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Arthritis Care Res (Hoboken). 2016 May;68(5):667-72. doi: 10.1002/acr.22741.

Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds Consensus Exercises.

Author information

1
Auckland District Health Board, Auckland, New Zealand.
2
University of Otago, Wellington, New Zealand.
3
University of Sheffield, Sheffield, UK.
4
Schlosspark-Klinik, Charité, University Medicine Berlin, Berlin, Germany.
5
Hospital General de México, Mexico City, Mexico.
6
Christchurch Hospital, Christchurch, New Zealand.
7
Università di Genova, Genova, Italy.
8
Pedro Ernesto University Hospital, Rio de Janeiro, Brazil.
9
University of New South Wales and St Vincent's Hospital, Sydney, Australia.
10
University of Massachusetts Medical School, Worcester, and Corrona, LLC, Southborough.
11
Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK.
12
Rijnstate Hospital, Arnhem, The Netherlands.
13
Veterans Affairs Medical Center, Georgetown and Howard University Hospitals, Washington, DC.
14
University of California School of Medicine, San Diego.
15
University of Michigan, Ann Arbor.
16
University of Michigan and Ann Arbor VA Medical Center, Ann Arbor.
17
Taichung Veteran's General Hospital, Taichung, Taiwan.
18
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
19
Mater Misericordiae University Hospital and University College, Dublin, Ireland.
20
Nebraska-Western Iowa Health Care System and University of Nebraska Medical Center, Omaha.
21
Boston University School of Medicine, Boston, Massachusetts.
22
University of Pennsylvania, Philadelphia.
23
Hospital Universitario Cruces, OSI-EEC, and Biocruces Health Research Institute, Biscay, Spain.
24
Rutgers University Robert Wood Johnson Medical School, New Brunswick, New Jersey.
25
IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy.
26
University of Alabama at Birmingham and the Birmingham VA Medical Center, Birmingham.
27
Hospital General Universitario Elda, Elda, Spain.
28
Copenhagen University Hospital Glostrup, Glostrup, Denmark.
29
University of Otago, Christchurch, New Zealand.
30
University Hospital Carl Gustav Carus, Dresden, Germany.
31
University of California San Diego VA Medical Center, La Jolla.
32
National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
33
Universiteit Twente, Erschede, The Netherlands.
34
Waikato DHB and Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
35
Tokyo Women's Medical University, Tokyo, Japan.
36
Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China.
37
University of Auckland and Auckland District Health Board, Auckland, New Zealand.

Abstract

OBJECTIVE:

To establish consensus for potential remission criteria to use in clinical trials of gout.

METHODS:

Experts (n = 88) in gout from multiple countries were invited to participate in a web-based questionnaire study. Three rounds of Delphi consensus exercises were conducted using SurveyMonkey, followed by a discrete-choice experiment using 1000Minds software. The exercises focused on identifying domains, definitions for each domain, and the timeframe over which remission should be defined.

RESULTS:

There were 49 respondents (56% response) to the initial survey, with subsequent response rates ranging from 57% to 90%. Consensus was reached for the inclusion of serum urate (98% agreement), flares (96%), tophi (92%), pain (83%), and patient global assessment of disease activity (93%) as measurement domains in remission criteria. Consensus was also reached for domain definitions, including serum urate (<0.36 mm), pain (<2 on a 10-point scale), and patient global assessment (<2 on a 10-point scale), all of which should be measured at least twice over a set time interval. Consensus was not achieved in the Delphi exercise for the timeframe for remission, with equal responses for 6 months (51%) and 1 year (49%). In the discrete-choice experiment, there was a preference towards 12 months as a timeframe for remission.

CONCLUSION:

These consensus exercises have identified domains and provisional definitions for gout remission criteria. Based on the results of these exercises, preliminary remission criteria are proposed with domains of serum urate, acute flares, tophus, pain, and patient global assessment. These preliminary criteria now require testing in clinical data sets.

PMID:
26414176
DOI:
10.1002/acr.22741
[Indexed for MEDLINE]
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