Development of a Glucocorticoid Toxicity Index (GTI) using multicriteria decision analysis
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Open Access
- 29 July 2016
- journal article
- review article
- Published by BMJ in Annals Of The Rheumatic Diseases
- Vol. 76 (3), 543-546
- https://doi.org/10.1136/annrheumdis-2016-210002
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.Funding Information
- Genentech
This publication has 14 references indexed in Scilit:
- Oral Glucocorticoid-Sparing Effect of Mepolizumab in Eosinophilic AsthmaThe New England Journal of Medicine, 2014
- Multicriteria decision analysis methods with 1000Minds for developing systemic sclerosis classification criteriaJournal of Clinical Epidemiology, 2014
- Incidence and US Costs of Corticosteroid-Associated Adverse Events: A Systematic Literature ReviewClinical Therapeutics, 2011
- Monitoring adverse events of low-dose glucocorticoid therapy: EULAR recommendations for clinical trials and daily practiceAnnals Of The Rheumatic Diseases, 2010
- Importance of background rates of disease in assessment of vaccine safety during mass immunisation with pandemic H1N1 influenza vaccinesThe Lancet, 2010
- Epidemiology of atherosclerosis in systemic lupus erythematosusCurrent Rheumatology Reports, 2009
- The epidemiology of glucocorticoid-associated adverse eventsCurrent Opinion in Rheumatology, 2008
- Safety of low dose glucocorticoid treatment in rheumatoid arthritis: published evidence and prospective trial dataAnnals Of The Rheumatic Diseases, 2006
- Very low‐dose prednisolone in early rheumatoid arthritis retards radiographic progression over two years: A multicenter, double‐blind, placebo‐controlled trialArthritis & Rheumatism, 2005
- Lack of radiological and clinical benefit over two years of low dose prednisolone for rheumatoid arthritis: results of a randomised controlled trialAnnals Of The Rheumatic Diseases, 2004