Sheehan – Global Improvement Scales (S-CGI-21 and S-PGI-21)

About the Sheehan – Global Improvement Scales (S-CGI-21 and S-PGI-21)
Versions of the S-CGI-21 & S-PGI-21
License Agreement for Use of the S-CGI-21 or S-PGI-21
Training for the S-CGI-21 or S-PGI-21
Translations and Linguistic Validation of the S-CGI-21 or S-PGI-21
How to Cite the S-CGI-21 or S-PGI-21

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About the Sheehan – Global Improvement Scales (S-CGI-21 and S-PGI-21)

The Sheehan – Global Improvement Scales exist in a clinician rated format (S-CGI-21) and in a patient rated format (S-PGI-21).  These 21-point global improvement scales were designed as more sensitive outcome measures in detecting efficacy signals than the old standard 7-point CGI-I Scale (Clinician Global Impressions – Improvement) and the related 7 point PGI-I (Patient Global Impressions – Improvement), which were developed during the early PRB Collaborative Schizophrenia treatment studies. (ECDEU Assessment Manual. US Dept. of Health Education and Welfare. W. Guy. Editor. NIMH Psychopharmacology Research Branch 1976 Washington DC).  Since the original design of the 7-point CGI-I, research needs and treatment outcome expectations require greater sensitivity.

Each new generation of treatments brings incremental improvements over earlier treatments.  It is necessary to be able to detect such differences globally. The 21-point S-CGI-21 and S-PGI-21 have 10 points of improvement and 10 points of deterioration compared to baseline, while the original CGI-I has only 3 points of improvement and 3 points of deterioration compared to baseline.  This spread in the original CGI-I is not sufficiently sensitive to detect either small increments of improvement or small differences between treatments.  Such differences can be clinically meaningful.  For example, both a 40% and a 60% improvement are rated as “moderate” or a score of 2 on the old CGI-I whereas the S-CGI-21 and S-PGI-21 detect these as quite different.  Clinicians, researchers and pharmaceutical companies are increasingly interested in differences in efficacy among the many treatments available and between efficacy at different doses.

Scales designed using a discretized visual-analog format (like the S-CGI-21 and S-PGI-21) appear to be more sensitive than scales that adhere to categorical response options like the old CGI-I.  Discretized visual-analog scales use numerical, verbal and visual-spatial modes simultaneously in capturing a response, thereby anchoring the response more precisely and gaining sensitivity.

For more information about the design and logic behind Discan Metrics in rating scales such as the SDS, the SIS, the S-STS CMCM, the SIAS, the S-HTS CMCM, and the HIAS see citation 1 in How to Cite The SDS (click here).

For any scientific questions relating to the S-CGI-21 or S-PGI-21, contact David V Sheehan MD MBA directly by email at: davidVsheehan@gmail.com

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Versions of the S-CGI-21 & S-PGI-21

Standard Versions of the S-CGI-21 & S-PGI-21

The S-PGI-21 and S-CGI-21 are designed to provide an overall assessment of how much a patient’s symptoms have improved or worsened since the start of treatment.

To view a watermarked, preview copy of the S-CGI-21 and S-PGI-21 (click here)

To purchase and download a watermarked, preview copy of the S-CGI-21 and S-PGI-21 (click here)

 

 

Customizable

Dr. Sheehan can design customized versions of the S-PGI-21 & S-CGI-21 to meet the needs of a specific study or clinical setting.  Contact Dr. Sheehan at davidVsheehan@gmail.com to discuss a customized version designed for your needs.

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License Agreement for Use of the S-PGI-21 or S-CGI-21

Dr. Sheehan licenses the S-PGI-21 & S-CGI-21 in paper format for distribution as follows: 1) in paper format for any uses; or 2) in fixed pdf form, paper form, or both for use in clinical or academic research trials or studies.

To license the S-PGI-21 or S-CGI-21 for use there is a charge of $4 per single administration (not per patient enrolled) for non-customized versions. The amount must be paid in full before study initiation. (click here to download a copy of this license agreement)

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Training for the S-CGI-21 or S-PGI-21

For information about training on the S-CGI-21 or S-PGI-21, please contact: davidVsheehan@gmail.com

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Translations and Linguistic Validation of the S-CGI-21 or S-PGI-21

 

 

 

 

 

 

* in field testing.