Format

Send to

Choose Destination
Rheumatology (Oxford). 2015 Oct;54(10):1797-805. doi: 10.1093/rheumatology/kev112. Epub 2015 May 13.

International Consensus for ultrasound lesions in gout: results of Delphi process and web-reliability exercise.

Author information

1
Rheumatology Department, Clinica Reumatologica, Università Politecnica delle Marche, Jesi, Ancona, Italy, dr.gmarwin@gmail.com.
2
Rheumatology Department, Immanuel Krankenhaus, Medical Centre for Rheumatology, Berlin, Germany.
3
Department of Medicine, Allergy/Immunology and Rheumatology Division, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
4
School of Medicine and Pharmacology Fiona Stanley Hospital Unit, University of Western Australia, Perth, Australia.
5
Division of Rheumatology, University of Florida College of Medicine, Jacksonville, FL, USA.
6
Rheumatology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
7
Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome.
8
Rheumatology Department, MC Groep Hospitals, Lelystad, Netherlands.
9
3rd Rheumatology Department, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary.
10
Rheumatology Department, Clinica Reumatologica, Università Politecnica delle Marche, Jesi, Ancona, Italy.
11
Division of Rheumatology, Medical University of Vienna, Vienna, Austria.
12
Rheumatology Department, Trinity College, Dublin, Ireland.
13
Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico City, Mexico.
14
Rheumatology Unit, University of Pisa, Pisa, Italy.
15
Rheumatology Department, Diakonhjemmet Hospital, Oslo, Norway.
16
Musculoskeletal Statistics Unit, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark.
17
INSERM U1173, Rheumatology Department, Laboratoire d'excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Saint-Quentin en Yvelines, France and.
18
Rheumatology Department, Center for Rheumatology and Spine diseases, Copenhagen University Hospital, Copenhagen, Denmark.

Abstract

OBJECTIVE:

To produce consensus-based definitions of the US elementary lesions in gout and to test their reliability in a web-based exercise.

METHODS:

The process consisted of two steps. In the first step a written Delphi questionnaire was developed from a systematic literature review and expert international consensus. This collated information resulted in four statements defining US elementary lesions: double contour (DC), tophus, aggregates and erosion. The Delphi questionnaire was sent to 35 rheumatology experts in US, asking them to rate their level of agreement or disagreement with each statement. The second step tested the reliability by a web-exercise. US images of both normal and gouty elementary lesions were collected by the participants. A facilitator then constructed an electronic database of 110 images. The database was sent to the participants, who evaluated the presence/absence of US elementary lesions. A group of 20 images was displayed twice to evaluate intra-reader reliability.

RESULTS:

A total of 32 participants responded to the questionnaires. Good agreement (>80%) was obtained for US definitions on DC, tophus, aggregates and erosion in the Delphi exercise after three rounds. The reliability on images showed inter-reader κ values for DC, tophus, aggregates, erosion findings of 0.98, 0.71, 0.54 and 0.85, respectively. The mean intra-reader κ values were also acceptable: 0.93, 0.78, 0.65 and 0.78, respectively.

CONCLUSION:

This, the first consensus-based US definition of elementary lesions in gout, demonstrated good reliability overall. It constitutes an essential step in developing a core outcome measurement that permits a higher degree of homogeneity and comparability between multicentre studies.

KEYWORDS:

Delphi process; elementary lesions; gout; ultrasound; web reliability

PMID:
25972391
DOI:
10.1093/rheumatology/kev112
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for University of Turin Instituional Repository AperTO
Loading ...
Support Center