Klinikum Saarbrücken, Saarbrücken, Germany, and Technische Universität München, Munich, Germany.
University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Arthritis Care Res (Hoboken). 2021 May;73(5):617-625. doi: 10.1002/acr.24202.
To study the prevalence of fibromyalgia (FM) in the general population according to a 2016 modification of the American College of Rheumatology criteria (FM 2016) and the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society pain taxonomy criteria (AAPT), and to compare diagnostic and clinical variables between the criteria sets.
We studied 2,531 randomly selected subjects from the German general population in 2019. Pain regions from the Michigan Body Map were fitted to the FM 2016 and the AAPT criteria, and criteria symptom items were derived from validated questionnaires assessing somatic and psychological symptom burden and disability. We determined FM criteria prevalence and criteria-related scales including widespread and multisite pain (MSP) and symptom scales, and measured symptom burden and disability.
According to the FM 2016 criteria, the prevalence of FM was 3.4% (n = 75 subjects; 95% confidence interval [95% CI] 2.7, 4.3) compared with 5.7% (n = 130 subjects; 95% CI 4.8, 6.8) for the AAPT criteria; κ = 0.65. Compared with AAPT-positive subjects, FM 2016-positive subjects had higher MSP, Widespread Pain Index score, Polysymptomatic Distress Scale scores, Symptom Severity Scores, and psychological symptom burden. Physician-diagnosed FM was reported by 1.1% of the subjects. Of these, 44.0% met the FM 2016 criteria, and 47.5% met the AAPT criteria.
The prevalence of FM in the German general population is 73% greater using the AAPT criteria than the FM 2016 criteria. The AAPT criteria select individuals with less symptom severity and fewer pain sites. The FM 2016 criteria, but not the AAPT criteria, provide a general severity measure for FM.
根据美国风湿病学院 2016 年修订的标准（FM 2016）和镇痛、麻醉和成瘾临床试验转化创新机会和网络-美国疼痛协会疼痛分类标准（AAPT），研究一般人群中纤维肌痛（FM）的患病率，并比较两套标准的诊断和临床变量。
我们于 2019 年研究了来自德国一般人群的 2531 名随机选择的受试者。密歇根身体图谱中的疼痛区域符合 FM 2016 和 AAPT 标准，标准症状项目来自评估躯体和心理症状负担和残疾的有效问卷。我们确定了 FM 标准的患病率和与标准相关的量表，包括广泛和多部位疼痛（MSP）和症状量表，并测量了症状负担和残疾。
根据 FM 2016 标准，FM 的患病率为 3.4%（n=75 例；95%置信区间[95%CI]2.7，4.3），而 AAPT 标准为 5.7%（n=130 例；95%CI 4.8，6.8）；κ=0.65。与 AAPT 阳性受试者相比，FM 2016 阳性受试者的 MSP、广泛疼痛指数评分、多症状困扰量表评分、症状严重程度评分和心理症状负担更高。有 1.1%的受试者报告了医生诊断的 FM。其中，44.0%符合 FM 2016 标准，47.5%符合 AAPT 标准。
使用 AAPT 标准，德国一般人群中 FM 的患病率比 FM 2016 标准高 73%。AAPT 标准选择的个体症状严重程度较低，疼痛部位较少。FM 2016 标准，但不是 AAPT 标准，为 FM 提供了一般严重程度的衡量标准。
