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Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds Consensus Exercises
Author(s) -
de Lautour Hugh,
Taylor William J.,
Adebajo Ade,
Alten Rieke,
BurgosVargas Ruben,
Chapman Peter,
Cimmino Marco A.,
da Rocha Castelar Pinheiro Geraldo,
Day Ric,
Harrold Leslie R.,
Helliwell Philip,
Janssen Matthijs,
Kerr Gail,
Kavanaugh Arthur,
Khanna Dinesh,
Khanna Puja P.,
Lin Chingtsai,
Louthrenoo Worawit,
McCarthy Geraldine,
VazquezMellado Janitzia,
Mikuls Ted R.,
Neogi Tuhina,
Ogdie Alexis,
PerezRuiz Fernando,
Schlesinger Naomi,
Ralph Schumacher H.,
Scirè Carlo A.,
Singh Jasvinder A.,
Sivera Francisca,
Slot Ole,
Stamp Lisa K.,
Tausche AnneKathrin,
Terkeltaub Robert,
Uhlig Till,
van de Laar Mart,
White Douglas,
Yamanaka Hisashi,
Zeng Xuejun,
Dalbeth Nicola
Publication year - 2016
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22741
Subject(s) - tophus , medicine , delphi method , physical therapy , delphi , gout , family medicine , uric acid , statistics , hyperuricemia , computer science , operating system , mathematics
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.