Survey Definitions of Gout for Epidemiologic Studies

Comparison With Crystal Identification as the Gold Standard

Nicola Dalbeth, H. Ralph Schumacher, Jaap Fransen, Tuhina Neogi, Tim L. Jansen, Melanie Brown, Worawit Louthrenoo, Janitzia Vazquez-Mellado, Maxim Eliseev, Geraldine McCarthy, Lisa K. Stamp, Fernando Perez-Ruiz, Francisca Sivera, Hang Korng Ea, Martijn Gerritsen, Carlo A. Scire, Lorenzo Cavagna, Chingtsai Lin, Yin Yi Chou, Anne Kathrin Tausche & 6 others Geraldo da Rocha Castelar-Pinheiro, Matthijs Janssen, Jiunn Horng Chen, Marco A. Cimmino, Till Uhlig, William J. Taylor

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1894-1898
Number of pages5
JournalArthritis Care and Research
Volume68
Issue number12
DOIs
Publication statusPublished - Dec 1 2016

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Gout
Uric Acid
Epidemiologic Studies
Self Report
Rheumatic Diseases
Sensitivity and Specificity
Rheumatology
Hyperuricemia
Genome-Wide Association Study
Colchicine
Surveys and Questionnaires
Therapeutics
Logistic Models
Datasets

ASJC Scopus subject areas

  • Rheumatology

Cite this

Dalbeth, N., Schumacher, H. R., Fransen, J., Neogi, T., Jansen, T. L., Brown, M., ... Taylor, W. J. (2016). Survey Definitions of Gout for Epidemiologic Studies: Comparison With Crystal Identification as the Gold Standard. Arthritis Care and Research, 68(12), 1894-1898. https://doi.org/10.1002/acr.22896

Survey Definitions of Gout for Epidemiologic Studies : Comparison With Crystal Identification as the Gold Standard. / Dalbeth, Nicola; Schumacher, H. Ralph; Fransen, Jaap; Neogi, Tuhina; Jansen, Tim L.; Brown, Melanie; Louthrenoo, Worawit; Vazquez-Mellado, Janitzia; Eliseev, Maxim; McCarthy, Geraldine; Stamp, Lisa K.; Perez-Ruiz, Fernando; Sivera, Francisca; Ea, Hang Korng; Gerritsen, Martijn; Scire, Carlo A.; Cavagna, Lorenzo; Lin, Chingtsai; Chou, Yin Yi; Tausche, Anne Kathrin; da Rocha Castelar-Pinheiro, Geraldo; Janssen, Matthijs; Chen, Jiunn Horng; Cimmino, Marco A.; Uhlig, Till; Taylor, William J.

In: Arthritis Care and Research, Vol. 68, No. 12, 01.12.2016, p. 1894-1898.

Research output: Contribution to journalArticle

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 & Taylor, WJ 2016, 'Survey Definitions of Gout for Epidemiologic Studies: Comparison With Crystal Identification as the Gold Standard', Arthritis Care and Research, vol. 68, no. 12, pp. 1894-1898. https://doi.org/10.1002/acr.22896
Dalbeth, Nicola ; Schumacher, H. Ralph ; Fransen, Jaap ; Neogi, Tuhina ; Jansen, Tim L. ; Brown, Melanie ; Louthrenoo, Worawit ; Vazquez-Mellado, Janitzia ; Eliseev, Maxim ; McCarthy, Geraldine ; Stamp, Lisa K. ; Perez-Ruiz, Fernando ; Sivera, Francisca ; Ea, Hang Korng ; Gerritsen, Martijn ; Scire, Carlo A. ; Cavagna, Lorenzo ; Lin, Chingtsai ; Chou, Yin Yi ; Tausche, Anne Kathrin ; da Rocha Castelar-Pinheiro, Geraldo ; Janssen, Matthijs ; Chen, Jiunn Horng ; Cimmino, Marco A. ; Uhlig, Till ; Taylor, William J. / Survey Definitions of Gout for Epidemiologic Studies : Comparison With Crystal Identification as the Gold Standard. In: Arthritis Care and Research. 2016 ; Vol. 68, No. 12. pp. 1894-1898.
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abstract = "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.",
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