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  • #17464

    My stock response to an unclear gout diagnosis question is “get a joint fluid test from a rheumatologist.” There are lots of reasons why this might not be an option, and it’s always good to see if there are alternatives.

    Whilst I was researching possible alternatives I found a gout study that investigated a potential “Diagnostic rule for acute gouty arthritis without joint fluid analysis.” That study correlates various symptoms and other personal gout facts with the risk of having gout. Whilst I’m reviewing that, you might like to try the gout calculator which is based on that study. Simply choose your gender, then check all the factors that apply to you. Your chance of having gout is shown in the box automatically.

    None of the results you select are recorded anywhere. This is a gout diagnostic tool you can play around with to see which factors are most important. The calculator was pulled from an external website, so I have no control over wording. If you want an explanation of any of the wording, just ask.

    [Gout Calculator Withdrawn by Authors]

    I’m not convinced yet that this calculator is the best it can be. I’ve noticed that one of the factors does not change the result, and I think the gender choice for female should distinguish between pre and post menopause. Leaving those reservations aside, I believe this is a fascinating learning and diagnostic tool for gout.

    Gout Calculator 2018 Update
    Unfortunately, the gout calculator website has been closed. However, that research is now largely out-of-date. So, I’ve been thinking about generating my own gout risk calculator using more recent research. Because this would be very useful for arthritis sufferers who think they might have gout.

    If you are interested, please start a new discussion about gout calculators.

    Keith Taylor

    Cool diagnostic tool for gout. I am a male, and checked all factors except for big toe (MTP1 involvement). My calculated risk for gout with those symptoms is 79%.

    Keith Taylor

    The data that was used to generate that calculator has been published in various journals and scientific meetings. The most high profile is Rheumatology journal in August 2014 titled: The validation of a diagnostic rule for gout without joint fluid analysis.

    The abstract is widely available, but the full report is expensive. If anyone has a full version of the report, I’d love to see the exact values on which the calculations have been based. Also, there might be explanations about my reservations about the calculator. Does the report consider menopause? Also, there is the emphasis on big toe involvement, but this can be lifestyle specific. The big toe is the coldest large joint for most people, but lifestyle, environment, or work factors make other joints more important risk factors for some people.

    Keith Taylor

    One of my reservations about the calculator was ‘Onset within 1 day’ as it does not appear to change anything. Looki9ng at the code, it is only makes a fraction of a percent difference. As the result is rounded to whole percentage points, you do not see the difference. There might be some combination of factors that cause the result to change by 1%, but this is not a factor to worry about.

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