International recommendations and guidelines
| Source | Systematic reviews and meta analyses | |||
|---|---|---|---|---|
| American College of Rheumatology9 | Patient.co.uk10 | Drugs.com11Also App | Cochrane Database of Systematic Reviews12 | |
| Yes, probably (some COI problems) | No | Not for selection of drugs | Yes |
| a. Is up to date? | 2012/2013 | No information | No information | 2012 |
| b. Is the content based on best available evidences? | Systematic review with evidences tables, recommendation based on cases (Delphi/nominal group) | Stated that authors shall base recommendations on best available evidences | Stated sources solely from independent agents such as the ASHP, FDA, Micromedex, | Systematic review |
| c. Is the process for the preparation fully described and transparent? | Full description of methods (RAND/UCLA, cases, consensus/voting) and level of evidences, and safety and quality | Written by one single author No further information available | No | Each step in the process and the analysis for each comparison of effect is described in detail with responsible person/s |
| d. Are important experts, users and customers involved? | Core expert panel and a task force panel (11 members) including several rheumatologists, primary care physicians, nephrologist, and patient representative | Not possible to assess. Stated to be peer-reviewed, accurate and independent data | Three authors belonging to a Cochrane review group. Only experts involved. | |
| e. Is COI declared and taken account of? | COI fully declared. At least 51% of experts without COI at any given time. No information decision participation | Not possible to assess | Declared COI. If COI excluded. No COI known | |
| 2. Can we use it? | Not in this case. It does not address the exact question. | Yes, quick and easy | Easy available | Yes, with some effort |
| a. Is it easy to read, understand and apply? | With some effort | Short text and very easy to read, understand and apply | Not in this case | Comparator to a newer preparation in 5 of 6 studies. Time consuming too read in detail 154 pages. |
| b. Does it give us information to improve patient care? | Not in patients without previous gout attacks | Clear recommendations that asymptomatic hyperuricaemia is not gout and does not warrant management with drugs | Only state that Colchicine is ‘involved’ | Studies on patients with gout and high serum uric acid levels where lowering of levels (by allopurinol or febuxostat, placebo not studied) decreased number of gout attacks after several years. |
| What should we recommend based on the case? | No direct information | The patient has no gout, and does not warrant management with drugs | No usable information | The 90-year-old patient has never had gout, and there is no evidence that prophylaxis treatment is effective. Suggest withdrawal of treatment |