ACR preliminary diagnostic criteria for fm and measurement of symptom severity
RES: The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity
kelly to CO-CURE May 16
[k:Note: Like many committee definitions, the authors of this definition are
drawn from varying disciplines and ideological persuasions.]
Arthritis Care Res (Hoboken). 2010 May;62(5):600-10.
*The American College of Rheumatology preliminary diagnostic criteria for
fibromyalgia and measurement of symptom severity***
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russell
AS, Russell IJ, Winfield JB, Yunus MB.
National Data Bank for Rheumatic Diseases and University of Kansas School of
Medicine, Wichita, KS 67214, USA. fwolfe@arthritis-research.org
Comment in:
- Arthritis Care Res (Hoboken). 2010 May;62(5):583-4.
http://www.ncbi.nlm.nih.gov/pubmed/20461781 Wolfe F
http://www.ncbi.nlm.nih.gov/pubmed?term="Wolfe F"[Author] .
New American College of Rheumatology criteria for fibromyalgia: a twenty-year journey.
*Abstract*
OBJECTIVE: To develop simple, practical criteria for clinical diagnosis of
fibromyalgia that are suitable for use in primary and specialty care and
that do not require a tender point examination, and to provide a severity
scale for characteristic fibromyalgia symptoms.
METHODS: We performed a multicenter study of 829 previously diagnosed
fibromyalgia patients and controls using physician physical and interview
examinations, including a widespread pain index (WPI), a measure of the
number of painful body regions. Random forest and recursive partitioning
analyses were used to guide the development of a case definition of
fibromyalgia, to develop criteria, and to construct a symptom severity (SS)
scale.
RESULTS: Approximately 25% of fibromyalgia patients did not satisfy the
American College of Rheumatology (ACR) 1990 classification criteria at the
time of the study. The most important diagnostic variables were WPI and
categorical scales for cognitive symptoms, unrefreshed sleep, fatigue, and
number of somatic symptoms. The categorical scales were summed to create an
SS scale. We combined the SS scale and the WPI to recommend a new case
definition of fibromyalgia: (WPI > or =7 AND SS > or =5) OR (WPI 3-6 AND SS
> or =9).
CONCLUSION: This simple clinical case definition of fibromyalgia correctly
classifies 88.1% of cases classified by the ACR classification criteria, and
does not require a physical or tender point examination. The SS scale
enables assessment of fibromyalgia symptom severity in persons with current
or previous fibromyalgia, and in those to whom the criteria have not been
applied. It will be especially useful in the longitudinal evaluation of
patients with marked symptom variability.
PMID: 20461783 [PubMed - in process]
RES: The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity
kelly to CO-CURE May 16
[k:Note: Like many committee definitions, the authors of this definition are
drawn from varying disciplines and ideological persuasions.]
Arthritis Care Res (Hoboken). 2010 May;62(5):600-10.
*The American College of Rheumatology preliminary diagnostic criteria for
fibromyalgia and measurement of symptom severity***
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russell
AS, Russell IJ, Winfield JB, Yunus MB.
National Data Bank for Rheumatic Diseases and University of Kansas School of
Medicine, Wichita, KS 67214, USA. fwolfe@arthritis-research.org
Comment in:
- Arthritis Care Res (Hoboken). 2010 May;62(5):583-4.
http://www.ncbi.nlm.nih.gov/pubmed/20461781 Wolfe F
http://www.ncbi.nlm.nih.gov/pubmed?term="Wolfe F"[Author] .
New American College of Rheumatology criteria for fibromyalgia: a twenty-year journey.
*Abstract*
OBJECTIVE: To develop simple, practical criteria for clinical diagnosis of
fibromyalgia that are suitable for use in primary and specialty care and
that do not require a tender point examination, and to provide a severity
scale for characteristic fibromyalgia symptoms.
METHODS: We performed a multicenter study of 829 previously diagnosed
fibromyalgia patients and controls using physician physical and interview
examinations, including a widespread pain index (WPI), a measure of the
number of painful body regions. Random forest and recursive partitioning
analyses were used to guide the development of a case definition of
fibromyalgia, to develop criteria, and to construct a symptom severity (SS)
scale.
RESULTS: Approximately 25% of fibromyalgia patients did not satisfy the
American College of Rheumatology (ACR) 1990 classification criteria at the
time of the study. The most important diagnostic variables were WPI and
categorical scales for cognitive symptoms, unrefreshed sleep, fatigue, and
number of somatic symptoms. The categorical scales were summed to create an
SS scale. We combined the SS scale and the WPI to recommend a new case
definition of fibromyalgia: (WPI > or =7 AND SS > or =5) OR (WPI 3-6 AND SS
> or =9).
CONCLUSION: This simple clinical case definition of fibromyalgia correctly
classifies 88.1% of cases classified by the ACR classification criteria, and
does not require a physical or tender point examination. The SS scale
enables assessment of fibromyalgia symptom severity in persons with current
or previous fibromyalgia, and in those to whom the criteria have not been
applied. It will be especially useful in the longitudinal evaluation of
patients with marked symptom variability.
PMID: 20461783 [PubMed - in process]