Marwin Gutierrez1, Wolfgang A Schmidt2, Ralf G Thiele3, Helen I Keen4, Gurjit S Kaeley5, Esperanza Naredo6, Annamaria Iagnocco7, George A Bruyn8, Peter V Balint9, Emilio Filippucci10, Peter Mandl11, David Kane12, Carlos Pineda13, Andrea Delle Sedie14, Hilde Berner Hammer15, Robin Christensen16, Maria Antonietta D'Agostino17, Lene Terslev18. 1. Rheumatology Department, Clinica Reumatologica, Università Politecnica delle Marche, Jesi, Ancona, Italy, dr.gmarwin@gmail.com. 2. Rheumatology Department, Immanuel Krankenhaus, Medical Centre for Rheumatology, Berlin, Germany. 3. Department of Medicine, Allergy/Immunology and Rheumatology Division, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA. 4. School of Medicine and Pharmacology Fiona Stanley Hospital Unit, University of Western Australia, Perth, Australia. 5. Division of Rheumatology, University of Florida College of Medicine, Jacksonville, FL, USA. 6. Rheumatology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 7. Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome. 8. Rheumatology Department, MC Groep Hospitals, Lelystad, Netherlands. 9. 3rd Rheumatology Department, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary. 10. Rheumatology Department, Clinica Reumatologica, Università Politecnica delle Marche, Jesi, Ancona, Italy. 11. Division of Rheumatology, Medical University of Vienna, Vienna, Austria. 12. Rheumatology Department, Trinity College, Dublin, Ireland. 13. Rheumatology Department, Instituto Nacional de Rehabilitacion, Mexico City, Mexico. 14. Rheumatology Unit, University of Pisa, Pisa, Italy. 15. Rheumatology Department, Diakonhjemmet Hospital, Oslo, Norway. 16. Musculoskeletal Statistics Unit, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark. 17. INSERM U1173, Rheumatology Department, Laboratoire d'excellence INFLAMEX, UFR Simone Veil, Versailles-Saint-Quentin University, Saint-Quentin en Yvelines, France and. 18. Rheumatology Department, Center for Rheumatology and Spine diseases, Copenhagen University Hospital, Copenhagen, Denmark.
Abstract
OBJECTIVE: To produce consensus-based definitions of the US elementary lesions in gout and to test their reliability in a web-based exercise. METHODS: The process consisted of two steps. In the first step a written Delphi questionnaire was developed from a systematic literature review and expert international consensus. This collated information resulted in four statements defining US elementary lesions: double contour (DC), tophus, aggregates and erosion. The Delphi questionnaire was sent to 35 rheumatology experts in US, asking them to rate their level of agreement or disagreement with each statement. The second step tested the reliability by a web-exercise. US images of both normal and gouty elementary lesions were collected by the participants. A facilitator then constructed an electronic database of 110 images. The database was sent to the participants, who evaluated the presence/absence of US elementary lesions. A group of 20 images was displayed twice to evaluate intra-reader reliability. RESULTS: A total of 32 participants responded to the questionnaires. Good agreement (>80%) was obtained for US definitions on DC, tophus, aggregates and erosion in the Delphi exercise after three rounds. The reliability on images showed inter-reader κ values for DC, tophus, aggregates, erosion findings of 0.98, 0.71, 0.54 and 0.85, respectively. The mean intra-reader κ values were also acceptable: 0.93, 0.78, 0.65 and 0.78, respectively. CONCLUSION: This, the first consensus-based US definition of elementary lesions in gout, demonstrated good reliability overall. It constitutes an essential step in developing a core outcome measurement that permits a higher degree of homogeneity and comparability between multicentre studies.
OBJECTIVE: To produce consensus-based definitions of the US elementary lesions in gout and to test their reliability in a web-based exercise. METHODS: The process consisted of two steps. In the first step a written Delphi questionnaire was developed from a systematic literature review and expert international consensus. This collated information resulted in four statements defining US elementary lesions: double contour (DC), tophus, aggregates and erosion. The Delphi questionnaire was sent to 35 rheumatology experts in US, asking them to rate their level of agreement or disagreement with each statement. The second step tested the reliability by a web-exercise. US images of both normal and gouty elementary lesions were collected by the participants. A facilitator then constructed an electronic database of 110 images. The database was sent to the participants, who evaluated the presence/absence of US elementary lesions. A group of 20 images was displayed twice to evaluate intra-reader reliability. RESULTS: A total of 32 participants responded to the questionnaires. Good agreement (>80%) was obtained for US definitions on DC, tophus, aggregates and erosion in the Delphi exercise after three rounds. The reliability on images showed inter-reader κ values for DC, tophus, aggregates, erosion findings of 0.98, 0.71, 0.54 and 0.85, respectively. The mean intra-reader κ values were also acceptable: 0.93, 0.78, 0.65 and 0.78, respectively. CONCLUSION: This, the first consensus-based US definition of elementary lesions in gout, demonstrated good reliability overall. It constitutes an essential step in developing a core outcome measurement that permits a higher degree of homogeneity and comparability between multicentre studies.
