Objective. To develop and perform an initial validation of a damage index for systemic lupus erythematosus (SLE). Methods.A list of items considered to reflect damage in SLE was generated through a nominal group

Objective. To test the reliability of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) in the assessment of patients with SLE. Methods. Ten patients with SLE, representing a spectrum of damage and activity, were included. Each patient was examined by 6 of 10 physicians from 5 countries, representing 10 lupus clinics. The SLICC/ACR Damage Index was used to assess accumulated damage, and the SLEDAI was used to assess disease activity. The order of the patients and physicians was randomized according to a Youden square design. Results. The SLICC/ACR Damage Index detected differences among patients (P < 0.001). There was no detectable observer difference (P = 0.933), and there was no order effect (P = 0.261). Similar results were obtained with the SLEDAI. There was concordance in the SLICC/ACR Damage Index among observers, despite a wide spectrum of disease activity detected by the SLEDAI. Conclusion. Physicians from different centers are able to assess patients with SLE in a reproducible way, using the SLEDAI to assess disease activity and the SLICC/ACR Damage Index to assess accumulated damage.

Objective. Different sets of diagnostic criteria have been proposed for Sjogren's syndrome (SS), but none have been validated with a large series of patients or in a multicenter study. We conducted the present study involving 26 centers from 12 countries (11 in Europe, plus Israel), with the goals of reaching a consensus on the diagnostic procedures for SS and defining classification criteria to be used in epidemiologic surveys and adopted by the scientific community.Methods. The study protocol was subdivided into two parts. For part I, questionnaires regarding both ocular and oral involvement were developed; they in-

Short running title: BSR and BHPR Guideline for the Management of Gout Scope and purpose Background to the disease Gout is the most common cause of inflammatory arthritis worldwide. In UK general practice, the overall prevalence has increased from 1.4% in 1999 to 2.49% in 2012 1 , despite the availability of effective and potentially 'curative' urate-lowering drugs for more than 50 years and evidence-based British and European management guidelines for nearly a decade 2;3. Clinical manifestations of gout resulting from monosodium urate (MSU) crystal deposition, include tophi, chronic arthritis, urolithiasis and renal disease as well as recurrent acute arthritis, bursitis and cellulitis. Gouty arthritis and tophi are associated with chronic disability, impairment of health-related quality of life (HRQOL) 4-7 , increased use of healthcare resources, and reduced productivity 8. Gout is also frequently associated with co-morbidities such as obesity, dyslipidaemia, diabetes mellitus, chronic renal insufficiency, hypertension, cardiovascular disease, hypothyroidism, anaemia, psoriasis, chronic pulmonary diseases, depression and osteoarthritis 1 as well as with an increase in all-cause mortality (adjusted hazard ratio 1.13, 95% CI 1.08 to 1.18) and urogenital malignancy 1;9. Sustained hyperuricaemia is the single most important risk factor for the development of gout. Hyperuricaemia occurs secondary to reduced fractional clearance of uric acid in more than 90% of patients with gout 10. Age, male gender, menopausal status in females, impairment of renal function, hypertension and the co-morbidities that comprise the metabolic syndrome are all risk factors for incident Recently published guidelines include the 2012 American College of Rheumatology Guidelines for the Management of Gout 34,35 and the 2013 evidence-based recommendations for the diagnosis and management of gout by a multinational panel of rheumatologists participating in the 3e initiative 36. Other National and Regional guidelines include the US Government 2014 Agency for Healthcare Research and Quality (AHRQ) Guidelines for the Diagnosis and Management of Gout 37,38 , and the Australian and New Zealand 39 and Portuguese 40 recommendations for the diagnosis and management of gout which arose from the 3e initiative. 36 Updated EULAR recommendations for the management of gout will be published in 2016. Objective This guideline aims to offer revised and updated, concise, patient-focussed, evidence-based, expert recommendations for the management of gout in the UK.

WOMAC is the instrument of choice for evaluating the outcome of knee replacement surgery in OA. The SF-36 provides a more general insight into patients' health and may be more responsive to change than the WOMAC in a heterogeneous rheumatology clinic population. Researchers wishing to undertake an economic evaluation might consider the EQ-5D for a surgical, but not a rheumatology clinic group.