title: Australian and New Zealand recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion in the 3e Initiative.
abstract: OBJECTIVE
  To develop evidence-based recommendations for the diagnosis and management of gout in Australia and New Zealand as part of the multi-national 3e Initiative.
  
  
  METHODS
  Using a formal voting process, a panel of 78 international rheumatologists selected 10 key clinical questions pertinent to the diagnosis and management of gout. An additional question was also developed by participating Australian and New Zealand rheumatologists. Each question was investigated with a systematic literature review. MEDLINE, EMBASE, Cochrane CENTRAL and abstracts from 2010 to 2011 European League Against Rheumatism and American College of Rheumatology meetings were searched in each review. Relevant studies were independently reviewed by two individuals for data extraction and synthesis and risk of bias assessment. Using this evidence, 47 Australian and New Zealand rheumatologists developed national recommendations. For each recommendation the level of agreement was assessed and the level of evidence graded.
  
  
  RESULTS
  Eleven recommendations were produced relating to the diagnosis of gout, different aspects of the management of gout, cardiovascular and renal comorbidities and the management of asymptomatic hyperuricemia. The mean level of agreement with the recommendations was 9.1 on a 1-10 scale, with 10 representing full agreement.
  
  
  CONCLUSIONS
  Eleven Australian and New Zealand recommendations on the diagnosis and management of gout were developed combining systematically reviewed evidence with local expertise, enhancing their utility in clinical practice.
authors.affiliation: Rheumatology Unit and Department of General Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Graf
authors.forename: Samuel L
authors.initials: SL
authors.lastname: Whittle
authors.forename: Mihir D
authors.initials: MD
authors.lastname: Wechalekar
authors.forename: John H Y
authors.initials: JH
authors.lastname: Moi
authors.forename: Claire
authors.initials: C
authors.lastname: Barrett
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Hill
authors.forename: Geoff
authors.initials: G
authors.lastname: Littlejohn
authors.forename: Nora
authors.initials: N
authors.lastname: Lynch
authors.forename: Gabor
authors.initials: G
authors.lastname: Major
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Taylor
authors.forename: Rachelle
authors.initials: R
authors.lastname: Buchbinder
authors.forename: Jane
authors.initials: J
authors.lastname: Zochling
mesh_terms: D001315:Australia; D015897:Comorbidity; D032921:Consensus; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine / Q000379:methods / Q000592:standards*; D006073:Gout / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D033461:Hyperuricemia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D007391:International Cooperation; D009520:New Zealand; D011237:Predictive Value of Tests; D012196:Review Literature as Topic; D012219:Rheumatology / Q000379:methods / Q000592:standards*; D012307:Risk Factors; D016896:Treatment Outcome
keywords: drug treatment metabolic and crystal arthropathies; metabolic and crystal arthropathies