HealthDay News – A comparison was made between the physician-based (MD) 2010 American College of Rheumatology (ACR) criteria for diagnosing fibromyalgia (FM) and the patient-based (PT) 2011 survey/research modified ACR criteria for FM diagnosis. In general, good agreement was found between the MD and PT diagnostic criteria, though multiple widely discordant pairs were also identified, according to a study published in Arthritis Care & Research.
Frederick Wolfe, MD, from the University of Kansas School of Medicine in Wichita, and colleagues obtained rheumatology practice data for 514 patients and 30 physicians. Widespread pain index, polysymptomatic distress (PSD) scale, tender point count (TPC), and fibromyalgia diagnosis were evaluated using 2010 and 2011 rules.
Agreement and disagreement were measured using the Bland-Altman 95% limits of agreement (LOA), kappa statistic, Lin’s concordance coefficient, and the area under the receiver operating curve.
The researchers observed considerable diagnostic agreement for the MD and PT criteria (83.4%; κ = 0.67). Slight differences were seen in PSD scores (12.3 MD, 12.8 PT; P = 0.213). For PSD, the LOA were −8.5 and 7.77, with a bias of −0.42. There was a strong association for the TPC with both MD and PT PSD scales (r = 0.779 and 0.702, respectively).
“There is acceptable agreement in diagnosis and PSD for research, but insufficient agreement for clinical decisions and diagnosis,” the authors write. “We suggest adjudication of symptom data by patients and physicians, as recommended by the 2010 American College of Rheumatology criteria.”
Several authors disclosed financial ties to the pharmaceutical industry.
Wolfe F, Fitzcharles MA, Goldenberg DL, et al. Comparison of Physician-Based and Patient-Based Criteria for the Diagnosis of Fibromyalgia. Arthritis Care Res (Hoboken). 2016;68(5):652-9.