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2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative
OBJECTIVE: Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available. The current effort was undertaken to develop new classification criteria for gout. METHODS: An international group of inve...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602275/ https://www.ncbi.nlm.nih.gov/pubmed/26359487 http://dx.doi.org/10.1136/annrheumdis-2015-208237 |
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author | Neogi, Tuhina Jansen, Tim L Th A Dalbeth, Nicola Fransen, Jaap Schumacher, H Ralph Berendsen, Dianne Brown, Melanie Choi, Hyon Edwards, N Lawrence Janssens, Hein J E M Lioté, Frédéric Naden, Raymond P Nuki, George Ogdie, Alexis Perez-Ruiz, Fernando Saag, Kenneth Singh, Jasvinder A Sundy, John S Tausche, Anne-Kathrin Vaquez-Mellado, Janitzia Yarows, Steven A Taylor, William J |
author_facet | Neogi, Tuhina Jansen, Tim L Th A Dalbeth, Nicola Fransen, Jaap Schumacher, H Ralph Berendsen, Dianne Brown, Melanie Choi, Hyon Edwards, N Lawrence Janssens, Hein J E M Lioté, Frédéric Naden, Raymond P Nuki, George Ogdie, Alexis Perez-Ruiz, Fernando Saag, Kenneth Singh, Jasvinder A Sundy, John S Tausche, Anne-Kathrin Vaquez-Mellado, Janitzia Yarows, Steven A Taylor, William J |
author_sort | Neogi, Tuhina |
collection | PubMed |
description | OBJECTIVE: Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available. The current effort was undertaken to develop new classification criteria for gout. METHODS: An international group of investigators, supported by the American College of Rheumatology and the European League Against Rheumatism, conducted a systematic review of the literature on advanced imaging of gout, a diagnostic study in which the presence of monosodium urate monohydrate (MSU) crystals in synovial fluid or tophus was the gold standard, a ranking exercise of paper patient cases, and a multi-criterion decision analysis exercise. These data formed the basis for developing the classification criteria, which were tested in an independent data set. RESULTS: The entry criterion for the new classification criteria requires the occurrence of at least one episode of peripheral joint or bursal swelling, pain, or tenderness. The presence of MSU crystals in a symptomatic joint/bursa (ie, synovial fluid) or in a tophus is a sufficient criterion for classification of the subject as having gout, and does not require further scoring. The domains of the new classification criteria include clinical (pattern of joint/bursa involvement, characteristics and time course of symptomatic episodes), laboratory (serum urate, MSU-negative synovial fluid aspirate), and imaging (double-contour sign on ultrasound or urate on dual-energy CT, radiographic gout-related erosion). The sensitivity and specificity of the criteria are high (92% and 89%, respectively). CONCLUSIONS: The new classification criteria, developed using a data-driven and decision-analytic approach, have excellent performance characteristics and incorporate current state-of-the-art evidence regarding gout. |
format | Online Article Text |
id | pubmed-4602275 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-46022752015-10-21 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative Neogi, Tuhina Jansen, Tim L Th A Dalbeth, Nicola Fransen, Jaap Schumacher, H Ralph Berendsen, Dianne Brown, Melanie Choi, Hyon Edwards, N Lawrence Janssens, Hein J E M Lioté, Frédéric Naden, Raymond P Nuki, George Ogdie, Alexis Perez-Ruiz, Fernando Saag, Kenneth Singh, Jasvinder A Sundy, John S Tausche, Anne-Kathrin Vaquez-Mellado, Janitzia Yarows, Steven A Taylor, William J Ann Rheum Dis Criteria OBJECTIVE: Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available. The current effort was undertaken to develop new classification criteria for gout. METHODS: An international group of investigators, supported by the American College of Rheumatology and the European League Against Rheumatism, conducted a systematic review of the literature on advanced imaging of gout, a diagnostic study in which the presence of monosodium urate monohydrate (MSU) crystals in synovial fluid or tophus was the gold standard, a ranking exercise of paper patient cases, and a multi-criterion decision analysis exercise. These data formed the basis for developing the classification criteria, which were tested in an independent data set. RESULTS: The entry criterion for the new classification criteria requires the occurrence of at least one episode of peripheral joint or bursal swelling, pain, or tenderness. The presence of MSU crystals in a symptomatic joint/bursa (ie, synovial fluid) or in a tophus is a sufficient criterion for classification of the subject as having gout, and does not require further scoring. The domains of the new classification criteria include clinical (pattern of joint/bursa involvement, characteristics and time course of symptomatic episodes), laboratory (serum urate, MSU-negative synovial fluid aspirate), and imaging (double-contour sign on ultrasound or urate on dual-energy CT, radiographic gout-related erosion). The sensitivity and specificity of the criteria are high (92% and 89%, respectively). CONCLUSIONS: The new classification criteria, developed using a data-driven and decision-analytic approach, have excellent performance characteristics and incorporate current state-of-the-art evidence regarding gout. BMJ Publishing Group 2015-10 /pmc/articles/PMC4602275/ /pubmed/26359487 http://dx.doi.org/10.1136/annrheumdis-2015-208237 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Criteria Neogi, Tuhina Jansen, Tim L Th A Dalbeth, Nicola Fransen, Jaap Schumacher, H Ralph Berendsen, Dianne Brown, Melanie Choi, Hyon Edwards, N Lawrence Janssens, Hein J E M Lioté, Frédéric Naden, Raymond P Nuki, George Ogdie, Alexis Perez-Ruiz, Fernando Saag, Kenneth Singh, Jasvinder A Sundy, John S Tausche, Anne-Kathrin Vaquez-Mellado, Janitzia Yarows, Steven A Taylor, William J 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative |
title | 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative |
title_full | 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative |
title_fullStr | 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative |
title_full_unstemmed | 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative |
title_short | 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative |
title_sort | 2015 gout classification criteria: an american college of rheumatology/european league against rheumatism collaborative initiative |
topic | Criteria |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602275/ https://www.ncbi.nlm.nih.gov/pubmed/26359487 http://dx.doi.org/10.1136/annrheumdis-2015-208237 |
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