Rethinking the Criteria for Fibromyalgia in 2019: the ABC Indicators

Overview

Journal J Pain Res

Publisher Dove Medical Press

Date 2019 Aug 3

PMID 31372029

Citations 5

Authors

Julian A Stewart

Simone Mailler-Burch

Darius Muller

Martina Studer

Roland von Kanel

Martin Grosse Holtforth

Kyrill Schwegler

Niklaus Egloff

Affiliations

Soon will be listed here.

Abstract

Purpose: Diagnostic criteria for fibromyalgia have been subject to debate and controversy for many years. The preliminary diagnostic criteria introduced in 2010 and 2011 have been criticized for different reasons, including questionable diagnostic specificity and a lack of an etiopathogenetic foundation. The "ABC indicators" presented in this study reflect a further development of the 2011 criteria and refer to (A) algesia, (B) bilateral, axial-symmetric pain distribution, and (C) chronic distress.

Patients And Methods: We compared the diagnostic performance of the ABC indicators with that of the 2011 criteria by analyzing the data of 409 inpatients with chronic functional pain divided into two subgroups of pain patients: Those with whole-body pain and those with pain not involving the whole body. Under the premise that FM phenotypically represents a whole-body pain disorder, sensitivity, specificity, correct classification and diagnostic odds ratios were calculated.

Results: The 2011 criteria demonstrated a specificity of 68.1%, a sensitivity of 75.5%, a correct classification of 71.0% and a diagnostic odds ratio of 6.56 (CI: 4.17-10.31). The ABC indicators achieved a specificity of 88.3%, a sensitivity of 62.3%, a correct classification of 78.6%, and a diagnostic odds ratio of 12.47 (CI: 7.30-21.28).

Conclusion: The ABC fibromyalgia indicators demonstrated better specificity, lower sensitivity, and better overall diagnostic effectiveness than the original 2011 criteria.

Citing Articles

Evaluating the Effect of Delayed Diagnosis on Disease Outcome in Fibromyalgia: A Multi-Center Cross-Sectional Study.

Moshrif A, Mosallam A, Abu-Zaid M, Gouda W J Pain Res. 2023; 16:1355-1365.

PMID: 37123049 PMC: 10132293. DOI: 10.2147/JPR.S381314.

Differences and similarities among questionnaires to assess pain status in chronic widespread pain population: a quantitative analysis.

Evans V, Duarte F, Linde L, Kumbhare D Br J Pain. 2021; 15(4):441-449.

PMID: 34840792 PMC: 8611303. DOI: 10.1177/2049463720979340.

Central pain modulatory mechanisms of attentional analgesia are preserved in fibromyalgia.

Oliva V, Gregory R, Brooks J, Pickering A Pain. 2021; 163(1):125-136.

PMID: 33941755 PMC: 8675057. DOI: 10.1097/j.pain.0000000000002319.

Assessing our approach to diagnosing Fibromyalgia.

Hackshaw K Expert Rev Mol Diagn. 2020; 20(12):1171-1181.

PMID: 33301346 PMC: 11829810. DOI: 10.1080/14737159.2020.1858054.

Chronic Pain Diagnosis Using Machine Learning, Questionnaires, and QST: A Sensitivity Experiment.

Santana A, De Santana C, Montoya P Diagnostics (Basel). 2020; 10(11).

PMID: 33212774 PMC: 7697204. DOI: 10.3390/diagnostics10110958.

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