title: Large epidemiologic studies of gout: challenges in diagnosis and diagnostic criteria.
abstract: Large epidemiologic studies of gout can improve insight into the etiology, pathology, impact, and management of the disease. Identification of monosodium urate monohydrate crystals is considered the gold standard for diagnosis, but its application is often not possible in large studies. Therefore, under such circumstances, several proxy approaches are used to classify patients as having gout, including ICD coding in several types of databases or questionnaires that are usually based on the existing classification criteria. However, agreement among these methods is disappointing. Moreover, studies use the terms acute, recurrent, and chronic gout in different ways and without clear definitions. Better definitions of the different manifestations and stages of gout may provide better insight into the natural course and burden of disease and can be the basis for valid approaches to correctly classifying patients within large epidemiologic studies.
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Research School Caphri, Maastricht University, PO Box 5800, NL-6202 AZ, Maastricht, The Netherlands. j.wijnands@maastrichtuniversity.nl
authors.forename: José M A
authors.initials: JM
authors.lastname: Wijnands
authors.forename: Annelies
authors.initials: A
authors.lastname: Boonen
authors.forename: Ilja C W
authors.initials: IC
authors.lastname: Arts
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Dagnelie
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: Sjef
authors.initials: S
authors.lastname: van der Linden
mesh_terms: D015415:Biomarkers / Q000032:analysis; D016021:Epidemiologic Studies; D006073:Gout / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D015203:Reproducibility of Results; D013582:Synovial Fluid / Q000737:chemistry; D014527:Uric Acid / Q000032:analysis
chemical_list: D015415:Biomarkers; D014527:Uric Acid