Miloslavsky, EM;
Naden, RP;
Bijlsma, JW;
Brogan, PA;
Brown, ES;
Brunetta, P;
Buttgereit, F;
... Stone, JH; + view all
(2017)
Development of a Glucocorticoid Toxicity Index (GTI) using multicriteria decision analysis.
Annals of the Rheumatic Diseases
, 76
pp. 543-546.
10.1136/annrheumdis-2016-210002.
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Abstract
OBJECTIVES: To develop a Glucocorticoid Toxicity Index (GTI) to assess glucocorticoid (GC)-related morbidity and GC-sparing ability of other therapies. METHODS: Nineteen experts on GC use and outcome measures from 11 subspecialties participated. Ten experts were from the USA; nine from Canada, Europe or Australia. Group consensus methods and multicriteria decision analysis (MCDA) were used. A Composite GTI and Specific List comprise the overall GTI. The Composite GTI reflects toxicity likely to change during a clinical trial. The Composite GTI toxicities occur commonly, vary with GC exposure, and are weighted and scored. Relative weights for items in the Composite GTI were derived by group consensus and MCDA. The Specific List is designed to capture GC toxicity not included in the Composite GTI. The Composite GTI was evaluated by application to paper cases by the investigators and an external group of 17 subspecialists. RESULTS: Thirty-one toxicity items were included in the Composite GTI and 23 in the Specific List. Composite GTI evaluation showed high inter-rater agreement (investigators κ 0.88, external raters κ 0.90). To assess the degree to which the Composite GTI corresponds to expert clinical judgement, participants ranked 15 cases by clinical judgement in order of highest to lowest GC toxicity. Expert rankings were then compared with case ranking by the Composite GTI, yielding excellent agreement (investigators weighted κ 0.87, external raters weighted κ 0.77). CONCLUSIONS: We describe the development and initial evaluation of a comprehensive instrument for the assessment of GC toxicity.
| Type: | Article |
|---|---|
| Title: | Development of a Glucocorticoid Toxicity Index (GTI) using multicriteria decision analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/annrheumdis-2016-210002 |
| Publisher version: | http://dx.doi.org/10.1136/annrheumdis-2016-210002 |
| Language: | English |
| Additional information: | Copyright © 2016 The authors. Produced by BMJ Publishing Group Ltd and European League Against Rheumatism (EULAR) under licence. All rights reserved. This article has been accepted for publication in Annals of the Rheumatic Diseases following peer review. The definitive copyedited, typeset version Miloslavsky EM, Naden RP, Bijlsma JWJ, et al Development of a Glucocorticoid Toxicity Index (GTI) using multicriteria decision analysis Annals of the Rheumatic Diseases 2017;76:543-546 is available online at: http://dx.doi.org/10.1136/annrheumdis-2016-210002 |
| Keywords: | Corticosteroids, Outcomes research, Treatment |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1508910 |
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