From the Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada (SH, DK); and Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada (DK).
Am J Phys Med Rehabil. 2022 Mar 1;101(3):262-269. doi: 10.1097/PHM.0000000000001768.
Obtaining a diagnosis is an essential and integral part of physical and rehabilitation medicine in practice and research. Standardized psychometric properties are required of any classifications, diagnostic criteria, and diagnostic rules used. Physicians and researchers, in physical and rehabilitation medicine, need to understand these properties to determine the accuracy and consistency of their diagnosis. Although chronic musculoskeletal pain disorders are among the highly prevalent disorders seen in physical and rehabilitation medicine, limitations regarding existing diagnostic criteria for chronic musculoskeletal pain disorders still exist. Hence, the quest for developing diagnostic tools for chronic musculoskeletal pain that align with the standard properties remains open. These are discussed with an example for existing diagnostic criteria for fibromyalgia. This article primarily aimed to provide an overview of standard psychometric properties. A secondary aim was to critically appraise the tools currently used to diagnose chronic musculoskeletal pain disorders. The challenges and limitations of existing diagnostic tools are discussed. Potential approaches on how to improve the conceptualization of the construct of musculoskeletal pain disorders are also discussed. Adopting a network perspective, for example, can better constitute the disease instead of a single known underlying etiology for persistent or recurrent pain symptoms.
获得诊断是物理医学和康复实践和研究中的一个重要组成部分。任何分类、诊断标准和诊断规则的使用都需要具有标准化的心理测量特性。物理医学和康复领域的医生和研究人员需要了解这些特性，以确定其诊断的准确性和一致性。尽管慢性肌肉骨骼疼痛障碍是物理医学和康复中常见的疾病之一，但现有的慢性肌肉骨骼疼痛障碍诊断标准仍然存在局限性。因此，寻求与标准特性一致的慢性肌肉骨骼疼痛诊断工具仍然是一个未解决的问题。本文通过现有的纤维肌痛症诊断标准的示例对这些问题进行了讨论。本文主要旨在概述标准心理测量特性。次要目的是批判性地评价目前用于诊断慢性肌肉骨骼疼痛障碍的工具。讨论了现有诊断工具的挑战和局限性。还讨论了如何改善肌肉骨骼疼痛障碍结构概念的潜在方法。例如，采用网络视角可以更好地构成疾病，而不是单一的已知潜在病因引起持续或复发性疼痛症状。
