The Prevalence of Fibromyalgia in the General Population A Comparison of the American College of Rheumatology 1990, 2010, and Modified 2010 Classification Criteria
The Prevalence of Fibromyalgia in the General Population A Comparison of the American College of Rheumatology 1990, 2010, and Modified 2010 Classification Criteria
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DOI：
10.1002/art.38905
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发表时间：
2015-02-01
影响因子：
13.3
通讯作者：
Macfarlane, Gary J.
中科院分区：
文献类型：
--
作者：
Jones, Gareth T.;Atzeni, Fabiola;Macfarlane, Gary J.
目标。美国风湿病学会（ACR） 1990纤维肌痛分类标准是基于广泛疼痛和压痛的存在。2010年，提出了更侧重于多种症状的新标准，这些标准后来被修改为只要求自我报告症状。目前的研究旨在确定纤维肌痛的人群患病率，并使用替代标准比较患病率的差异。进行了横断面调查。调查问卷，包括疼痛、症状和风湿病诊断，邮寄给苏格兰东北部的4600名成年人。患有慢性广泛性疼痛或符合2010年修订标准的参与者，加上其他参与者的子样本，被邀请参加一个研究诊所。参与者完成了额外的问卷调查，并进行了风湿病学检查，他们的体征和症状根据ACR 1990、2010和修改的2010标准进行分类。根据每组标准计算纤维肌痛的患病率，并按年龄、性别和居住地区加权回到目标人群。在1604名问卷参与者中，269人被邀请参加研究诊所，104人（39%）参加；其中32名受试者（31%）符合bbb1组纤维肌痛标准。根据1990年、2010年和修改后的2010年标准，纤维肌痛的患病率分别为1.7%（95%可信区间[95% CI] 0.7-2.8）、1.2% （95% CI 0.3-2.1）和5.4% （95% CI 4.7-6.1）。符合相应标准者男女比例分别为13.7:1、4.8:1和2.3:1。纤维肌痛的患病率随不同的分类标准而变化。特别是，与需要临床医生投入的标准集相比，流行率更高，并且确定符合2010年修订标准的男性比例更大。这对于在研究和临床实践中使用新标准具有重要意义。
Objective. The American College of Rheumatology (ACR) 1990 fibromyalgia classification criteria are based on the presence of widespread pain and tenderness. In 2010, new criteria were proposed that focused more on multiple symptoms, and these criteria were later modified to require only self report of symptoms. The current study aimed to determine the population prevalence of fibromyalgia and to compare differences in prevalence using the alternative criteria.Methods. A cross-sectional survey was conducted. Questionnaires, including items on pain, symptoms, and rheumatologic diagnoses, were mailed to 4,600 adults in northeast Scotland. Participants who had chronic widespread pain or those who met the modified 2010 criteria, plus a subsample of other participants, were invited to attend a research clinic. Attendees completed an additional questionnaire and underwent a rheumatologic examination, and their signs and symptoms were classified according to the ACR 1990, 2010, and modified 2010 criteria. The prevalence of fibromyalgia according to each set of criteria was calculated, weighting back to the target population by age, sex, and area of residence.Results. Of 1,604 questionnaire participants, 269 were invited to attend the research clinic, and 104 (39%) attended; 32 of these subjects (31%) met > 1 set of fibromyalgia criteria. The prevalence of fibromyalgia according to the 1990, 2010, and modified 2010 criteria was 1.7% (95% confidence interval [95% CI] 0.7-2.8), 1.2% (95% CI 0.3-2.1), and 5.4% (95% CI 4.7-6.1), respectively. The ratio of females to males was 13.7:1, 4.8:1, and 2.3:1 of those meeting the respective criteria sets.Conclusion. Fibromyalgia prevalence varies with the different sets of classification criteria applied. In particular, prevalence is higher and a greater proportion of men are identified with the modified 2010 criteria as compared to the criteria sets requiring clinician input. This has important implications for the use of the new criteria, both in research and in clinical practice.