OMERACT Measurement for Chronic Gout Studies
Thirty-one patients with gout (median age, 66.5 years; range, 39–90 years; 87.1% were male) performed the initial generation of areas of importance (Table 1). These areas were combined to form 14 items (Table 2), which were ranked and scored by 107 patients (32.7% from primary care).
The patients who performed the ranking and rating exercise were mainly middle-aged men with nontophaceous gout (Table 1). Diagnosis was confirmed using ARA survey criteria in the majority of patients, especially in the patients from primary care where synovial fluid analysis was used very infrequently (3%). Patients had very well-established gout and were continuing to experience episodes of gout, with more than half experiencing more than 1 attack in the previous year.
Four areas were ranked first to third most important by at least 20% of participants. These were pain (median rating, 10), loss of joint motion (median rating, 9), work loss (median rating, 7), and joint inflammation/swelling (median rating, 8). A regression model that modeled the rank of importance for each area by participant characteristics (age, sex, primary care/secondary care, tophaceous or not, duration of disease, time since last attack, number of attacks in previous 12 months, and whether daily pain present) found that "ugliness of tophi" was ranked much more highly by primary care patients (median ranking, 1) compared with patients from the specialist rheumatology clinic (median ranking, 12; β weight, -0.83; P = 0.02), and "loss of joint range of motion" was ranked less highly by older people compared with younger people (β weight, 1.27; P = 0.03). Otherwise, there were no significant associations between patient characteristics and importance rankings.
Results
Thirty-one patients with gout (median age, 66.5 years; range, 39–90 years; 87.1% were male) performed the initial generation of areas of importance (Table 1). These areas were combined to form 14 items (Table 2), which were ranked and scored by 107 patients (32.7% from primary care).
The patients who performed the ranking and rating exercise were mainly middle-aged men with nontophaceous gout (Table 1). Diagnosis was confirmed using ARA survey criteria in the majority of patients, especially in the patients from primary care where synovial fluid analysis was used very infrequently (3%). Patients had very well-established gout and were continuing to experience episodes of gout, with more than half experiencing more than 1 attack in the previous year.
Four areas were ranked first to third most important by at least 20% of participants. These were pain (median rating, 10), loss of joint motion (median rating, 9), work loss (median rating, 7), and joint inflammation/swelling (median rating, 8). A regression model that modeled the rank of importance for each area by participant characteristics (age, sex, primary care/secondary care, tophaceous or not, duration of disease, time since last attack, number of attacks in previous 12 months, and whether daily pain present) found that "ugliness of tophi" was ranked much more highly by primary care patients (median ranking, 1) compared with patients from the specialist rheumatology clinic (median ranking, 12; β weight, -0.83; P = 0.02), and "loss of joint range of motion" was ranked less highly by older people compared with younger people (β weight, 1.27; P = 0.03). Otherwise, there were no significant associations between patient characteristics and importance rankings.
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