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Is fibromyalgia (FM) a distinct clinical entity? The epidemiologist’s evidence

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The key features of fibromyalgia are chronic widespread pain,

general distress and enhanced pain sensitivity as revealed by

a tender point count. Fibromyalgia could be considered a

distinct entity if the key features defined a patient group

with any one of the following: a characteristics feature or

cluster of features with a distribution clearly demarcating

the group from the rest of the population, identifiable risk

factors, a characteristic natural course or prognosis, or a

specific response to treatment. This should be seen in

population studies, not only in selected clinic series. The

available epidemiological evidence suggests that the

distributions of the key features are continuous and no clear

population groups can be defined. Also, difficulties in

identifying changes such as incidence and recovery, and

unreliable measurements of the key features themselves,

detract from the utility of the concept of fibromyalgia as an

epidemiological entity.

Makela MO

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