Ontology highlight
ABSTRACT: Objective
Patients with acute gout are frequently treated in the emergency department (ED) and represent a typically underresourced and understudied population. A key limitation for gout research in the ED is the timely ability to identify acute gout patients. Our goal was to refine a multicriteria, electronic medical record alert for gout flares and to determine its diagnostic characteristics in the ED.Methods
The gout flare alert used electronic medical record data from ED nursing notes and was triggered by the term 'gout' preceding past medical history in the chief complaint, the term 'gout' and a musculoskeletal problem in the chief complaint, or the term 'gout' in the problem list and a musculoskeletal chief complaint. We validated its diagnostic properties to assess presence/absence of gout through manual medical record review using adjudicated expert consensus as the gold standard.Results
In January 2020, we analyzed 202 patient records from 2 university-based EDs; from these records, 57 patients were identified by our gout flare alert, and 145 were identified by other means as potentially having an acute gout flare. The gout flare alert's positive predictive value was 47% (95% confidence interval [95% CI] 34-60%), negative predictive value was 94% (95% CI 90-98%), sensitivity was 75% (95% CI 61-89%), and specificity was 82% (95% CI 76-88%). The diagnostic properties were similar at both institutions.Conclusion
Our multicomponent gout flare alert had reasonable sensitivity and specificity, albeit a modest positive predictive value. An electronic gout flare alert may help enable the conduct of gout research in the ED setting.
SUBMITTER: Jackson LE
PROVIDER: S-EPMC10500930 | biostudies-literature | 2023 Aug
REPOSITORIES: biostudies-literature
Jackson Lesley E LE Annapureddy Narender N Hansen Megan E ME Saag Kenneth G KG Booth James J Rosas Giovanna G Foster Phillip J PJ Mudano Amy A Sun Dongmei D Osborne John D JD Bongartz Tim T Hess Erik E Lawrence Colleen C Dunkel Leah L Danila Maria I MI
Arthritis care & research 20230219 8
<h4>Objective</h4>Patients with acute gout are frequently treated in the emergency department (ED) and represent a typically underresourced and understudied population. A key limitation for gout research in the ED is the timely ability to identify acute gout patients. Our goal was to refine a multicriteria, electronic medical record alert for gout flares and to determine its diagnostic characteristics in the ED.<h4>Methods</h4>The gout flare alert used electronic medical record data from ED nurs ...[more]