Figure 1.

Patient inclusion flowchart. According to the inclusion criteria, 97, 408, and 7216 patients were identified to have a first diagnosis of gout at age 30 years or younger, at age 31‐40 years, and at over 40 years of age, respectively, during the initial review of the electronic medical database based on the age documented when gout was first listed on the problem list. After a detailed chart review and after applying the exclusion criteria, 87 and 140 patients were identified in groups 1 and 2, respectively; 100 patients were randomly selected from patients aged over 40 years and defined as group 3. *Ten patients were found on the chart review to have a first gout diagnosis at age 40 years and younger; however, all were excluded because of inadequate information.