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Cited by 1,499Fibromyalgia and Chronic Fatigue Syndrome ResearchPsychosomatic Disorders and Their TreatmentsMyofascial pain diagnosis and treatment

Fibromyalgia Criteria and Severity Scales for Clinical and Epidemiological Studies: A Modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia

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WOLFE, FREDERICK, CLAUW, DANIEL J., FITZCHARLES, MARY-ANN, GOLDENBERG, DON L., HÄUSER, WINFRIED, KATZ, ROBERT S., MEASE, PHILIP, RUSSELL, ANTHONY S. +2 more·2011·The Journal of Rheumatology
DOI 10.3899/jrheum.100594
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Abstract

Objective.: To develop a fibromyalgia (FM) survey questionnaire for epidemiologic and clinical studies using a modification of the 2010 American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia (ACR 2010). We also created a new FM symptom scale to further characterize FM severity. Methods.: The ACR 2010 consists of 2 scales, the Widespread Pain Index (WPI) and the Symptom Severity (SS) scale. We modified these ACR 2010 criteria by eliminating the physician’s estimate of the extent of somatic symptoms and substituting the sum of 3 specific self-reported symptoms. We also created a 0–31 FM Symptom scale (FS) by adding the WPI to the modified SS scale. We administered the questionnaire to 729 patients previously diagnosed with FM, 845 with osteoarthritis (OA) or with other noninflammatory rheumatic conditions, 439 with systemic lupus erythematosus (SLE), and 5210 with rheumatoid arthritis (RA). Results.: The modified ACR 2010 criteria were satisfied by 60% with a prior diagnosis of FM, 21.1% with RA, 16.8% with OA, and 36.7% with SLE. The criteria properly identified diagnostic groups based on FM severity variables. An FS score ≥ 13 best separated criteria+ and criteria− patients, classifying 93.0% correctly, with a sensitivity of 96.6% and a specificity of 91.8% in the study population. Conclusion.: A modification to the ACR 2010 criteria will allow their use in epidemiologic and clinical studies without the requirement for an examiner. The criteria are simple to use and administer, but they are not to be used for self-diagnosis. The FS may have wide utility beyond the bounds of FM, including substitution for widespread pain in epidemiological studies.

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Authors
WOLFE, F., CLAUW, D. J., FITZCHARLES, M.-A., GOLDENBERG, D. L., HÄUSER, W., KATZ, R. S., MEASE, P., RUSSELL, A. S., RUSSELL, I. J., & WINFIELD, J. B.
Affiliations
  • The National Databank for Rheumatic Diseases (US)
  • University of Michigan (US)
  • Tufts University (US)
  • Rush University (US)
  • University of Washington (US)
  • University of Alberta (CA)
  • The University of Texas at San Antonio Health Science Center (US)
ORCID
Venue
The Journal of Rheumatology
Publisher
The Journal of Rheumatology
Published
2011-02-01
Volume
38
Issue
6
Pages
1113-1122
ISSN
  • 0315-162X (ISSN-L)
  • 1499-2752
DOI
10.3899/jrheum.100594
OpenAlex
W1998713427
Cited by
1,499
References
6
Citations by year
2026: 59 · 2025: 82 · 2024: 95 · 2023: 114 · 2022: 138 · 2021: 140 · 2020: 132 · 2019: 123 · 2018: 105 · 2017: 106 · 2016: 106 · 2015: 106 · 2014: 69 · 2013: 54 · 2012: 44
FWCI
41.14
Type
journal article
Language
en
Open access
Locations
  • The Journal of Rheumatology (publishedVersion)
  • PubMed (publishedVersion)
  • mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
Keywords
fibromyalgia, Widespread Pain Index, symptom severity scale, self-reported symptoms, questionnaire development, diagnostic accuracy, rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, widespread pain
MeSH terms
Adult, Aged, Aged, 80 and over, Arthritis, Rheumatoid, Cognition Disorders, Diagnosis, Differential, Disability Evaluation, Fatigue, Female, Fibromyalgia, Health Surveys, Humans, Lupus Erythematosus, Systemic, Male, Middle Aged, Osteoarthritis, Sensitivity and Specificity, Severity of Illness Index, Sleep Wake Disorders, Comorbidity, Incidence

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