{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T08:24:47Z","timestamp":1792571087196,"version":"4.5.0"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T00:00:00Z","timestamp":1517875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010721","name":"Ironwood Pharmaceuticals, Incorporated","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010721","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003545","name":"Minist\u00e9rio da Ci\u00eancia, Tecnologia e Inova\u00e7\u00e3o","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008333","name":"University of Alabama at Birmingham","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008333","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001537","name":"University of Auckland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001537","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007326","name":"Diakonhjemmet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007326","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005111","name":"Rigshospitalet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005111","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To perform external validation of a provisional definition of disease flare in patients with gout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Five hundred nine patients with gout were enrolled in a cross\u2010sectional study during a routine clinical care visit at 17 international sites. Data were collected to classify patients as experiencing or not experiencing a gout flare, according to a provisional definition. A local expert rheumatologist performed the final independent adjudication of gout flare status. Sensitivity, specificity, predictive values, and receiver operating characteristic (\n                      <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>\n                      ) curves were used to determine the diagnostic performance of gout flare definitions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean \u00b1\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      age of the patients was 57.5 \u00b1 13.9 years, and 89% were male. The definition requiring fulfillment of at least 3 of 4 criteria (patient\u2010defined gout flare, pain at rest score of &gt;3 on a 0\u201310\u2010point numerical rating scale, presence of at least 1 swollen joint, and presence of at least 1 warm joint) was 85% sensitive and 95% specific in confirming the presence of a gout flare, with an accuracy of 92%. The ROC area under the curve was 0.97. The definition based on a classification and regression tree algorithm (entry point, pain at rest score &gt;3, followed by patient\u2010defined flare \u201cyes\u201d) was 73% sensitive and 96% specific.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The definition of gout flare that requires fulfillment of at least 3 of 4 patient\u2010reported criteria is now validated to be sensitive, specific, and accurate for gout flares, as demonstrated using an independent large international patient sample. The availability of a validated gout flare definition will improve the ascertainment of an important clinical outcome in studies of gout.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.40381","type":"journal-article","created":{"date-parts":[[2017,11,21]],"date-time":"2017-11-21T15:48:39Z","timestamp":1511279319000},"page":"462-467","source":"Crossref","is-referenced-by-count":102,"title":["Brief Report: Validation of a Definition of Flare in Patients With Established Gout"],"prefix":"10.1002","volume":"70","author":[{"given":"Angelo L.","family":"Gaffo","sequence":"first","affiliation":[{"name":"University of Alabama at Birmingham and Birmingham VA Medical Center Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Dalbeth","sequence":"additional","affiliation":[{"name":"University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth G.","family":"Saag","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3485-0006","authenticated-orcid":false,"given":"Jasvinder A.","family":"Singh","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham and Birmingham VA Medical Center Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth J.","family":"Rahn","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy S.","family":"Mudano","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Hsing","family":"Chen","sequence":"additional","affiliation":[{"name":"Taichung Veterans General Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Tsai","family":"Lin","sequence":"additional","affiliation":[{"name":"Taichung Veterans General Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Bourke","sequence":"additional","affiliation":[{"name":"University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Worawit","family":"Louthrenoo","sequence":"additional","affiliation":[{"name":"Chiang Mai University Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janitzia","family":"Vazquez\u2010Mellado","sequence":"additional","affiliation":[{"name":"Hospital General de Mexico Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hansel","family":"Hern\u00e1ndez\u2010Llinas","sequence":"additional","affiliation":[{"name":"Hospital General de Mexico Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuhina","family":"Neogi","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5307-0254","authenticated-orcid":false,"given":"Ana Beatriz","family":"Vargas\u2010Santos","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine, Boston, Massachusetts and Universidade do Estado do Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldo","family":"da Rocha Castelar\u2010Pinheiro","sequence":"additional","affiliation":[{"name":"Universidade do Estado do Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo B. 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