Fibromyalgia Diagnostic Criteria – New vs. Old: Which is Better?

Do new diagnostic criteria for fibromyalgia provide treatment opportunity to those previously untreated?
By Julide Oncu, et al.


BACKGROUND AND OBJECTIVES: It has been known that tender points detected by ACR 1990 criteria alone might not describe the essence of fibromyalgia, so preliminary diagnostic ACR 2010 criteria was developed. Since there has been no clear evidence exist examining the concordance rates and sensitivity to treatment of these two criteria comparatively, we aimed to shed light on this ambiguity.

MATHERIAL AND METHODS: One hundred patients with widespread pain were studied. Fulfillment of both criteria was determined at baseline, at 3th and 12th months. Sensitivity and specificity values were identified. The relationship between Fibromyalgia Impact Questionnaire and components of two criteria was detected by pearson correlation. And the concordance rate was evaluated by kappa coefficient.


  • At the 1st visit (baseline), two criteria were concordant in 48.5% (n=49) of cases (κ=0.43[95%CI.0.22,0.58]).

  • However, the concordance was present in only 25(25%) of the subjects (κ=0.29[95%CI:0.12,0.36]) at the end of the study.

  • After 1 year of follow-up, the sensitivity of ACR 2010 was higher than that of ACR 1990 (0.88; 0.56 respectively) (p< 0.05).

CONCLUSION: ACR 2010 criteria is more sensitive than ACR 1990 both at first diagnosis and after 1 year of follow-up. So; it enables to diagnose and may give opportunity to treat more underdiagnosed FM patients.

Source: Journal of Back and Musculoskeletal Rehabilitation, April 29, 2013. By Julide Oncu, Resat Iliser, Banu Kuran. Department of Physical Medicine and Rehabilitation, Istanbul Sisli Etfal Education and Research Hospital, Istanbul, Turkey.

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