Survey Definitions of Gout for Epidemiologic Studies: Comparison With Crystal Identification as the Gold Standard
Por:
Dalbeth N, Schumacher HR, Fransen J, Neogi T, Jansen TL, Brown M, Louthrenoo W, Vazquez-Mellado J, Eliseev M, McCarthy G, Stamp LK, Perez-Ruiz F, Sivera F, Ea HK, Gerritsen M, Scire CA, Cavagna L, Lin C, Chou YY, Tausche AK, da Rocha Castelar-Pinheiro G, Janssen M, Chen JH, Cimmino MA, Uhlig T and Taylor WJ
Publicada:
1 dic 2016
Ahead of Print:
28 oct 2016
Categoría:
Rheumatology
Resumen:
Objective. To identify the best-performing survey definition of gout from items commonly available in epidemiologic studies.
Methods. Survey definitions of gout were identified from 34 epidemiologic studies contributing to the Global Urate Genetics Consortium (GUGC) genome-wide association study. Data from the Study for Updated Gout Classification Criteria (SUGAR) were randomly divided into development and test data sets. A data-driven case definition was formed using logistic regression in the development data set. This definition, along with definitions used in GUGC studies and the 2015 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) gout classification criteria were applied to the test data set, using monosodium urate crystal identification as the gold standard.
Results. For all tested GUGC definitions, the simple definition of "self-report of gout or urate-lowering therapy use" had the best test performance characteristics (sensitivity 82%, specificity 72%). The simple definition had similar performance to a SUGAR data-driven case definition with 5 weighted items: self-report, self-report of doctor diagnosis, colchicine use, urate-lowering therapy use, and hyperuricemia (sensitivity 87%, specificity 70%). Both of these definitions performed better than the 1977 American Rheumatism Association survey criteria (sensitivity 82%, specificity 67%). Of all tested definitions, the 2015 ACR/EULAR criteria had the best performance (sensitivity 92%, specificity 89%).
Conclusion. A simple definition of "self-report of gout or urate-lowering therapy use" has the best test performance characteristics of existing definitions that use routinely available data. A more complex combination of features is more sensitive, but still lacks good specificity. If a more accurate case definition is required for a particular study, the 2015 ACR/EULAR gout classification criteria should be considered.
Filiaciones:
Dalbeth N:
University of Auckland, Auckland, New Zealand
Schumacher HR:
University of Pennsylvania, Philadelphia
Fransen J:
Radboud University Medical Centre, Nijmegen, The Netherlands
Neogi T:
Boston University School of Medicine, Boston, Massachusetts
Jansen TL:
Viecuri Medical Center, Venlo, The Netherlands
Brown M:
University of Otago, Wellington, New Zealand
Louthrenoo W:
Chiang Mai University, Chiang Mai, Thailand
Vazquez-Mellado J:
Hospital General de Mexico, Mexico City, Mexico
Eliseev M:
Nasonova Research Institute of Rheumatology of Russia, Moscow, Russia
McCarthy G:
Geraldine McCarthy, MD, FRCPI, University College Dublin School of Medicine and Medical Science, Dublin, Ireland
Stamp LK:
University of Otago, Christchurch, New Zealand
Perez-Ruiz F:
Hospital Universitario Cruces & BioCruces Health Research Institute, Vizcaya, Spain
:
Hospital General Universitario de Elda, Alicante, Spain
Ea HK:
Université Paris Diderot, Sorbonne Paris Cité, UFR de Médecine, INSERM, UMR 1132, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, and Hôpital Lariboisière, Paris, France
Gerritsen M:
Westfries Gasthuis, Hoorn, The Netherlands
Scire CA:
Carlo A. Scire, MD, PhD, Italian Society for Rheumatology, Milan, Italy
Cavagna L:
University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
Lin C:
Taichung Veterans General Hospital, Taichung, Taiwan
Chou YY:
Taichung Veterans General Hospital, Taichung, Taiwan
Tausche AK:
University Hospital Carl Gustav Carus, Dresden, Germany
da Rocha Castelar-Pinheiro G:
Universidade de Estado do Rio de Janeiro, Rio de Janeiro, Brazil
Janssen M:
Rijnstate Hospital, Arnhem, The Netherlands
Chen JH:
China Medical University School of Medicine, Taichung, Taiwan
Cimmino MA:
University of Genoa, Genoa, Italy
Uhlig T:
Diakonhjemmet Hospital, Oslo, Norway
Taylor WJ:
University of Otago, Wellington, New Zealand
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