Development of a multidimensional measure of fibromyalgia symptomatology: The comprehensive rating scale for fibromyalgia symptomatology. A Critical and Comprehensive Review.
Health Qual Life Outcomes. Published online Feb This article has been cited by other articles in PMC. Abstract Background Fibromyalgia is a chronic health condition characterized by widespread musculoskeletal pain, multiple tender points on physical examination, generalized muscular aching, stiffness, fatigue, nonrestorative sleep pattern, cognitive dysfunction, and mood disturbance.
Recently, the Outcome Measures in Rheumatoid Arthritis Clinical Trials OMERACT Fibromyalgia Syndrome Workshop ranked and prioritized the domains that should be consistently measured in fibromyalgia clinical trials, specifically, pain, generic health-related quality of life, fatigue, sleep quality, and physical function.
The focus of these deliberations was exclusively on adult patients, and to our knowledge, these domains have not been previously tested within a multidimensional framework in children and adolescents with fibromyalgia.
Pediatric patients with fibromyalgia self-reported severely impaired physical and psychosocial functioning, significantly lower on most dimensions when compared to pediatric cancer patients receiving cancer treatment, and significantly lower on all dimensions than pediatric patients with other rheumatologic diseases.
Patients with fibromyalgia self-reported significantly greater pain and fatigue than pediatric patients with other rheumatologic conditions, and generally more fatigue than pediatric patients receiving treatment for cancer. Regular monitoring of pediatric patients with fibromyalgia An analysis of fibromyalgia help identify children and adolescents at risk for severely impaired HRQOL.
Background Fibromyalgia FM is a chronic health condition characterized by widespread musculoskeletal pain, multiple tender points on physical examination, generalized muscular aching, stiffness, fatigue, nonrestorative sleep pattern, cognitive dysfunction, and mood disturbance [ 1 - 3 ].
FM is considered a clinical syndrome presumably related to central neuromodulatory dysregulation [ 4 ]. The treatment of FM is complicated by the fact that there are no objective findings on the physical examination or laboratory tests that, in other rheumatologic conditions, confirm the extent of disease severity and aid in the establishment of a diagnosis.
Consequently, the diagnosis of FM is based on illness history, exclusion of other causes of symptoms, verbal self-report, and physical examination [ 1 ].
Yunus and Masi were the first to describe the juvenile primary fibromyalgia syndrome JPFS in pediatric patients [ 5 ]. Consistent with the literature regarding adult patients [ 6 ], FM in pediatric patients is more common in girls than boys [ 5 ].
The lack of physiological markers of disease activity for FM complicates the clinical decision-making process, since the treating physician cannot monitor the course of the illness with objective disease indicators that are available for other rheumatologic diseases such as juvenile idiopathic arthritis.
Given the lack of objective outcomes measures, and the emerging therapies currently being tested for FM, the need for reliable and valid patient-reported outcome instruments for FM, including health-related quality of life instruments, has become urgent [ 4 ].
Health-related quality of life assessment in fibromyalgia Health-related quality of life HRQOL has been progressively acknowledged as an essential health outcome measure in clinical trials and health services research and evaluation [ 8 - 10 ]. A HRQOL instrument must be multidimensional, consisting at the minimum of the physical, psychological including emotional and cognitiveand social health dimensions delineated by the World Health Organization [ 1112 ].
Studies with adult patients with FM have demonstrated that in comparison to healthy controls, patients with FM report substantially lower HRQOL across multiple domains [ 13 - 15 ].
Health-related quality of life assessment in pediatric patients Although the measurement of HRQOL in pediatric clinical trials has been advocated for a number of years [ 16 ], the emerging paradigm shift toward patient-reported outcomes PROs in clinical trials [ 12 ] has provided the opportunity to further emphasize the value and essential need for pediatric patient self-report measurement as efficacy outcomes in clinical trials for pediatric chronic health conditions [ 17 - 20 ].
By definition, patient-reported outcomes PROs are self-report instruments that directly measure the patient's perceptions of the impact of disease and treatment as clinical trial endpoints [ 12 ]. It is well documented in both the adult and pediatric literature that information provided by proxy-respondents is not equivalent to that reported by the patient [ 2425 ].
Imperfect agreement between self-report and proxy-report, termed cross-informant variance [ 26 ], has been consistently documented in the HRQOL measurement of children with chronic health conditions and healthy children [ 27 - 34 ].
While pediatric patient self-report should be considered the standard for measuring perceived HRQOL [ 35 ], there may be circumstances when the child is too young, too cognitively impaired, too ill or fatigued to complete a HRQOL instrument, and parent proxy-report may be needed in such cases [ 36 ].
Further, it is typically parents' perceptions of their children's HRQOL that influences healthcare utilization [ 37 - 39 ].
Thus, HRQOL instruments should be selected that measure the perspectives of both the child and parent since these perspectives may be independently related to healthcare utilization, risk factors, and quality of care [ 40 ].
Ideally, parent and child HRQOL instruments should measure the same constructs with parallel items in order to make comparisons between self and proxy report more meaningful [ 4142 ].
Even when children are able to self-report, parent proxy-report should be considered as a secondary outcome measure given parents' expanding role in clinical decision-making and home treatment regimens for pediatric chronic health conditions [ 40 ].
Thus, there is a clear and defined role for parent proxy-report instruments in the assessment of pediatric HRQOL outcomes.Methods: This meta-analysis of 49 fibromyalgia treatment outcome studies assessed the efficacy of pharmacological and nonpharmacological treatment across four types of outcome measures—physical status, self-report of FMS symptoms, psychological status, and daily functioning.
Fibromyalgia; Synonyms: Fibromyalgia syndrome (FMS) obesity and lack of physical activity may increase the risk of an individual developing fibromyalgia. A meta analysis found psychological trauma to be associated with FM, although not as strongly as in chronic fatigue syndrome. The aim of this paper was to compare the efficacy of the treatments for fibromyalgia currently available in both primary care and specialised settings.
Published reports of randomised controlled trials (RCTs) researching pharmacological and non-pharmacological treatments in patients with fibromyalgia were found in the MEDLINE, . To examine prospectively the accuracy of an initial diagnosis for fibromyalgia (FM).
Methods. All patients newly referred for rheumatology consultation in a 6‐month period were evaluated prospectively for either a preceding, current or subsequent diagnosis of FM. Complementary and alternative exercise for fibromyalgia: a meta-analysis Scott David Mist, Kari A Firestone, and Kim Dupree Jones Fibromyalgia Research and Treatment Group, School of Nursing, Oregon Health and Science University, Portland, OR, USA.
Fibromyalgia is a chronic musculoskeletal pain disorder of unknown aetiology, characterised by widespread pain and muscle tenderness and often accompanied by fatigue, sleep disturbance and depressed mood [1, 2].With an estimated lifetime prevalence of approximately 2% in community samples , it accounts for 15% of outpatient rheumatology visits and 5% of primary care visits .