCincinnati Children's Hospital Medical Center Cincinnati OhioCincinnati Children's Hospital Medical Center Cincinnati OhioCincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine Cincinnati OhioObjective We compared the measurement properties of a traditional physician global assessment of disease activity (PhGA) 10‐cm visual analog scale (PhGA0–10) with that of the three‐point numeric scale (PhGA0–3) in childhood‐onset systemic lupus erythematosus (cSLE) as part of the childhood Lupus Low Disease Activity State (cLLDAS). Methods We used a secondary data analysis from a convenience sample of 100 patients with cSLE followed every three months for up to seven visits. Ratings of PhGA0–10, PhGA0–3, parent assessment of patient well‐being (ParGA) (range: 0= very poorly, 10 = very well), disease activity as measured by the SLE disease activity index 2000 (SLEDAI‐2k), Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA) SLEDAI, and the British Isles International Lupus Activity Group index (BILAG; A = 9, B = 3, C = 1, D/E = 0) were compared. After linear transformation of PhGA0–10 to a 0 to 3 range (tPhGA0–10), the frequency of PhGA0–3 ≤1 was assessed to estimate the impact of scale type on the scoring of the cLLDAS. Results In 600 visits, the median (range) scores of PhGA0–10, PhGA0–3, SLEDAI‐2k, SELENA‐SLEDAI, and BILAG were 2 (0–10), 1(0–3), 4 (0–28), 4 (0–32), and 2 (0–28), respectively. PhGA0–10 and PhGA0–3 ratings were strong to moderately correlated with (r = 0.73; P < 0.0001) and with more variability for PhGA0–3 ≥2. SELENA‐SLEDAI and SLEDAI‐2k scores were moderately correlated with PhGA0–10 (r = 0.56/0.54; P < 0.0001). ParGA values were weakly correlated with all other measures considered (all r = −0.19 to −0.34). There were 490 of 600 visits with PhGA0−3 ≤1 and 497 of 600 visits with tPhGA0−10 ≤1 (κ (SE) =0.59 (0.04), McNemar P = 0.4). Conclusion PhGA0–3 and PhGA0–10 have comparable measurement properties and yield almost identical cLLDAS rates when used in cSLE.https://doi.org/10.1002/acr2.11737 |
| spellingShingle | Ekemini A. Ogbu Anna Carmela P. Sagcal‐Gironella B. Anne Eberhard Jennifer M. Huggins Marisa S. Klein‐Gitelman Karen Onel Chen Chen Bin Huang Hermine I. Brunner Implementation of the Lupus Low Disease Activity State in Pediatric Rheumatology Care: The Role of the Visual Analog Scale ACR Open Rheumatology |
| title | Implementation of the Lupus Low Disease Activity State in Pediatric Rheumatology Care: The Role of the Visual Analog Scale |
| title_full | Implementation of the Lupus Low Disease Activity State in Pediatric Rheumatology Care: The Role of the Visual Analog Scale |
| title_fullStr | Implementation of the Lupus Low Disease Activity State in Pediatric Rheumatology Care: The Role of the Visual Analog Scale |
| title_full_unstemmed | Implementation of the Lupus Low Disease Activity State in Pediatric Rheumatology Care: The Role of the Visual Analog Scale |
| title_short | Implementation of the Lupus Low Disease Activity State in Pediatric Rheumatology Care: The Role of the Visual Analog Scale |
| title_sort | implementation of the lupus low disease activity state in pediatric rheumatology care the role of the visual analog scale |
| url | https://doi.org/10.1002/acr2.11737 |
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