Table 6

 Future research agenda: propositions developed through three Delphi rounds

Proposition
EULAR, European League Against Rheumatism; MRI, magnetic resonance imaging; MSU, monosodium urate.
1The clinical manifestations of gout require validation against a diagnosis established by identification of MSU crystals.
2An optimal protocol (including training) and European standard for the identification of MSU crystals needs to be established.
3The validity of diagnosis (sensitivity and specificity) by MSU crystal identification from asymptomatic joints during the intercritical periods needs to be determined.
4The diagnostic utility of synovial fluid examination in undiagnosed inflammatory arthritis should be determined.
5The value of the saturation point for MSU crystallisation as a cut off point for diagnosis requires investigation.
6The possible role of SUA as in independent risk factor for cardiovascular and renal disease requires investigation.
7The best method to determine renal urate clearance (to identify relative underexcretion or overproduction or both) and the diagnostic utility of this measure need to be determined.
8The value of ultrasound and MRI for diagnosis and monitoring of gout should be investigated.
9Genetic factors that predispose to gout need to be identified.
10EULAR criteria for classification of gout should be developed.