Table.
GRADE evaluation of interventions for gout
| Important outcomes | Symptom severity, recurrence of gout, adverse effects | ||||||||
| Number of studies (participants) | Outcome | Comparison | Type of evidence | Quality | Consistency | Directness | Effect size | GRADE | Comment |
| What are the effects of treatments for acute gout? | |||||||||
| 1 (43) | Symptom severity | Colchicine v placebo | 4 | –1 | 0 | –1 | 0 | Low | Quality point deducted for sparse data. Directness point deducted for narrow inclusion criteria |
| 1 (90) | Symptom severity | Corticosteroids v NSAIDS | 4 | –1 | –1 | 0 | 0 | Low | Quality point deducted for sparse data. Consistency point deducted for different results at different end points |
| 1 (31) | Symptom severity | Corticosteroids v corticotropin | 4 | –1 | 0 | –1 | 0 | Low | Quality point deducted for sparse data. Directness point deducted for only assessing one corticosteroid |
| 1 (30) | Symptom severity | NSAIDs v placebo | 4 | –2 | –1 | –1 | +1 | Very low | Quality points deducted for sparse data and statistical flaws. Consistency point deducted for conflicting results at different end points. Directness point deducted for assessing only one drug. Effect-size point added for RR greater than 2 |
| 6 (548) | Symptom severity | NSAIDs v each other | 4 | 0 | 0 | –1 | 0 | Moderate | Directness point deducted for assessment of only some NSAIDs |
| What are the effects of treatments to prevent gout in people with prior acute episodes? | |||||||||
| 1 RCT | Recurrence of gout | Sulfinpyrazone plus colchicine v colchicine plus placebo | 4 | –2 | 0 | 0 | 0 | Low | Quality points deducted for sparse data and incomplete reporting of results |
| 1 (760) | Recurrence of gout | Xanthine oxidase inhibitors v each other | 4 | 0 | –1 | 0 | 0 | Moderate | Consistency point deducted for conflicting results at different end points and with different doses |
| 1 (43) | Recurrence of gout | Xanthine oxidase inhibitors alone v xanthine oxidase inhibitors plus prophylactic drugs | 4 | –2 | 0 | 0 | 0 | Low | Quality points deducted for sparse data and for uncertainty about basis of statistical analysis |
Type of evidence: 4 = RCT; 2 = Observational; Consistency: similarity of results across studies. Directness: generalisability of population or outcomes.Effect size: based on relative risk or odds ratio.