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Diagnosis and management of gout<br />Key questions:<br /><ol> <li>What is the accuracy of clinical criteria only in the diagnosis of acute gouty arthropathy instead of synovial fluid analysis?</li> <li>In adults with a history of gout, do…

NOMINATED TOPIC | March 11, 2013
Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

Diagnosis and management of gout
Key questions:

  1. What is the accuracy of clinical criteria only in the diagnosis of acute gouty arthropathy instead of synovial fluid analysis?
  2. In adults with a history of gout, do results of baseline uric acid levels and blood and urine chemistries predict the effectiveness of diet and/or pharmacological treatment on final health outcomes and intermediate (joint/ gout/systemic) events and outcomes, and reduce treatment adverse effects?
    1. Do effectiveness and adverse effects of treatment differ according to patient baseline uric acid levels and blood and urine biochemical measures?
    2. Does treatment tailored to the results of baseline uric acid levels and blood and urine chemistries improve final health outcomes and intermediate (Joint/ gout/systemic) events and outcomes, and reduce adverse effects compared with empiric treatment?
  3. In adults with a history of gout, what is the effectiveness and comparative effectiveness of different dietary therapies on final health outcomes and intermediate (gout/joint/ systemic) outcomes?
    1. Does effectiveness of diet therapy differ according to patient baseline demographic and co-morbid characteristics?
    2. Does effectiveness of diet therapy differ according to patient baseline diet and fluid intake?
    3. Does effectiveness of diet therapy differ according to uric acid level and quantitative urine uric acid levels?
  4. In adults with a history of gout, what is the evidence that dietary therapies to reduce risk of recurrent gout episodes are associated with adverse effects?
    1. Does the risk of adverse effects differ according to patient baseline demographic and co-morbid characteristics?
    2. Does the risk of adverse effects differ according to patient baseline diet and fluid intake?
    3. Does the risk of adverse effects differ according to joint vs. systemic involvement in gout?
  5. In adults with a history of gout what is the effectiveness and comparative effectiveness of different pharmacological therapies on final health outcomes and intermediate (joint/ gout/systemic) outcomes?
    1. Does effectiveness differ according to patient baseline demographic and co-morbid characteristics?
    2. Does effectiveness differ according to patient baseline diet and fluid intake?
    3. Does effectiveness differ according to characteristics of (joint/gout/systemic)?
  6. In adults with a history of gout, what is the evidence that pharmacological therapies to reduce risk of recurrent gout episodes are associated with adverse effects?
    1. Does the risk of adverse effects differ according to patient demographic and co-morbid characteristics?
    2. Does the risk of adverse effects differ according to patient baseline diet and fluid intake?
    3. Does the risk of adverse effects differ according to characteristics of (joint/ gout/systemic)
  7. In adults with a history of gout being treated to prevent gout recurrence, do results of follow-up blood and urine biochemistry measures predict final health outcomes and intermediate (joint/ gout/systemic ) outcomes?
    1. a. Does prediction of final health outcomes and intermediate gout outcomes (joint/ gout/systemic) differ according to the frequency or duration of follow-up biochemistry measurements?
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yes

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What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)
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Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)
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Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?
Which priority area(s) and population(s) does this topic apply to? (check all that apply)
EHC Priority Conditions (updated in 2008)
  • Arthritis and nontraumatic joint disorders
AHRQ Priority Populations
None
Federal Health Care Program
None

Importance

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What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)
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Potential Impact

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Organization

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Project Timeline

Diagnosis and Management of Gout

Jan 21, 2014
Topic Initiated
Jul 17, 2014
Nov 3, 2014
Nov 1, 2016
Nov 1, 2016
Jan 31, 2017
Consumer Summary Archived
Jan 31, 2017
Aug 23, 2017
Consumer Summary Archived
Page last reviewed November 2017
Page originally created March 2013

Internet Citation: Diagnosis and management of gout<br />Key questions:<br /><ol> <li>What is the accuracy of clinical criteria only in the diagnosis of acute gouty arthropathy instead of synovial fluid analysis?</li> <li>In adults with a history of gout, do…. Content last reviewed November 2017. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD.
https://effectivehealthcare.ahrq.gov/get-involved/nominated-topics/diagnosis-and-management-of-goutbr-key-questionsbr-ol-liwhat-is-the-accuracy-of-clinical-criteria-only-in-the-diagnosis-of-acute-gouty-arthropathy-instead-of-synovial-fluid-analysisli-liin-adults-with-a-history-of-gout-do-re

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