Fibromyalgia 2016 criteria and assessments: comprehensive validation in a Norwegian population

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_sjpain-2020-0002_s_999_w2aab3b7b1b1b6b1aab1c13b1Aa"><jats:title>Background and aims</jats:title><jats:p>The ACR1990 criteria of fibromyalgia (FM) have been criticized due to poor reliability of tender points counting (TPC), inconsistent definitions of the widespread pain, and by not considering other symptoms than pain in the FM phenotype. Therefore, several newer self-report measures for FM criteria have emerged. The aim of this study was to translate the fibromyalgia survey questionnaire (FSQ) to Norwegian and validate both the 2011 and the 2016 fibromyalgia survey diagnostic criteria (FSDC) against the ACR1990 criteria.</jats:p></jats:sec><jats:sec id="j_sjpain-2020-0002_s_998_w2aab3b7b1b1b6b1aab1c13b2Aa"><jats:title>Methods</jats:title><jats:p>One hundred and twenty chronic pain patients formerly diagnosed with fibromyalgia according to the ACR1990 criteria, and 62 controls not diagnosed or where fibromyalgia was not suspected, were enrolled in this study. All responded to a Norwegian version of the FSQ. Also, they had a clinical examination according to ACR1990 fibromyalgia criteria including a counting of significant tender points with an algometer (TPC). The FSQ with the Widespread Pain Index (WPI) and Symptom Severity scale (SSS) subscales, Fibromyalgia Severity (FS) sum score, was examined for correlations with the fibromyalgia impact questionnaire (FIQ) and TPCs. Face-validity, internal consistence, test-retest reliability and construct validity with convergent and divergent approaches were examined and a Receiver Operating Characteristics (ROC) analysis was performed.</jats:p></jats:sec><jats:sec id="j_sjpain-2020-0002_s_997_w2aab3b7b1b1b6b1aab1c13b3Aa"><jats:title>Results</jats:title><jats:p>The internal consistency of FS measured by Cronbach’s alfa was good (=0.904). The test-retest reliability measures using intra class correlation were respectable for the FS, including WPI and SSS subscales (0.86, 0.84 and 0.87). FS, WPI and SSS correlated significantly with FIQ (0.74, 0.59 and 0.85) and TPC indicating an adequate construct, convergent validity. The medians of FS, WPI and SSS in the fibromyalgia-group were significantly different from the non-fibromyalgia-group indicating good construct, divergent validity. Using the 2011 and 2016 FSDC vs. ACR 1990 as a reference, sensitivity, specificity, positive likelihood ratio (LR +) and negative likelihood ratio (LR−) were identified. The accuracy rate for both 2011 and 2016 FSDC were respectable (84%). ROC analysis using FS revealed a very good Area Under the Curve (AUC) = 0.860.</jats:p></jats:sec><jats:sec id="j_sjpain-2020-0002_s_996_w2aab3b7b1b1b6b1aab1c13b4Aa"><jats:title>Conclusion</jats:title><jats:p>The current study revealed that the Norwegian versions of FSQ is a valid tool for assessment of fibromyalgia according to the 2011 and 2016 (FSDC).</jats:p></jats:sec>

Development and external validation of a prediction model for patient‐relevant outcomes in patients with chronic widespread pain and fibromyalgia

“…The instrument consists of two separate sub‐scales: the Widespread Pain Index which assesses the number of areas in which the patient has had pain over the last week (score ranging from 0 to 19), and the Symptom Severity Scale which assesses fatigue, quality of sleep and cognitive symptoms (score ranging from 0 to 12, with higher scores for greater severity). The instrument is a valid tool for the assessment of fibromyalgia and can validly differentiate severity subgroups with FM (Fors et al, 2020; Wolfe et al, 2015).…”

Pain acceptance and its impact on function and symptoms in fibromyalgia

“…We cannot guarantee that not all the respondents would satisfy the clinical diagnostic criteria, given that we lack information about their diagnostic workup. The epidemiological approach for inclusion was chosen because this study is based on the same data collection as an ongoing validation study of the revised 2016 diagnostic criteria [50].…”

Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): a randomized controlled trial

“…As a measure of pre-existing pain we used a modified version of the Fibromyalgia Survey Diagnostic-2016 criteria (FSD-2016 criteria) (80) translated and validated for Norwegian participants (81). The modified questionnaire asks about pain in the four quadrants of the body (left upper, left lower, right upper, right lower), if this has persisted for more than 3 months and if it is bothersome, it also covers head and visceral pain to exclude this from the picture, giving a short and pragmatic index of chronic widespread pain.…”