A Survey of Physicians’ Knowledge and Adherence to the Diagnostic Criteria for Fibromyalgia
Open accessAbstract
Objective: In 2010, Wolfe et al. demonstrated poor physician use of the 1990 fibromyalgia diagnostic criteria and proposed the 2010 criteria to address physician shortcomings. No follow-up studies have investigated whether physicians are using these criteria. The purpose of this study was to provide seminal data on physician knowledge and use of the fibromyalgia diagnostic criteria. Methods: This was an observational study. A questionnaire was distributed to a convenience sample of physicians who diagnose chronic pain conditions. Physician agreement was evaluated with statements testing their knowledge on the fibromyalgia criteria, and then intraclass correlations were calculated to determine the homogeneity of physicians' responses. We also determined whether physician knowledge was impacted by their specialist training and clinical experience. Results: Physician responses varied between correct and incorrect agreement on most questions. Physician specialist training was positively correlated with knowledge of the criteria. Physician knowledge overall was not comprehensive and was very poor for the 1990 and 2010 criteria. Fifty-one percent of physicians used a set of criteria in their practice, and 49% used their clinical acumen. Conclusions: Physicians do not have adequate and homogenous knowledge of the fibromyalgia diagnostic criteria. Approximately half of physicians did not adhere to the criteria. Poor knowledge and adherence to the criteria may increase diagnosis delays and misdiagnoses. Knowledge translation strategies should be implemented to address this problem.
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Clinicians may choose to excessively or inappropriately rely on their instinctual judgment instead of established diagnostic criteria, which can result in inconsistent care and increase morbidity and mortality.
“Clinicians may choose to excessively or inappropriately rely on their instinctual judgment instead of established diagnostic criteria, which can result in inconsistent care [84] and increase morbidity and mortality [85].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [84]
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- Authors
- Kumbhare, D., Ahmed, S., Sander, T., Grosman-Rimon, L., & Srbely, J.
- Affiliations
- University of Toronto (CA)
- McMaster University (CA)
- University of Guelph (CA)
- Division of Physical Medicine and Rehabilitation, Deptartment of Medicine, University of Toronto, Toronto, Ontario, Canada
- Corresponding author
- Kumbhare, Dinesh
- Venue
- Pain Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-11-21
- Volume
- 19
- Issue
- 6
- Pages
- 1254-1264
- ISSN
- 1526-2375 (ISSN-L)
- 1526-4637
- OpenAlex
- W2770822079
- Cited by
- 51
- References
- 34
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 8 · 2023: 8 · 2022: 6 · 2021: 7 · 2020: 5 · 2019: 4 · 2018: 3
- FWCI
- 2.71
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Pain Medicine (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- fibromyalgia, diagnostic criteria, physician knowledge, chronic pain diagnosis, specialist training, clinical experience, knowledge translation, delayed diagnosis, misdiagnosis
- MeSH terms
- Female, Fibromyalgia, Humans, Health Knowledge, Attitudes, Practice, Male, Physicians, Surveys and Questionnaires, Guideline Adherence
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