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Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia.

Abstract

OBJECTIVE

To develop a fibromyalgia (FM) survey questionnaire for epidemiologic and clinical studies using a modification of the 2010 American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia (ACR 2010). We also created a new FM symptom scale to further characterize FM severity.

METHODS

The ACR 2010 consists of 2 scales, the Widespread Pain Index (WPI) and the Symptom Severity (SS) scale. We modified these ACR 2010 criteria by eliminating the physician's estimate of the extent of somatic symptoms and substituting the sum of 3 specific self-reported symptoms. We also created a 0-31 FM Symptom scale (FS) by adding the WPI to the modified SS scale. We administered the questionnaire to 729 patients previously diagnosed with FM, 845 with osteoarthritis (OA) or with other noninflammatory rheumatic conditions, 439 with systemic lupus erythematosus (SLE), and 5210 with rheumatoid arthritis (RA).

RESULTS

The modified ACR 2010 criteria were satisfied by 60% with a prior diagnosis of FM, 21.1% with RA, 16.8% with OA, and 36.7% with SLE. The criteria properly identified diagnostic groups based on FM severity variables. An FS score ≥ 13 best separated criteria+ and criteria- patients, classifying 93.0% correctly, with a sensitivity of 96.6% and a specificity of 91.8% in the study population.

CONCLUSION

A modification to the ACR 2010 criteria will allow their use in epidemiologic and clinical studies without the requirement for an examiner. The criteria are simple to use and administer, but they are not to be used for self-diagnosis. The FS may have wide utility beyond the bounds of FM, including substitution for widespread pain in epidemiological studies.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    National Data Bank for Rheumatic Diseases, 1035 N. Emporia, Suite 288, Wichita, KS 67214, USA. fwolfe@arthritis-research.org

    , , , , , , , ,

    Source

    The Journal of rheumatology 38:6 2011 Jun pg 1113-22

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Arthritis, Rheumatoid
    Cognition Disorders
    Comorbidity
    Diagnosis, Differential
    Disability Evaluation
    Fatigue
    Female
    Fibromyalgia
    Health Surveys
    Humans
    Incidence
    Lupus Erythematosus, Systemic
    Male
    Middle Aged
    Osteoarthritis
    Sensitivity and Specificity
    Severity of Illness Index
    Sleep Wake Disorders

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    21285161

    Citation

    Wolfe, Frederick, et al. "Fibromyalgia Criteria and Severity Scales for Clinical and Epidemiological Studies: a Modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia." The Journal of Rheumatology, vol. 38, no. 6, 2011, pp. 1113-22.
    Wolfe F, Clauw DJ, Fitzcharles MA, et al. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. J Rheumatol. 2011;38(6):1113-22.
    Wolfe, F., Clauw, D. J., Fitzcharles, M. A., Goldenberg, D. L., Häuser, W., Katz, R. S., ... Winfield, J. B. (2011). Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. The Journal of Rheumatology, 38(6), pp. 1113-22. doi:10.3899/jrheum.100594.
    Wolfe F, et al. Fibromyalgia Criteria and Severity Scales for Clinical and Epidemiological Studies: a Modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. J Rheumatol. 2011;38(6):1113-22. PubMed PMID: 21285161.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. AU - Wolfe,Frederick, AU - Clauw,Daniel J, AU - Fitzcharles,Mary-Ann, AU - Goldenberg,Don L, AU - Häuser,Winfried, AU - Katz,Robert S, AU - Mease,Philip, AU - Russell,Anthony S, AU - Russell,I Jon, AU - Winfield,John B, Y1 - 2011/02/01/ PY - 2011/2/3/entrez PY - 2011/2/3/pubmed PY - 2011/10/14/medline SP - 1113 EP - 22 JF - The Journal of rheumatology JO - J. Rheumatol. VL - 38 IS - 6 N2 - OBJECTIVE: To develop a fibromyalgia (FM) survey questionnaire for epidemiologic and clinical studies using a modification of the 2010 American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia (ACR 2010). We also created a new FM symptom scale to further characterize FM severity. METHODS: The ACR 2010 consists of 2 scales, the Widespread Pain Index (WPI) and the Symptom Severity (SS) scale. We modified these ACR 2010 criteria by eliminating the physician's estimate of the extent of somatic symptoms and substituting the sum of 3 specific self-reported symptoms. We also created a 0-31 FM Symptom scale (FS) by adding the WPI to the modified SS scale. We administered the questionnaire to 729 patients previously diagnosed with FM, 845 with osteoarthritis (OA) or with other noninflammatory rheumatic conditions, 439 with systemic lupus erythematosus (SLE), and 5210 with rheumatoid arthritis (RA). RESULTS: The modified ACR 2010 criteria were satisfied by 60% with a prior diagnosis of FM, 21.1% with RA, 16.8% with OA, and 36.7% with SLE. The criteria properly identified diagnostic groups based on FM severity variables. An FS score ≥ 13 best separated criteria+ and criteria- patients, classifying 93.0% correctly, with a sensitivity of 96.6% and a specificity of 91.8% in the study population. CONCLUSION: A modification to the ACR 2010 criteria will allow their use in epidemiologic and clinical studies without the requirement for an examiner. The criteria are simple to use and administer, but they are not to be used for self-diagnosis. The FS may have wide utility beyond the bounds of FM, including substitution for widespread pain in epidemiological studies. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/21285161/full_citation L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&pmid=21285161 DB - PRIME DP - Unbound Medicine ER -