Results of the Delphi exercise and face-to-face consensus meeting for agreement on the labels for the disease states of gout
| Disease states represented by disease element clusters | Delphi exercise | Face-to-face meeting | Agreed label | |||
| Consensus achieved* (round) | Agreement (%) | Consensus achieved† | Agreement (%) | |||
| Pre-clinical states | Hyperuricaemia‡ without clinical disease elements† of gout | Yes (3) | 85% | – | – | Asymptomatic hyperuricaemia‡ |
| Imaging evidence of MSU crystal deposition without clinical disease elements of gout | Yes (3) | 86% | – | – | Asymptomatic MSU crystal deposition | |
| Hyperuricaemia‡ with imaging evidence of MSU crystal deposition without clinical disease elements† of gout | No | – | Yes | 100% | Asymptomatic hyperuricaemia‡ with MSU crystal deposition | |
| Clinical states | Presence of MSU crystals with clinical disease elements† of gout | No | – | Yes | 97% | Gout |
| Presence of MSU crystals with any of the following: frequent recurrent gout flares, chronic gouty arthritis, subcutaneous tophi or imaging disease elements¶ of gout | Yes (2) | 82% | – | – | Severe gout** | |
| Presence of MSU crystals with subcutaneous tophi | Yes (1) | 89% | – | – | Tophaceous gout | |
| Presence of MSU crystals with clinical disease elements† of gout and with at least one gouty bone erosion | Yes (1) | 82% | – | – | Erosive gout | |
| Disease course states | The first episode of gout flare without preceding intercritical gout | Yes (3) | 83% | – | – | First gout flare |
| More than one episode of gout flare with intercritical gout | Yes (3) | 89% | – | – | Recurrent gout flares | |
*Consensus defined as ≥80% agreement on preferred label.
†Clinical disease elements: gout flare, intercritical gout, chronic gouty arthritis, subcutaneous tophus.
‡In British English, hyperuricaemia.
§Imaging disease elements: imaging evidence of MSU crystal deposition, gouty bone erosion.
¶The disease state ‘severe gout’ was subsequently determined not to be clinically meaningful by consensus agreement2 during the face-to-face consensus meeting.
MSU, monosodium urate.