A delphi exercise to identify characteristic features of gout - opinions from patients and psysicians, the first stage in developing new classification criteria

Rebecca L. Prowse, Nicola Dalbeth, Arthur Kavanaugh, Adewale O. Adebajo, A.L. Gaffo, R. Terkeltaub, B.F. Mandell, B.P. Suryana, C. Goldenstein-Schainberg, C. Diaz-Torne, D. Khanna, F. Lioté, G. McCarthy, G.S. Kerr, H. Yamanaka, H. Janssens, H.F. Baraf, J.H. Chen, J. Vazquez-Mellado, L.R. HarroldL.K. Stamp, M.A. van de Laar, M. Janssen, M. Doherty, M. Boers, N.L. Edwards, P. Gow, P. Chapman, P. Khanna, P.S. Helliwell, R. Grainger, H.R. Schumacher, T. Neogi, T.L. Jansen, W. Louthrenoo, F. Sivera, W.J. Taylor, R. Alten

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Abstract

Objective: To identify a comprehensive list of features that might discriminate between gout andother rheumatic musculoskeletal conditions, to be used subsequently for a case-control study todevelop and test new classification criteria for gout.

Methods: Two Delphi exercises were conducted using Web-based questionnaires: one with physicians from several countries who had an interest in gout and one with patients from New Zealand who had gout. Physicians rated a list of potentially discriminating features that were identified by literature review and expert opinion, and patients rated a list of features that they generated themselves. Agreement was defined by the RAND/UCLA disagreement index.

Results: Forty-four experienced physicians and 9 patients responded to all iterations. For physicians,71 items were identified by literature review and 15 more were suggested by physicians. Thephysician survey showed agreement for 26 discriminatory features and 15 as not discriminatory. Thepatients identified 46 features of gout, for which there was agreement on 25 items as being discriminatory and 7 items as not discriminatory.

Conclusion: Patients and physicians agreed upon several key features of gout. Physicians emphasized objective findings, imaging, and patterns of symptoms, whereas patients emphasized severity, functional results, and idiographic perception of symptoms.
Original languageEnglish
Pages (from-to)498-505
Number of pages8
JournalJournal of rheumatology
Volume40
Issue number4
DOIs
Publication statusPublished - 2013

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