Brief Report: Validation of a Definition of Flare in Patients With Established Gout

© 2017, American College of Rheumatology Objective: To perform external validation of a provisional definition of disease flare in patients with gout. Methods: Five hundred nine patients with gout were enrolled in a cross-sectional study during a routine clinical care visit at 17 international sites...

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Main Authors: Angelo L. Gaffo, Nicola Dalbeth, Kenneth G. Saag, Jasvinder A. Singh, Elizabeth J. Rahn, Amy S. Mudano, Yi Hsing Chen, Ching Tsai Lin, Sandra Bourke, Worawit Louthrenoo, Janitzia Vazquez-Mellado, Hansel Hernández-Llinas, Tuhina Neogi, Ana Beatriz Vargas-Santos, Geraldo da Rocha Castelar-Pinheiro, Rodrigo B.C. Amorim, Till Uhlig, Hilde B. Hammer, Maxim Eliseev, Fernando Perez-Ruiz, Lorenzo Cavagna, Geraldine M. McCarthy, Lisa K. Stamp, Martijn Gerritsen, Viktoria Fana, Francisca Sivera, William Taylor
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Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/58768
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spelling th-cmuir.6653943832-587682018-09-05T04:36:02Z Brief Report: Validation of a Definition of Flare in Patients With Established Gout Angelo L. Gaffo Nicola Dalbeth Kenneth G. Saag Jasvinder A. Singh Elizabeth J. Rahn Amy S. Mudano Yi Hsing Chen Ching Tsai Lin Sandra Bourke Worawit Louthrenoo Janitzia Vazquez-Mellado Hansel Hernández-Llinas Tuhina Neogi Ana Beatriz Vargas-Santos Geraldo da Rocha Castelar-Pinheiro Rodrigo B.C. Amorim Till Uhlig Hilde B. Hammer Maxim Eliseev Fernando Perez-Ruiz Lorenzo Cavagna Geraldine M. McCarthy Lisa K. Stamp Martijn Gerritsen Viktoria Fana Francisca Sivera William Taylor Immunology and Microbiology Medicine © 2017, American College of Rheumatology Objective: To perform external validation of a provisional definition of disease flare in patients with gout. Methods: Five hundred nine patients with gout were enrolled in a cross-sectional study during a routine clinical care visit at 17 international sites. Data were collected to classify patients as experiencing or not experiencing a gout flare, according to a provisional definition. A local expert rheumatologist performed the final independent adjudication of gout flare status. Sensitivity, specificity, predictive values, and receiver operating characteristic (ROC) curves were used to determine the diagnostic performance of gout flare definitions. Results: The mean ± SD age of the patients was 57.5 ± 13.9 years, and 89% were male. The definition requiring fulfillment of at least 3 of 4 criteria (patient-defined gout flare, pain at rest score of >3 on a 0–10-point numerical rating scale, presence of at least 1 swollen joint, and presence of at least 1 warm joint) was 85% sensitive and 95% specific in confirming the presence of a gout flare, with an accuracy of 92%. The ROC area under the curve was 0.97. The definition based on a classification and regression tree algorithm (entry point, pain at rest score >3, followed by patient-defined flare “yes”) was 73% sensitive and 96% specific. Conclusion: The definition of gout flare that requires fulfillment of at least 3 of 4 patient-reported criteria is now validated to be sensitive, specific, and accurate for gout flares, as demonstrated using an independent large international patient sample. The availability of a validated gout flare definition will improve the ascertainment of an important clinical outcome in studies of gout. 2018-09-05T04:30:34Z 2018-09-05T04:30:34Z 2018-03-01 Journal 23265205 23265191 2-s2.0-85041569387 10.1002/art.40381 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85041569387&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/58768
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Immunology and Microbiology
Medicine
spellingShingle Immunology and Microbiology
Medicine
Angelo L. Gaffo
Nicola Dalbeth
Kenneth G. Saag
Jasvinder A. Singh
Elizabeth J. Rahn
Amy S. Mudano
