New ACR Criteria Proposed for Diagnosing Fibromyalgia
Find out how you measure up … take the symptom survey
The new, but still preliminary criteria for the fibromyalgia diagnosis were published in May of 2010.* More details on how the American College of Rheumatology (ACR) and researchers arrived at the end result, a one-page symptom checklist, appear in our Latest News section. In place of the tender point count, patients (or their physician) may endorse 19 body regions in which pain has been experienced during the past week. This number is referred to as the Widespread Pain Index (WPI) and it is one of the two required scores needed for a doctor to make a diagnosis of fibromyalgia.
The second part of the score needed to determine if a patient has fibromyalgia involves the evaluation of a person’s symptoms. The end result is a Symptom Severity score or SS score. The diagnosis is based on evaluating both the WPI score and the SS score. Overall, it takes into consideration the widespread nature of your pain and your other bothersome symptoms.
The greatest problem with the new criteria is that the authors do not state how severe the pain must be in order to check “yes” for that area. What if the pain is just a dull ache or intermittent? The criteria do not specify the intensity or quantity of pain that one must have in a given area over the past week to merit a “yes” answer. Quantifying the symptoms for the SS score is even more vague. In fact, the control patients scored an average of 3 on a scale of 0 to 12, which is not far from the SS score required for fibromyalgia.
On the downside, is it possible these new criteria may greatly increase the number of patients diagnosed with fibro by diluting what is called “fibromyalgia.” Quite possibly, people with chronic, painful illnesses that do not involve widespread pain will meet the preliminary criteria for diagnosis. This could diminish the credibility of people with fibromyalgia.
Now that we’ve introduced you to the new preliminary criteria, we invite you to see how you measure up to this new grading system in the following survey. The survey is open to everyone. You do not have to have fibromyalgia to take the survey and learn about the new criteria. This does not take the place of a professional diagnosis, but will give you an idea of what is being proposed.
While taking the survey, consider that your current medications may be greatly helping you or you may be experiencing a good week. Both situations could classify some fibromyalgia patients as not having the illness. Although you are asked about your symptoms for the past week, it is assumed that they have persisted for at least three consecutive months in order to meet the diagnosis. You will be offered an opportunity to comment at the end of the survey. We invite you to let us know what you think.
* Wolfe F, et al. Arthritis Care Res 62(5):600-10, 2010.