Background/Purpose:

Clinical assessment instruments to accurately assess disease activity in the fibromyalgia population have been difficult to develop because of the subjective nature of the disease. The Symptom Severity (SS) scale is an instrument completed by the healthcare provider based on the provider’s perception of the patient’s symptoms. The Revised Fibromyalgia Impact Questionnaire (FIQR) is a tool completed by the patient and based on the patient’s perception of their symptoms severity. The purpose of this study was to determine whether a provider-generated assessment tool, the SS scale, would provide comparable results to a patient-generated assessment tool, the FIQR, for evaluation of symptom severity in adults with an established diagnosis of fibromyalgia.

Methods:

One hundred fifty five participants were recruited from a convenience sample of adult patients at a private rheumatology office in the south central United States. The participants had an established diagnosis of fibromyalgia. After providing consent for study participation, the participants were provided with a copy of the FIQR to complete prior to their appointment with the medical provider. During the medical assessment, the healthcare provider completed the SS scale based on the provider’s perception of the patient’s symptoms. The assessment instruments were completed at the same clinic visit and kept separated and blinded from each other.

Results:

Spearman’s rank-based correlation coefficients showed that SS-fatigue was weakly correlated with FIQR Domain 1 (ρ = .285) and moderately correlated with Domains 2 and 3 (ρ = .438; ρ = .447) and the FIQR total score (ρ = .420). Similarly, SS-waking unrefreshed was weakly correlated with FIQR Domain 1 (ρ = .250) and moderately correlated with Domains 2 and 3 (ρ = .353, ρ = .385) and FIQR total score (ρ = .358). SS-somatic symptoms and SS-total scores were moderately correlated with all three FIQR domains and the FIQR total score (ρs ranging from .371 to .527). FIQR scores were, on average, higher than were SS scores (M = .559 compared to M = .479), and the difference between them was statistically significant, t (154) = 5.094, p < .001.

Conclusion:

All five subscales of the Symptom Severity scale were significantly related to the four FIQR domains and the FIQR total score. Higher scores on the SS scale were associated with higher scores on the FIQR questionnaire. The strength of the relationships, however, was moderate. The FIQR completed by the patient had significantly higher total scores than the SS scale completed by the healthcare provider. These findings suggest that the study participants perceived their FM disease activity to be higher than was perceived by the healthcare provider.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparative-study-of-instruments-to-assess-disease-activity-in-fibrolyalgia/