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Abstract Number: 2064

Assessment of the Spanish Version of the American College Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia

B Casanueva1, F Garcia-Fructuoso2, R Belenguer3, C Alegre4, R López-Mejías5, F Genre5, J.V. Moreno6, J.L. Hernandez7 and MA González-Gay5, 1Rheumatologist. Rheumatology Service at the Specialist Clinic of Cantabria, Santander, Spain, 2Rheumatologist. CIMA Hospital, Barcelona, Spain, 3Rheumatologist. 12 de Octubre Hospital., Valencia, Spain, 4Rheumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain, 5Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain, 6Rheumatologist. Vall D’Hebron Hospital, Barcelona, Spain, 7Internist. Marqués de Valdecilla Hospital. IDIVAL., Santander, Spain

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: fibromyalgia

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Session Information

Title: Fibromyalgia, Soft Tissue Disorders, Regional and Specific Clinical Pain Syndromes: Research Focus

Session Type: Abstract Submissions (ACR)

Background/Purpose: Fibromyalgia (FM) requires an expert clinical examination that impedes an easy assessment of diagnostic criteria of American College Rheumatology (ACR) 1990 in some health settings. This problem delays its diagnostic, treatment, and referral to specialized services. To solve this drawback, a new screening criteria, the ACR Preliminary Diagnostic Criteria for FM was created. The aim of this study is to investigate the reliability and validity of the Spanish version of the 2010 ACR Preliminary Diagnostic Criteria for FM.

Methods: The traslation and cultural adaptation process of the ACR Preliminary Diagnostic Criteria for FM were adjusted to Spanish version to the perspective of the Rheumatology Spanish Society Study Group of Fibromyalgia. We recruited FM patients who met the previous criteria of the ACR 1990 diagnosed by a Rheumatologist, and other patients with diseases associated with chronic pain such as Rheumatoid Arthritis (RA) and Osteoarthritis (OA) who had not been diagnosed previously with FM, as control group, in a multicenter study. Informed consent was obtained and then baseline data were collected. Ethical Committee of the regional health authority approved the study protocol. FM were evaluated by tender points (TP), Fibromyalgia Impact Questionnaire (FIQ), Widespread Pain Index (WPI), and  Symptom Severity Scale (SS). RA and OA patients were evaluated by WPI and SS. Results were expressed as median and interquartile range (IC) and  data was analyzed with the Mann-Whitney U test. Sensitivity, specificity and predictive values were calculated. We used the SPSS 15 software for statistical analysis. P values < 0.05 were considered significant. 

Results: This study included 1169 patients, divided into the FM group (777 females and 26 males) and non-fibromyalgia group (147 RA, and 219 OA). The mean of FIQ in the FM group were 73.29. The median of TP were 16 (Interquartile range 14-18). In the beginning of this study, the preliminary ACR 2010 criteria were satisfied by 665 FM patients. In the non-fibromyalgia group (RA + OA), 112 patients fulfill ACR 2010 criteria whereas 254 not achieve criteria. The comparison of FM patients who fulfill ACR 2010 criteria versus FM patients who no meet the criteria, exhibit significant differences in the number of TP ( p < 0.03), FIQ (p < 0.0001), WPI ( p < 0.0001) and SS (p < 0.0001). The sensitivity of the Spanish version of the modified 2010 ACR criteria was 87.7% (IC 95%: 85.3 to 90.1), the specificity was 69.4% (95% IC: 64.5 to 74,3), the positive predictive value was 85.6% (95% IC: 83.0 to 88.1) and the negative predictive value was 73.2% (95% IC: 68.4 to 78.0). 

Conclusion: Our findings indicate that sensitivity of Spanish version of ACR preliminary diagnostic criteria (87.7%) were similar to the original study (88.1%). The specificity and predictive value of this version might be suitable for assessing FM among Spanish chronic pain populations.


Disclosure:

B. Casanueva,
None;

F. Garcia-Fructuoso,
None;

R. Belenguer,
None;

C. Alegre,
None;

R. López-Mejías,
None;

F. Genre,
None;

J. V. Moreno,
None;

J. L. Hernandez,
None;

M. González-Gay,
None.

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