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Session (II)-Reading the article

The article on the clinical diagnosis of gout is a bit cumbersome to read.

In fact this work is done with patients recruited for the implementation of a clinical trial on drug treatment for such trial gota.En start of 216 patients with confirmed in liquid crystals sinovial.En the

study we took the first thing you do is assess the diagnostic performance of family physicians against the "gold standard" represented by the presence of crystals in synovial fluid in 381 patients with monoarthritis

With the data provided the item can calculate a "2 x 2" with the help calculator CASP

Then the authors of the article build a Clinical Prediction Rule

To implement the proposed readingand CASP for this kind of articles I intend to continue this formulario.Puedes fill in the blog or if you have trouble click here

can also be helpful to consult the chapter of the book Jama the "Guidelines for users of medical literature"

Basically we have to compare the diagnostic performance of family physicians with whom we get to apply the new rule . It is to choose the method that best classify us "gout" "non-gout"

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Session (I)-Diagnosis of "drop" without tap joint: is it possible?

Gout is a common diagnosis in reality AP.En requires final confirmation of uric acid crystals in the liquid sinovial.Pero this is not a common practice in our clinics. ACR
The proposed his diagnosis based at least 6 of a list of 12 criteria:

• More an attack of acute arthritis
• The maximum inflammation developed within 1 day
Attack of monoarthritis
• joint Redness
• First metatarsophalangeal joint painful and swollen
• Prime unilateral attack on first metatarsophalangeal joint
• Tophi (tested or suspected) Hyperuricemia
• Asymmetric swelling within a joint (radiology)
• subcortical cysts without erosions (radiology)
• joint fluid culture negative during the acute attack.

But these criteria published in 1977 were not validated by any study.
One of the priorities of primary care research studies on diagnostic tests in our environment.
In the latest issue of the journal Archives ofInternal Medicine published a work studying the validity of the diagnosis of gout in primary care without recourse to examination of synovial fluid.
The proposal for the next session has two objectives:
-discuss the applicability of their results
-Discuss the difficulties in reading and review of the paper.

To help with the reading of the article may refer to this reference Fisterra "Critical reading an article on diagnosis" and Casp Spain page

Although material and methods section seems a bit cumbersome should not panic and remember what a clinical prediction rule and constructed as . For more information English



The article is available in pdf and it can be downloaded from the collection of journals Osakidetza Ovid