Dataset Information

Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout.

ABSTRACT: OBJECTIVE:There is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout. METHODS:A content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions. RESULTS:The content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: 'asymptomatic hyperuricaemia', 'asymptomatic monosodium urate crystal deposition', 'asymptomatic hyperuricaemia with monosodium urate crystal deposition', 'gout', 'tophaceous gout', 'erosive gout', 'first gout flare' and 'recurrent gout flares'. There was consensus agreement that the label 'gout' should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus). CONCLUSION:Consensus agreement has been established for the labels and definitions of eight gout disease states, including 'gout' itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.

SUBMITTER: Bursill D

PROVIDER: S-EPMC7288724 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout.

Bursill David D Taylor William J WJ Terkeltaub Robert R Abhishek Abhishek A So Alexander K AK Vargas-Santos Ana Beatriz AB Gaffo Angelo Lino AL Rosenthal Ann A Tausche Anne-Kathrin AK Reginato Anthony A Manger Bernhard B Sciré Carlo C Pineda Carlos C van Durme Caroline C Lin Ching-Tsai CT Yin Congcong C Albert Daniel Arthur DA Biernat-Kaluza Edyta E Roddy Edward E Pascual Eliseo E Becce Fabio F Perez-Ruiz Fernando F Sivera Francisca F Lioté Frédéric F Schett Georg G Nuki George G Filippou Georgios G McCarthy Geraldine G da Rocha Castelar Pinheiro Geraldo G Ea Hang-Korng HK Tupinambá Helena De Almeida HA Yamanaka Hisashi H Choi Hyon K HK Mackay James J ODell James R JR Vázquez Mellado Janitzia J Singh Jasvinder A JA Fitzgerald John D JD Jacobsson Lennart T H LTH Joosten Leo L Harrold Leslie R LR Stamp Lisa L Andrés Mariano M Gutierrez Marwin M Kuwabara Masanari M Dehlin Mats M Janssen Matthijs M Doherty Michael M Hershfield Michael S MS Pillinger Michael M Edwards N Lawrence NL Schlesinger Naomi N Kumar Nitin N Slot Ole O Ottaviani Sebastien S Richette Pascal P MacMullan Paul A PA Chapman Peter T PT Lipsky Peter E PE Robinson Philip P Khanna Puja P PP Gancheva Rada N RN Grainger Rebecca R Johnson Richard J RJ Te Kampe Ritch R Keenan Robert T RT Tedeschi Sara K SK Kim Seoyoung S Choi Sung Jae SJ Fields Theodore R TR Bardin Thomas T Uhlig Till T Jansen Tim T Merriman Tony T Pascart Tristan T Neogi Tuhina T Klück Viola V Louthrenoo Worawit W Dalbeth Nicola N

Annals of the rheumatic diseases 20190909 11

<h4>Objective</h4>There is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout.<h4>Methods</h4>A content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invit ...[more]

PMID: 31501138

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Project description:BackgroundSepsis is the leading cause of death in the intensive care unit (ICU). Expediting its diagnosis, largely determined by clinical assessment, improves survival. Predictive and explanatory modelling of sepsis in the critically ill commonly bases both outcome definition and predictions on clinical criteria for consensus definitions of sepsis, leading to circularity. As a remedy, we collected ground truth labels for sepsis.MethodsIn the Ground Truth for Sepsis Questionnaire (GTSQ), senior attending physicians in the ICU documented daily their opinion on each patient's condition regarding sepsis as a five-category working diagnosis and nine related items. Working diagnosis groups were described and compared and their SOFA-scores analyzed with a generalized linear mixed model. Agreement and discriminatory performance measures for clinical criteria of sepsis and GTSQ labels as reference class were derived.ResultsWe analyzed 7291 questionnaires and 761 complete encounters from the first survey year. Editing rates for all items were > 90%, and responses were consistent with current understanding of critical illness pathophysiology, including sepsis pathogenesis. Interrater agreement for presence and absence of sepsis was almost perfect but only slight for suspected infection. ICU mortality was 19.5% in encounters with SIRS as the "worst" working diagnosis compared to 5.9% with sepsis and 5.9% with severe sepsis without differences in admission and maximum SOFA. Compared to sepsis, proportions of GTSQs with SIRS plus acute organ dysfunction were equal and macrocirculatory abnormalities higher (p < 0.0001). SIRS proportionally ranked above sepsis in daily assessment of illness severity (p < 0.0001). Separate analyses of neurosurgical referrals revealed similar differences. Discriminatory performance of Sepsis-1/2 and Sepsis-3 compared to GTSQ labels was similar with sensitivities around 70% and specificities 92%. Essentially no difference between the prevalence of SIRS and SOFA ≥ 2 yielded sensitivities and specificities for detecting sepsis onset close to 55% and 83%, respectively.ConclusionsGTSQ labels are a valid measure of sepsis in the ICU. They reveal suspicion of infection as an unclear clinical concept and refute an illness severity hierarchy in the SIRS-sepsis-severe sepsis spectrum. Ground truth challenges the accuracy of Sepsis-1/2 and Sepsis-3 in detecting sepsis onset. It is an indispensable intermediate step towards advancing diagnosis and therapy in the ICU and, potentially, other health care settings.

Dataset Information

Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout.

Publications

Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout.

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