Authors: Tomas Cazenave; Victoria Martire; Anthony M Reginato; Marwin Gutierrez; Christian Alfredo Waimann; Carlos Pineda; Javier Eduardo Rosa; Santiago Ruta; Oscar Sedano-Santiago; Ana Maria Bertoli; Marcelo Audisio; Cristina Hernandez-Diaz; Lucio Ventura-Rios; Maritza Quintero; Eugenio De Miguel; Ana Laura Alvarez-Del-Castillo-Araujo; Andy Abril; Eliana Natalí Ayala-Ledesma; Edith Alarcon-Isidro; Maria Lida Santiago; Mariana Alejandra Pera; Cecilia Urquiola; Gustavo Rodriguez Gil; Lina Maria Saldarriaga Rivera; Cesar Cefferino; Mariana Benegas; Mario Enrique Diaz Cortes; Maximiliano Bravo; Diana Peiteado; Natalia Anahi Estrella; Roser Areny Micas; Jorge Saavedra Muñoz; Rodolfo Del Carmen Arape Toyo; Maria Soledad Gálvez Elkin; Walter Javier Spindler; Clarisa Sandobal; Josefina Marin; Manuella Lima Gomes Ochtrop; Ricardo Pavao Ayala; Erika Roxana Catay; Guillermo Enrique Py; Gabriel Hector Aguilar; Yvonne Yona Rengel Colina; Carla Antonela Airoldi; Claudia Selene Mora-Trujillo; Maria Paula Kohan; Lorena Evelin Urioste Eguez; Concepción Castillo-Gallego; Jose Francisco Diaz-Coto; Patricio Tate; Carla Magali Saucedo; Oscar Vega-Hinojosa; Cristian Jonatan Troitiño; Maria Florencia Marengo; Priscila Maria Marcaida; Irene Monjo Henry; Roberto Muñoz-Louis; Carla Solano; Felix Reinaldo Fernandez Castillo; Cesar Enrique Graf; Mara Guinsburg; Maria Julia Santa Cruz; David Alejandro Navarta Ortiz; Magaly Alva Linares; Marcos Gabriel Rosemffet Journal: Rheumatol Int Date: 2018-12-11 Impact factor: 2.631
Authors: Marwin Gutierrez; Cristina Hernandez-Diaz; Lucio Ventura-Rios; Lina María Saldarriaga-Rivera; Santiago Ruta; Magaly Alva; Claudia Mora -Trujillo; Wilkerson Pérez; Henry Terrazas; Rodolfo Del Carmen Arape Toyo; Maritza Quintero; Carla Solano; Oscar Sedano Santiago; Janet Grisel Huamán Sotomayor; Cesar Cefferino; Guillermo E Py; Marcelo J Audisio; Walter Javier Spindler; Horacio Berman; Carla Airoldi; Rómulo Wong; Ana Laura Álvarez Del Castillo Araujo; Mario E Díaz; Carmen Cerón Villaquiran; Rubén Darío Mantilla; José Alexandre Mendonça; Inês Guimarães da Silveira; Aline Defaveri do Prado; Melissa Cláudia Bisi; Violeta Rosario; Jeannette Medrano-Sánchez; Roberto Muñoz-Louis; Ana Cecilia Lozada-Navarro; Araceli Bernal; Maribel Lozano; Carlos Pineda Journal: Clin Rheumatol Date: 2016-08-30 Impact factor: 2.980
Authors: Alexis Ogdie; William J Taylor; Tuhina Neogi; Jaap Fransen; Tim L Jansen; H Ralph Schumacher; Worawit Louthrenoo; Janitzia Vazquez-Mellado; Maxim Eliseev; Geraldine McCarthy; Lisa K Stamp; Fernando Perez-Ruiz; Francisca Sivera; Hang-Korng Ea; Martijn Gerritsen; Giovanni Cagnotto; Lorenzo Cavagna; Chingtsai Lin; Yin-Yi Chou; Anne-Kathrin Tausche; Manuella Lima Gomes Ochtrop; Matthijs Janssen; Jiunn-Horng Chen; Ole Slot; Juris Lazovskis; Douglas White; Marco A Cimmino; Till Uhlig; Nicola Dalbeth Journal: Arthritis Rheumatol Date: 2017-02 Impact factor: 10.995
Authors: Lucio Ventura-Ríos; Guadalupe Sánchez-Bringas; Carlos Pineda; Cristina Hernández-Díaz; Anthony Reginato; Magaly Alva; Marcelo Audisio; Ana Bertoli; Tomas Cazenave; Marwin Gutiérrez; Claudia Mora; Guillermo Py; Oscar Sedano; Carla Solano; Eugenio de Miguel Journal: Clin Rheumatol Date: 2016-05-28 Impact factor: 2.980