Casanueva Benigno, García-Fructuoso Ferrán, Belenguer Rafael, Alegre Cayetano, Moreno-Muelas José V, Hernández José L, Pina Tinitario, González-Gay Miguel Á
Rheumatology Division, Clínica de Especialidades Cantabria, IDIVAL, Santander, Spain.
Rheumatology Division, CIMA Hospital, Barcelona, Spain.
Clin Exp Rheumatol. 2016 Mar-Apr;34(2 Suppl 96):S55-8. Epub 2016 Jan 9.
To investigate the reliability and validity of the Spanish version of the 2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia (FM) in patients with chronic pain.
The 2010 ACR Preliminary Diagnostic Criteria for FM were adapted to a Spanish version following the guidelines of the Rheumatology Spanish Society Study Group of FM. Based on the 1990 ACR classi cation criteria for FM, patients with chronic pain were initially divided into two groups: a FM group and another group of non-FM individuals. Patients from the FM group were evaluated by tender points (TP) examination, Fibromyalgia Impact Questionnaire (FIQ), Widespread Pain Index (WPI), and Symptom Severity Scale (SSS). The non-FM (control) group included patients with rheumatoid arthritis (RA) and osteoarthritis (OA). They were evaluated by WPI and SSS.
We included 1,169 patients divided into two groups: FM group (n=803; 777 women and 26 men) and non-FM group (n= 366; 147 patients with RA, and 219 with OA). The median value of TP and FIQ in the FM group was 16 and 74 respectively. The preliminary 2010 ACR criteria were met by 665 (82.8%) FM patients and by 112 (30.6%) patients from the non-FM group (p<0.0001). Statistically signi cant differences in the number of TP (p<0.03), FIQ (p<0.0001), WPI (p<0.0001) and SSS (p<0.0001) were observed when FM patients fulfilling the 2010 ACR criteria were compared with the remaining FM patients who did not fulfill these criteria. Sensitivity of the Spanish version of the 2010 ACR criteria was 85.6% (95%CI: 83.1-88.1), speci city 73.2% (95%CI: 68.4-78), positive predictive value 87.7% (95%CI: 85.3-90.1) and negative predictive value 69.4% (95%CI: 64.5-74.2).
Our results indicate that the 2010 ACR Preliminary Diagnostic Criteria for FM may be useful to establish a diagnosis of FM in Spanish individuals with chronic pain.
探讨2010年美国风湿病学会（ACR）纤维肌痛（FM）初步诊断标准西班牙语版在慢性疼痛患者中的可靠性和有效性。
按照西班牙风湿病学会FM研究组的指南，将2010年ACR FM初步诊断标准改编为西班牙语版。基于1990年ACR FM分类标准，将慢性疼痛患者最初分为两组：FM组和另一组非FM个体。FM组患者通过压痛点（TP）检查、纤维肌痛影响问卷（FIQ）、广泛性疼痛指数（WPI）和症状严重程度量表（SSS）进行评估。非FM（对照）组包括类风湿关节炎（RA）和骨关节炎（OA）患者。他们通过WPI和SSS进行评估。
我们纳入了1169例患者，分为两组：FM组（n = 803；777名女性和26名男性）和非FM组（n = 366；147例RA患者和219例OA患者）。FM组中TP和FIQ的中位数分别为16和74。665例（82.8%）FM患者和112例（30.6%）非FM组患者符合2010年ACR初步标准（p < 0.0001）。将符合2010年ACR标准的FM患者与其余未符合这些标准的FM患者进行比较时，观察到TP数量（p < 0.03）、FIQ（p < 0.0001）、WPI（p < 0.0001）和SSS（p < 0.0001）存在统计学显著差异。2010年ACR标准西班牙语版的敏感性为85.6%（95%CI：83.1 - 88.1），特异性为73.2%（95%CI：68.4 - 78），阳性预测值为87.7%（95%CI：85.3 - 90.1）和阴性预测值为69.4%（95%CI：64.5 - 74.2）。
我们的结果表明，2010年ACR FM初步诊断标准可能有助于对西班牙慢性疼痛个体进行FM诊断。
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