The Korean Journal of Pain

  • 제32권2호
  • /
  • Pages.120-128
  • /
  • 2019
  • /
  • 2005-9159(pISSN)
  • /
  • 2093-0569(eISSN)
대한통증학회 (The Korean Pain Society)
권호 표지
DOI QR코드

DOI QR Code

Fibromyalgia diagnostic model derived from combination of American College of Rheumatology 1990 and 2011 criteria

  • Ghavidel-Parsa, Banafsheh (Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences) ;
  • Bidari, Ali (Department of Rheumatology, Iran University of Medical Sciences) ;
  • Hajiabbasi, Asghar (Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences) ;
  • Shenavar, Irandokht (Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences) ;
  • Ghalehbaghi, Babak (ENT and Head and Neck Research Center and Department, Iran University of Medical Sciences) ;
  • Sanaei, Omid (Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions)
  • 투고 : 2018.11.07
  • 심사 : 2019.03.04
  • 발행 : 2019.04.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: We aimed to explore the American College of Rheumatology (ACR) 1990 and 2011 fibromyalgia (FM) classification criteria's items and the components of Fibromyalgia Impact Questionnaire (FIQ) to identify features best discriminating FM features. Finally, we developed a combined FM diagnostic (C-FM) model using the FM's key features. Methods: The means and frequency on tender points (TPs), ACR 2011 components and FIQ items were calculated in the FM and non-FM (osteoarthritis [OA] and non-OA) patients. Then, two-step multiple logistic regression analysis was performed to order these variables according to their maximal statistical contribution in predicting group membership. Partial correlations assessed their unique contribution, and two-group discriminant analysis provided a classification table. Using receiver operator characteristic analyses, we determined the sensitivity and specificity of the final model. Results: A total of 172 patients with FM, 75 with OA and 21 with periarthritis or regional pain syndromes were enrolled. Two steps multiple logistic regression analysis identified 8 key features of FM which accounted for 64.8% of variance associated with FM group membership: lateral epicondyle TP with variance percentages (36.9%), neck pain (14.5%), fatigue (4.7%), insomnia (3%), upper back pain (2.2%), shoulder pain (1.5%), gluteal TP (1.2%), and FIQ fatigue (0.9%). The C-FM model demonstrated a 91.4% correct classification rate, 91.9% for sensitivity and 91.7% for specificity. Conclusions: The C-FM model can accurately detect FM patients among other pain disorders. Re-inclusion of TPs along with saving of FM main symptoms in the C-FM model is a unique feature of this model.

