A Delphi Exercise to Identify Characteristic Features of Gout -- Opinions from Patients and Physicians, the First Stage in Developing New Classification Criteria

UMMS Affiliation

Meyers Primary Care Institute; Department of Medicine, Division of Rheumatology; Department of Orthopedics and Physical Rehabilitation

Publication Date


Document Type



Gout; Delphi Technique


Health Services Research | Musculoskeletal Diseases | Rheumatology


OBJECTIVE: To identify a comprehensive list of features that might discriminate between gout and other rheumatic musculoskeletal conditions, to be used subsequently for a case-control study to develop and test new classification criteria for gout.

METHODS: Two Delphi exercises were conducted using Web-based questionnaires: one with physicians from several countries who had an interest in gout and one with patients from New Zealand who had gout. Physicians rated a list of potentially discriminating features that were identified by literature review and expert opinion, and patients rated a list of features that they generated themselves. Agreement was defined by the RAND/UCLA disagreement index.

RESULTS: Forty-four experienced physicians and 9 patients responded to all iterations. For physicians, 71 items were identified by literature review and 15 more were suggested by physicians. The physician survey showed agreement for 26 discriminatory features and 15 as not discriminatory. The patients identified 46 features of gout, for which there was agreement on 25 items as being discriminatory and 7 items as not discriminatory.

CONCLUSION: Patients and physicians agreed upon several key features of gout. Physicians emphasized objective findings, imaging, and patterns of symptoms, whereas patients emphasized severity, functional results, and idiographic perception of symptoms.

DOI of Published Version



J Rheumatol. 2013 Apr;40(4):498-505. Link to article on publisher's site

Journal/Book/Conference Title

The Journal of rheumatology


Full author list omitted for brevity. For the full list of authors, see article.

Related Resources

Link to Article in PubMed

PubMed ID