The shortage of robust data to inform the management of a common problem such as gout is surprising. All of the drugs used to treat gout can have serious side effects. The incidence of gout is highest in the elderly population. It is in this group, who are at a high risk of serious adverse events, that we are using drugs of known toxicity. The balance of risks and benefits for the drug treatment of gout needs to be reassessed.

On average, a general practitioner, who works with an average practice list size of 6000 people, will look after 30 patients with chronic heart failure and suspect a new diagnosis of heart failure in approximately 10 patients annually.