Performance of the 2016 diagnostic criteria for fibromyalgia in a tertiary care pain rehabilitation setting: a diagnostic accuracy study

Autor:	Bruun KD; Pain Centre, Pain Research Group, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark., Jensen HI; Department of Anesthesiology and Intensive Care, Vejle and Middelfart Hospitals, University Hospital of Southern Denmark, Odense, Denmark.; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark., Blichfeldt-Eckhardt MR; Pain Centre, Pain Research Group, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark., Vaegter HB; Pain Centre, Pain Research Group, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark., Toft P; Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark., Amris K; Department of Rheumatology, The Parker Institute, Copenhagen University Hospital, Frederiksberg, Denmark., Kvorning N; Pain Centre, Pain Research Group, Odense University Hospital, Odense, Denmark.; Department of Anaesthesiology, Multidisciplinary Pain Centre, Vejle and Middelfart Hospitals, University Hospital of Southern, Odense, Denmark.
Jazyk:	angličtina
Zdroj:	Scandinavian journal of pain [Scand J Pain] 2021 Oct 20; Vol. 22 (1), pp. 67-76. Date of Electronic Publication: 2021 Oct 20 (Print Publication: 2022).
DOI:	10.1515/sjpain-2021-0081
Abstrakt:	Objectives: With the International Classification of Diseases 11th revision (classifying fibromyalgia as a primary pain disorder) soon to be implemented, the importance of pain physicians being able to identify patients with fibromyalgia is emphasized. The diagnostic criteria proposed in 2016 are based on self-reported pain distribution and symptom severity. The study aimed to evaluate the diagnostic accuracy of the 2016 diagnostic criteria for fibromyalgia applied in a population of patients with high impact chronic pain referred for pain rehabilitation. Methods: The study was performed as a diagnostic accuracy study at two Danish interdisciplinary pain rehabilitation centers, including 215 participants. All participants were evaluated clinically to identify patients with fibromyalgia. The diagnosis was based on expert opinion, but the minimum requirements were: (1) pain in all four body quadrants and axially for at least three months and (2) minimum 8 of 18 positive tender points. Participants filled in the fibromyalgia survey questionnaire, the patient version of the 2016 diagnostic criteria. Sensitivity, specificity, likelihood ratios, and positive and negative post-test probabilities were calculated using a clinical diagnosis of fibromyalgia as the reference standard. Results: Based on clinical diagnosis 45% of the participants were diagnosed with fibromyalgia; of these, only 19% had been diagnosed previously. The 2016 diagnostic criteria demonstrated a sensitivity of 88.5%, a specificity of 81.5%, a positive likelihood ratio of 4.79, a negative likelihood ratio of 0.14, a positive post-test probability of 79.4%, and a negative post-test probability of 10.2%. Conclusions: Fibromyalgia was severely under-diagnosed among patients with high impact chronic pain referred to tertiary care in two pain rehabilitation centers in Denmark. The 2016 diagnostic criteria showed sufficient discriminatory properties suggesting that the fibromyalgia survey questionnaire can be used as a screening tool assisting the identification of fibromyalgia in this patient population. (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)
Databáze:	MEDLINE
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