Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

Diagnosis and management of gout
Key questions:

1. What is the accuracy of clinical criteria only in the diagnosis of acute gouty arthropathy instead of synovial fluid analysis?
2. In adults with a history of gout, do results of baseline uric acid levels and blood and urine chemistries predict the effectiveness of diet and/or pharmacological treatment on final health outcomes and intermediate (joint/ gout/systemic) events and outcomes, and reduce treatment adverse effects?
1. Do effectiveness and adverse effects of treatment differ according to patient baseline uric acid levels and blood and urine biochemical measures?
2. Does treatment tailored to the results of baseline uric acid levels and blood and urine chemistries improve final health outcomes and intermediate (Joint/ gout/systemic) events and outcomes, and reduce adverse effects compared with empiric treatment?
3. In adults with a history of gout, what is the effectiveness and comparative effectiveness of different dietary therapies on final health outcomes and intermediate (gout/joint/ systemic) outcomes?
1. Does effectiveness of diet therapy differ according to patient baseline demographic and co-morbid characteristics?
2. Does effectiveness of diet therapy differ according to patient baseline diet and fluid intake?
3. Does effectiveness of diet therapy differ according to uric acid level and quantitative urine uric acid levels?
4. In adults with a history of gout, what is the evidence that dietary therapies to reduce risk of recurrent gout episodes are associated with adverse effects?
1. Does the risk of adverse effects differ according to patient baseline demographic and co-morbid characteristics?
2. Does the risk of adverse effects differ according to patient baseline diet and fluid intake?
3. Does the risk of adverse effects differ according to joint vs. systemic involvement in gout?
5. In adults with a history of gout what is the effectiveness and comparative effectiveness of different pharmacological therapies on final health outcomes and intermediate (joint/ gout/systemic) outcomes?
1. Does effectiveness differ according to patient baseline demographic and co-morbid characteristics?
2. Does effectiveness differ according to patient baseline diet and fluid intake?
3. Does effectiveness differ according to characteristics of (joint/gout/systemic)?
6. In adults with a history of gout, what is the evidence that pharmacological therapies to reduce risk of recurrent gout episodes are associated with adverse effects?
1. Does the risk of adverse effects differ according to patient demographic and co-morbid characteristics?
2. Does the risk of adverse effects differ according to patient baseline diet and fluid intake?
3. Does the risk of adverse effects differ according to characteristics of (joint/ gout/systemic)
7. In adults with a history of gout being treated to prevent gout recurrence, do results of follow-up blood and urine biochemistry measures predict final health outcomes and intermediate (joint/ gout/systemic ) outcomes?
   
   1. a. Does prediction of final health outcomes and intermediate gout outcomes (joint/ gout/systemic) differ according to the frequency or duration of follow-up biochemistry measurements?

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Describe any health-related risks, side effects, or harms that you are concerned about.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Arthritis and nontraumatic joint disorders

AHRQ Priority Populations

None

Federal Health Care Program

None

Importance

Describe why this topic is important.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

If yes, please explain:

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

Describe the timeframe in which an answer to your question is needed.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

Are you making a suggestion as an individual or on behalf of an organization?

Organization

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