Ultrasound as an Outcome Measure in Gout. A Validation Process by the OMERACT Ultrasound Working Group

Terslev, Lene; Gutiérrez, Marwin; Schmidt, Wolfgang A.; Keen, Helen; Filippucci, Emilio; Kane, David; Thiele, Ralf; Kaeley, Gurjit S.; Bálint, Péter; Mandl, Péter; Sedie, Andrea Delle; Hammer, Hilde Berner; Christensen, Robin; Möller, Ingrid; Pineda, Carlos; Kissin, Eugene Y.; Bruyn, G. A. W.; Iagnocco, Annamaria; Naredo, Esperanza; D'Agostino, Maria Antonietta

doi:10.3899/jrheum.141294

Cited by 53 publications

(44 citation statements)

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“…The echogenicity and the size of the posterior acoustic shadow are variable from one tophus to another [27]. In certain cases, combination of hypoechoic tophus with a large posterior acoustic shadow complicates tophus outlining, and gives a more random measurement of its size (Additional file 1).…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study

et al. 2017

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BackgroundUltrasonography (US) and dual-energy computed tomography (DECT) can assess urate burden in gout. The objective of this study was to compare the quantification of urate deposition provided by US to the one provided by DECT.MethodsPatients with a diagnosis of gout were prospectively recruited to undergo quantification of urate deposition using US and DECT. US examination for tophi and the double contour (DC) sign was performed on the knees and feet and corresponding DECT scans provided volumes of tophi and of overall urate deposition. The primary endpoint was the intra-class correlation coefficient (ICC) of the volume of the index tophus measured by US and DECT and its 95% confidence interval (CI 95%).ResultsOf the 64 patients included, 34 presented with at least one tophus on US. DECT inter-reader agreement for urate deposition was perfect with an ICC of 1 (1–1) and good for the measurement of the index tophus with an ICC of 0.69 (0.47–0.83). The ICC for the measurement of the index tophus between the two techniques was poor with a value of 0.45 (0.1–0.71). The average ratio between the index tophi volume as assessed by DECT and US was 0.65. The number of DC-positive joints did not correlate with DECT volume of overall deposits (Spearman correlation coefficient of 0.23).ConclusionsDECT measurements of tophi give smaller volumes to the same tophi measured with US, and US signs of urate deposition in joints do not correlate with overall DECT volumes of extra-articular deposition.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-017-1381-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study

et al. 2017

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“…Monosodium urate crystals precipitate on the articular surface of hyaline cartilage and this precipitate forms a hyperechoic, bright band that parallels the hyperechoic bony cortex, forming a "double contour" of hyperechoic bone and bright-appearing monosodium urate deposits, as visualized on ultrasound images [26]. We performed a meta-analysis using published data of the sensitivity and specificity of ultrasound according to the double-contour sign for the diagnosis of gout in order to assess the diagnostic capability of ultrasound.…”

Section: An Example Of a Meta-analysis Of Diagnostic Test Accuracymentioning

confidence: 99%

Overview of the Process of Conducting Meta-analyses of the Diagnostic Test Accuracy

Lee

2018

J Rheum Dis

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Diagnosis is a critical step for clinical treatment. Many individual studies have been conducted to determine the accuracy of various diagnostic tests, but they had small sample sizes and correspondingly inadequate statistical strength. Combining the results from several such studies can help increase the statistical strength and precision of their results. Meta-analysis is a useful tool for evaluating the accuracy of diagnostic tests and can be used to obtain precise estimates when multiple small studies for a given test and subject pool are available. The need for meta-analysis on studies examining diagnostic test accuracy has increased noticeably, and more meta-analyses on diagnostic test accuracy studies are being published. A meta-analysis of diagnostic test accuracy studies differs from a typical meta-analysis because diagnostic test accuracy studies report a pair of statistics, such as sensitivity and specificity, rather than a single statistic. Therefore, meta-analyses of the diagnostic test accuracy need to deal with two summary statistics simultaneously. More complex statistical methods are required for conducting meta-analyses using diagnostic test accuracy studies compared to that required for conventional meta-analysis. This is because the sensitivity and specificity are generally inversely correlated due to a threshold effect, and there is considerable heterogeneity in the results of test accuracy studies. This review provides an overview of the process of meta-analysis of the diagnostic test accuracy. (J Rheum Dis 2018;25:3-10)

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“…Ved et internasjonalt samarbeid er det nå identifisert fire ultralydforandringer som angis å vaere typiske for urinsyregikt (10). Dobbelkontur.…”

Section: Ultralydundersøkelseunclassified

Urinsyregikt – nytt innen diagnostikk og behandling

Uhlig¹,

Eskild²,

Hammer³

2016

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Ultrasound as an Outcome Measure in Gout. A Validation Process by the OMERACT Ultrasound Working Group

Abstract: To summarize the work performed by the Outcome Measures in Rheumatology (OMERACT) Ultrasound (US) Working Group on the validation of US as a potential outcome measure in gout

Cited by 53 publications

References 20 publications

Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study

Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study

Overview of the Process of Conducting Meta-analyses of the Diagnostic Test Accuracy

Urinsyregikt – nytt innen diagnostikk og behandling

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