Abstract
The Fibromyalgia Survey Questionnaire (FSQ) assesses the key symptoms of fibromyalgia syndrome. The FSQ can be administrated in survey research and settings where the use of interviews to evaluate the number of pain sites and extent of somatic symptom intensity and tender point examination would be difficult. We validated the FSQ in a cross-sectional survey with FMS patients. In a cross-sectional survey, participants with physician diagnosis of FMS were recruited by FMS-self help organisations and nine clinical institutions of different levels of care. Participants answered the FSQ (composed by the Widespread Pain Index [WPI] and the Somatic Severity Score [SSS]) assessing the Fibromyalgia Survey Diagnostic Criteria (FSDC) and the Patient Health Questionnaire PHQ 4. American College of Rheumatology 1990 classification criteria were assessed in a subgroup of participants. 1,651 persons diagnosed with FMS were included into analysis. The acceptance of the FSQ-items ranged between 78.9 to 98.1% completed items. The internal consistency of the items of the SSS ranged between 0.75–0.82. 85.5% of the study participants met the FSDC. The concordance rate of the FSDC and ACR 1990 criteria was 72.7% in a subsample of 128 patients. The Pearson correlation of the SSS with the PHQ 4 depression score was 0.52 (p<0.0001) and with the PHQ anxiety score was 0.51 (p<0.0001) (convergent validity). 64/202 (31.7%) of the participants not meeting the FSDC criteria and 152/1283 (11.8%) of the participants meeting the FSDC criteria reported an improvement (slightly too very much better) in their health status since FMS-diagnosis (Chi2 = 55, p<0.0001) (discriminant validity). The study demonstrated the feasibility of the FSQ in a cross-sectional survey with FMS-patients. The reliability, convergent and discriminant validity of the FSQ were good. Further validation studies of the FSQ in clinical and general population settings are necessary.
Highlights
The publication of American College of Rheumatology (ACR) preliminary diagnostic criteria for fibromyalgia syndrome (FDC) [1] eliminated the tender point examination required for the clinical diagnosis of FMS by the ACR 1990 classification criteria [2]
Because most of the ACR 2010 items can be obtained by selfadministration, the FDC were slightly modified so that complete self-administration would be possible by the Fibromyalgia Survey Diagnostic Criteria (FSDC)
The FSDC were developed in a longitudinal study of patients of the National Data Bank for Rheumatic Diseases by substituting a count of three symptoms for the physician’s (0–3) evaluation of the extent of somatic symptom intensity by a questionnaire assessing the number of pain sites and somatic symptom severity
Summary
The publication of American College of Rheumatology (ACR) preliminary diagnostic criteria for fibromyalgia syndrome (FDC) [1] eliminated the tender point examination required for the clinical diagnosis of FMS by the ACR 1990 classification criteria [2]. Because most of the ACR 2010 items can be obtained by selfadministration, the FDC were slightly modified so that complete self-administration would be possible by the Fibromyalgia Survey Diagnostic Criteria (FSDC). The FSDC were developed in a longitudinal study of patients of the National Data Bank for Rheumatic Diseases by substituting a count of three symptoms for the physician’s (0–3) evaluation of the extent of somatic symptom intensity by a questionnaire assessing the number of pain sites and somatic symptom severity. The conditions 1 and 2 can be assessed by the Fibromyalgia survey questionnaire (FSQ) including the WPI and SSS. The assessment of the key symptoms of FMS by the FSQ allows administration in survey research and settings where the use of interviews to evaluate the number of pain sites and extent of somatic symptom intensity would be difficult
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