2015 Gout Classification Criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative.
Arthritis Rheumatol
; 67(10): 2557-68, 2015 Oct.
Article
em En
| MEDLINE
| ID: mdl-26352873
ABSTRACT
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 multicriterion 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 1 episode of peripheral joint or bursal swelling, pain, or tenderness. The presence of MSU crystals in a symptomatic joint/bursa (i.e., 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 computed tomography, radiographic gout-related erosion). The sensitivity and specificity of the criteria are high (92% and 89%, respectively).CONCLUSION:
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Gota
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
/
Systematic_reviews
Limite:
Humans
País como assunto:
America do norte
/
Europa
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article