The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity

Arthritis Care and Research - Tập 62 Số 5 - Trang 600-610 - 2010
Frederick Wolfe1, Daniel J. Clauw2, Mary‐Ann Fitzcharles3, Don L. Goldenberg4, Robert S. Katz5, Philip J. Mease6, Anthony S. Russell7, I. Jon Russell8, John B. Winfield9, Muhammad B. Yunus10
1National Data Bank for Rheumatic Diseases and University of Kansas School of Medicine; Wichita
2University of Michigan Medical School, Ann Arbor
3Montréal General Hospital and McGill University, Montréal, Québec, Canada.
4Newton‐Wellesley Hospital, Tufts University School of Medicine, Boston, Massachusetts
5Rush University Medical Center, Chicago, Illinois
6Seattle Rheumatology Associates and Swedish Medical Center, Seattle, Washington
7University of Alberta, Edmonton, Alberta, Canada
8University of Texas Health Sciences Center, San Antonio
9 University of North Carolina-Chapel Hill
10The University of Illinois College of Medicine, Peoria

Tóm tắt

AbstractObjectiveTo 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.MethodsWe 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.ResultsApproximately 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 ≥7 AND SS ≥5) OR (WPI 3–6 AND SS ≥9).ConclusionThis 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.

Từ khóa


Tài liệu tham khảo

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Thông tin xuất bản

Arthritis Care and Research

Tập 62 Số 5

600-610

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