Yi Hsing Chen
Ching Tsai Lin
Sandra Bourke
Worawit Louthrenoo
Janitzia Vazquez-Mellado
Hansel Hernández-Llinas
Tuhina Neogi
Ana Beatriz Vargas-Santos
Geraldo da Rocha Castelar-Pinheiro
Rodrigo B.C. Amorim
Till Uhlig
Hilde B. Hammer
Maxim Eliseev
Fernando Perez-Ruiz
Lorenzo Cavagna
Geraldine M. McCarthy
Lisa K. Stamp
Martijn Gerritsen
Viktoria Fana
Francisca Sivera
William Taylor
Brief Report: Validation of a Definition of Flare in Patients With Established Gout
description © 2017, American College of Rheumatology Objective: To perform external validation of a provisional definition of disease flare in patients with gout. Methods: Five hundred nine patients with gout were enrolled in a cross-sectional study during a routine clinical care visit at 17 international sites. Data were collected to classify patients as experiencing or not experiencing a gout flare, according to a provisional definition. A local expert rheumatologist performed the final independent adjudication of gout flare status. Sensitivity, specificity, predictive values, and receiver operating characteristic (ROC) curves were used to determine the diagnostic performance of gout flare definitions. Results: The mean ± SD age of the patients was 57.5 ± 13.9 years, and 89% were male. The definition requiring fulfillment of at least 3 of 4 criteria (patient-defined gout flare, pain at rest score of >3 on a 0–10-point numerical rating scale, presence of at least 1 swollen joint, and presence of at least 1 warm joint) was 85% sensitive and 95% specific in confirming the presence of a gout flare, with an accuracy of 92%. The ROC area under the curve was 0.97. The definition based on a classification and regression tree algorithm (entry point, pain at rest score >3, followed by patient-defined flare “yes”) was 73% sensitive and 96% specific. Conclusion: The definition of gout flare that requires fulfillment of at least 3 of 4 patient-reported criteria is now validated to be sensitive, specific, and accurate for gout flares, as demonstrated using an independent large international patient sample. The availability of a validated gout flare definition will improve the ascertainment of an important clinical outcome in studies of gout.
format Journal
author Angelo L. Gaffo
Nicola Dalbeth
Kenneth G. Saag
Jasvinder A. Singh
Elizabeth J. Rahn
Amy S. Mudano
Yi Hsing Chen
Ching Tsai Lin
Sandra Bourke
Worawit Louthrenoo
Janitzia Vazquez-Mellado
Hansel Hernández-Llinas
Tuhina Neogi
Ana Beatriz Vargas-Santos
Geraldo da Rocha Castelar-Pinheiro
Rodrigo B.C. Amorim
Till Uhlig
Hilde B. Hammer
Maxim Eliseev
Fernando Perez-Ruiz
Lorenzo Cavagna
Geraldine M. McCarthy
Lisa K. Stamp
Martijn Gerritsen
Viktoria Fana
Francisca Sivera
William Taylor
author_facet Angelo L. Gaffo
Nicola Dalbeth
Kenneth G. Saag
Jasvinder A. Singh
Elizabeth J. Rahn
Amy S. Mudano
Yi Hsing Chen
Ching Tsai Lin
Sandra Bourke
Worawit Louthrenoo
Janitzia Vazquez-Mellado
Hansel Hernández-Llinas
Tuhina Neogi
Ana Beatriz Vargas-Santos
Geraldo da Rocha Castelar-Pinheiro
Rodrigo B.C. Amorim
Till Uhlig
Hilde B. Hammer
Maxim Eliseev
Fernando Perez-Ruiz
Lorenzo Cavagna
Geraldine M. McCarthy
Lisa K. Stamp
Martijn Gerritsen
Viktoria Fana
Francisca Sivera
William Taylor
author_sort Angelo L. Gaffo
title Brief Report: Validation of a Definition of Flare in Patients With Established Gout
title_short Brief Report: Validation of a Definition of Flare in Patients With Established Gout
title_full Brief Report: Validation of a Definition of Flare in Patients With Established Gout
title_fullStr Brief Report: Validation of a Definition of Flare in Patients With Established Gout
title_full_unstemmed Brief Report: Validation of a Definition of Flare in Patients With Established Gout
title_sort brief report: validation of a definition of flare in patients with established gout
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85041569387&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/58768
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