Undertaking a literature search (with the patient present)

Abstract

Mr W B, a 67 year old company director, limped into my room complaining of an inflamed, painful and swollen right big toe – classic gout. He had an important meeting in two days time that he could not afford to miss. He demanded something to control the symptoms and enable him to attend the meeting. I knew that colchicine given in acute gout gives good relief, but is associated with diarrhoea. However, the previous day one of my colleagues had discussed a clinical meeting he had recently attended where one of the speakers doubted the efficacy of colchicine in acute gout. I decided to do a quick literature search, while the patient was sitting in front of me, to find out if indeed colchicine is no better than placebo in acute gout.