Which symptoms best distinguish fibromyalgia patients from those with other chronic pain disorders?

被引:5
作者
Bennett, Robert M. [1 ,2 ]
Jones, Kim D. [1 ,3 ,4 ]
Aebischer, Jonathan H. [5 ,6 ]
St John, Amanda W. [7 ]
Friend, Ronald [1 ,5 ,8 ]
机构
[1] Oregon Hlth & Sci Univ, Fibromyalgia Res Unit, Portland, OR 97201 USA
[2] Oregon Hlth & Sci Univ, Sch Med, Portland, OR 97201 USA
[3] Linfield Univ, Sch Nursing, 2900 NE 132nd Ave, Portland, OR 97230 USA
[4] Oregon Hlth & Sci Univ, Neurol Res Affiliate, OHSU Sch Med, Portland, OR 97201 USA
[5] Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR 97201 USA
[6] Cent City Concern, Portland, OR USA
[7] Oregon Hlth & Sci Univ, Sch Med Anesthesiol & Perioperat Med, Portland, OR 97201 USA
[8] SUNY Stony Brook, Coll Arts & Sci, Dept Psychol, Stony Brook, NY 11794 USA
关键词
chronic pain; fibromyalgia; novel symptoms; sensitivity; specificity; FUNCTIONAL SOMATIC SYNDROMES; CRITERIA; CLASSIFICATION; CHALLENGES; VALIDATION; DIAGNOSIS;
D O I
10.1111/jep.13615
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Rationale, aims and objectives The primary purpose of this study was to test both classic and novel FM pain and non-pain symptoms to determine their practical efficacy in aiding clinicians to distinguish FM pain from other chronic pain disorders. Methods 158 pain patients from two primary care clinics were evaluated with history, physical exam, chart review, and a questionnaire containing 26 exploratory symptoms (10 from the Symptom Impact Questionnaire (SIQR) and 16 from the FM literature)). The symptoms were rated on a 0-10 VAS for severity by those patients reporting pain over the past week. Somers' D and mean severity differences between FM and chronic pain patients without FM were used to rank the discriminatory and diagnostic contributions of symptoms. Results Fifty patients (14.2%) carried a chart diagnosis of FM, 108 (30.7%) had pain but not FM, and 192 (54.5%) who had neither pain nor FM. Comparing means between the two pain groups, the 5 best differentiating symptoms (all, P < .0001) were: a persistent deep aching over most of my body, poor balance (7.4 vs 3.1), environmental sensitivity (6.8 vs 3.0), tenderness to touch (6.8 vs 3.6) and pain after exercise (8.1 vs 4.1). Notably, VAS pain though significantly higher for FM was least discriminatory (6.5 vs 5.1, P < .001). The five best symptoms generated a ROC = 0.85 and Somers' D = 0.69, an accuracy of 81%, and an odd's ratio of 14.4. Conclusions Our results herein suggest that clinicians may be well-served to consider symptoms in addition to those contained in current diagnostic criteria when recognizing FM in their chronic pain patients.
引用
收藏
页码:225 / 234
页数:10
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