Ultrasound as an outcome measure in gout. A validation process by the OMERACT Ultrasound Working Group

Lene Terslev, Marwin Gutierrez, Wolfgang A. Schmidt, Helen I. Keen, Emilio Filippucci, David Kane, Ralf Thiele, Gurjit Kaeley, Peter Balint, Peter Mandl, Andrea Delle Sedie, Hilde Berner Hammer, Robin Christensen, Ingrid Möller, Carlos Pineda, Eugene Kissin, George A. Bruyn, Annamaria Iagnocco, Esperanza Naredo, Maria Antonietta D'Agostino*OMERACT Ultrasound Working Group The Journal of Rheumatology

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

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    Objective. To summarize the work performed by the Outcome Measures in Rheumatology (OMERACT) Ultrasound (US) Working Group on the validation of US as a potential outcome measure in gout. Methods. Based on the lack of definitions, highlighted in a recent literature review on US as an outcome tool in gout, a series of iterative exercises were carried out to obtain consensus-based definitions on US elementary components in gout using a Delphi exercise and subsequently testing these definitions in static images and in patients with proven gout. Cohen's κ was used to test agreement, and values of 0-0.20 were considered poor, 0.20-0.40 fair, 0.40-0.60 moderate, 0.60-0.80 good, and 0.80-1 excellent. Results. With an agreement of > 80%, consensus-based definitions were obtained for the 4 elementary lesions highlighted in the literature review: tophi, aggregates, erosions, and double contour (DC). In static images interobserver reliability ranged from moderate to almost perfect, and similar results were found for the intrareader reliability. In patients the intraobserver agreement was good for all lesions except DC (moderate). The interobserver agreement was poor for aggregates and DC but moderate for the other components. Conclusion. These first steps in evaluating the validity of US as an outcome measure for gout show that the reliability of the definitions ranged from moderate to excellent in static images and somewhat lower in patients, indicating that a standardized scanning technique may be needed, before testing the responsiveness of those definitions in a composite US score.

    Original languageEnglish
    Pages (from-to)2177-2181
    Number of pages5
    JournalJournal of Rheumatology
    Issue number11
    Publication statusPublished - 1 Nov 2015


    • Gout
    • Reproducibility of results
    • Ultrasound


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