키워드

참고문헌

  1. Borchers AT, Gershwin ME. Fibromyalgia: a critical and comprehensive review. Clin Rev Allergy Immunol 2015; 49: 100-51. https://doi.org/10.1007/s12016-015-8509-4
  2. Mease PJ, Arnold LM, Crofford LJ, Williams DA, Russell IJ, Humphrey L, et al. Identifying the clinical domains of fibromyalgia: contributions from clinician and patient Delphi exercises. Arthritis Rheum 2008; 59: 952-60. https://doi.org/10.1002/art.23826
  3. Wolfe F, Walitt B. Culture, science and the changing nature of fibromyalgia. Nat Rev Rheumatol 2013; 9: 751-5. https://doi.org/10.1038/nrrheum.2013.96
  4. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990; 33: 160-72. https://doi.org/10.1002/art.1780330203
  5. Wolfe F. Editorial: the status of fibromyalgia criteria. Arthritis Rheumatol 2015; 67: 330-3. https://doi.org/10.1002/art.38908
  6. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010; 62: 600-10. https://doi.org/10.1002/acr.20140
  7. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Hauser W, Katz RS, 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: 1113-22. https://doi.org/10.3899/jrheum.100594
  8. Egloff N, von Kanel R, Muller V, Egle UT, Kokinogenis G, Lederbogen S, et al. Implications of proposed fibromyalgia criteria across other functional pain syndromes. Scand J Rheumatol 2015; 44: 416-24. https://doi.org/10.3109/03009742.2015.1010103
  9. Smythe HA. Unhelpful criteria sets for "diagnosis" and "assessment of severity" of fibromyalgia. J Rheumatol 2011; 38: 975-8. https://doi.org/10.3899/jrheum.110142
  10. Friend R, Bennett RM. A critical examination of the polysymptomatic distress scale construct as a symptom severity questionnaire. J Rheumatol 2015; 42: 1364-7. https://doi.org/10.3899/jrheum.150611
  11. Desmeules JA, Cedraschi C, Rapiti E, Baumgartner E, Finckh A, Cohen P, et al. Neurophysiologic evidence for a central sensitization in patients with fibromyalgia. Arthritis Rheum 2003; 48: 1420-9. https://doi.org/10.1002/art.10893
  12. Bennett R. The Fibromyalgia Impact Questionnaire (FIQ): a review of its development, current version, operating characteristics and uses. Clin Exp Rheumatol 2005; 23(5 Suppl 39): S154-62.
  13. Bennett RM, Friend R, Marcus D, Bernstein C, Han BK, Yachoui R, et al. Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria. Arthritis Care Res (Hoboken) 2014; 66: 1364-73. https://doi.org/10.1002/acr.22301
  14. Ghavidel-Parsa B, Bidari A, Maafi AA, Hassankhani A, Hajiabbasi A, Montazeri A, et al. The impact of fibromyalgia on health status according to the types, demographic background and pain index. Clin Exp Rheumatol 2016; 34(2 Suppl 96): S134-9.
  15. Bidari A, Ghav idel-Parsa B , Amir M aafi A , Montazeri A, Ghalehbaghi B, Hassankhani A, et al. Validation of fibromyalgia survey questionnaire and polysymptomatic distress scale in a Persian population. Rheumatol Int 2015; 35: 2013-9. https://doi.org/10.1007/s00296-015-3340-z
  16. Bidari A, Hassanzadeh M, Mohabat MF, Talachian E, Khoei EM. Validation of a Persian version of the Fibromyalgia Impact Questionnaire (FIQ-P). Rheumatol Int 2014; 34: 181-9. https://doi.org/10.1007/s00296-013-2883-0
  17. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Hauser W, Katz RL, et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 2016; 46: 319-29. https://doi.org/10.1016/j.semarthrit.2016.08.012
  18. Schmidt-Wilcke T, Clauw DJ. Fibromyalgia: from pathophysiology to therapy. Nat Rev Rheumatol 2011; 7: 518-27. https://doi.org/10.1038/nrrheum.2011.98
  19. Segura-Jimenez V, Alvarez-Gallardo IC, Carbonell-Baeza A, Aparicio VA, Ortega FB, Casimiro AJ, et al. Fibromyalgia has a larger impact on physical health than on psychological health, yet both are markedly affected: the al-Andalus project. Semin Arthritis Rheum 2015; 44: 563-70. https://doi.org/10.1016/j.semarthrit.2014.09.010
  20. Tastekin N, Uzunca K, Sut N, Birtane M, Mercimek OB. Discriminative value of tender points in fibromyalgia syndrome. Pain Med 2010; 11: 466-71. https://doi.org/10.1111/j.1526-4637.2009.00784.x
  21. Friend R, Bennett RM. Distinguishing fibromyalgia from rheumatoid arthritis and systemic lupus in clinical questionnaires: an analysis of the revised Fibromyalgia Impact Questionnaire (FIQR) and its variant, the Symptom Impact Questionnaire (SIQR), along with pain locations. Arthritis Res Ther 2011; 13: R58. https://doi.org/10.1186/ar3311
  22. Silverman SL, Harnett J, Zlateva G, Mardekian J. Identifying fibromyalgia-associated symptoms and conditions from a clinical perspective: a step toward evaluating healthcare resource utilization in fibromyalgia. Pain Pract 2010; 10: 520-9. https://doi.org/10.1111/j.1533-2500.2010.00383.x
  23. Tesio V, Torta DM, Colonna F, Leombruni P, Ghiggia A, Fusaro E , et al. Are fibromyalgia patients c ognitively impaired? Objective and subjective neuropsychological evidence. Arthritis Care Res (Hoboken) 2015; 67: 143-50. https://doi.org/10.1002/acr.22403
  24. Fitzcharles MA, Ste-Marie PA, Goldenberg DL, Pereira JX, Abbey S, Choiniere M, et al. 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia syndrome: executive summary. Pain Res Manag 2013; 18: 119-26. https://doi.org/10.1155/2013/918216
  25. Ghav idel-Parsa B , Amir M aafi A , Aarabi Y , Haghdoost A, Khojamli M, Montazeri A, et al. Correlation of invalidation with symptom severity and health status in fibromyalgia. Rheumatology (Oxford) 2015; 54: 482-6. https://doi.org/10.1093/rheumatology/keu355

피인용 문헌

  1. Psychometric Properties of the Fibromyalgia Survey Questionnaire in Chilean Women With Fibromyalgia vol.27, pp.6, 2019, https://doi.org/10.1097/rhu.0000000000001547
  2. Predicting and Characterizing Neurodegenerative Subtypes with Multimodal Neurocognitive Signatures of Social and Cognitive Processes vol.83, pp.1, 2021, https://doi.org/10.3233/jad-210163