UMass Chan Medical School Faculty Publications


Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds(R) Consensus Exercises


Hugh de Lautour, Auckland District Health Board
William J. Taylor, University of Otago
Ade Adebajo, University of Sheffield
Rieke Alten, University Medicine Berlin
Ruben Burgos-Vargas, Hospital General de México
Peter Chapman, Christchurch Hospital
Marco A. Cimmino, Università di Genova
Geraldo da Rocha Castelar Pinheiro, Pedro Ernesto University Hospital
Ric Day, University of New South Wales
Leslie R. Harrold, University of Massachusetts Medical SchoolFollow
Philip Helliwell, Leeds Institute of Rheumatic and Musculoskeletal Medicine
Matthijs Janssen, Rijnstate Hospital
Gail Kerr, Georgetown and Howard University Hospitals
Arthur Kavanaugh, University of California, San Diego
Dinesh Khanna, University of Michigan
Puja P. Khanna, University of Michigan
Chingtsai Lin, Taichung Veteran's General Hospital
Worawit Louthrenoo, Chiang Mai University
Geraldine McCarthy, Mater Misericordiae University Hospital
Janitzia Vazquez-Mellado, Hospital General de México
Ted R. Mikuls, University of Nebraska Medical Center
Tuhina Neogi, Boston University School of Medicine
Alexis Ogdie, University of Pennsylvania
Fernando Perez-Ruiz, Hospital Universitario Cruces
Naomi Schlesinger, Rutgers University
H. Ralph Schumacher, University of Pennsylvania
Carlo A. Scire, University of Pavia
Jasvinder A. Singh, University of Alabama at Birmingham
Francisca Sivera, Hospital General Universitario Elda
Ole Slot, University Hospital Glostrup
Lisa K. Stamp, University of Otago
Anne-Kathrin Tausche, University Hospital Carl Gustav Carus
Robert Terkeltaub, University of California San Diego
Till Uhlig, Diakonhjemmet Hospital
Mart van de Laar, Universiteit Twente
Douglas White, University of Auckland
Hisashi Yamanaka, Tokyo Women's Medical University
Xuejun Zeng, Peking Union Medical College Hospital
Nicola Dalbeth, University of Auckland

UMMS Affiliation

Department of Orthopedics and Physical Rehabilitation; Meyers Primary Care Institute

Publication Date


Document Type



Musculoskeletal Diseases


OBJECTIVES: The aim of this study was to establish consensus for potential remission criteria for use in clinical trials of gout.

METHODS: Experts (n=88) in gout from multiple countries were invited to participate in a web-based questionnaire study. Three rounds of Delphi consensus exercises were conducted using SurveyMonkey(R) followed by a discrete choice experiment using 1000Minds(R). The exercises focused on identifying domains, definitions for each domain and the timeframe over which remission should be defined.

RESULTS: There were 49 respondents (56% response) to the initial survey with subsequent response rates ranging from 57% to 90%. Consensus was reached for the inclusion of serum urate (98% agreement), flares (96%), tophi (92%), pain (83%) and patient global assessment (93%) of disease activity as measurement domains in remission criteria. Consensus was also reached for domain definitions including serum urate ( < 0.36mM), pain ( < 2 on a 10-point scale) and patient global assessment ( < 2 on a 10-point scale), all of which should be measured at least twice over a set time interval. Consensus was not achieved in the Delphi exercise for the timeframe for remission with equal responses for six months (51%) and one year (49%). In the discrete choice experiment, there was a preference towards 12 months as a timeframe for remission.

CONCLUSION: These consensus exercises have identified domains and provisional definitions for gout remission criteria. Based on the results of these exercises, preliminary remission criteria are proposed with domains of serum urate, acute flares, tophus, pain and patient global assessment. These preliminary criteria now require testing in clinical datasets.


clinical trials, gout, outcomes, remission

DOI of Published Version



Arthritis Care Res (Hoboken). 2016 May;68(5):667-72. doi: 10.1002/acr.22741. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Arthritis care and research

PubMed ID