title: Identifying fibromyalgia-associated symptoms and conditions from a clinical perspective: a step toward evaluating healthcare resource utilization in fibromyalgia.
abstract: OBJECTIVE
  The study aims to determine from the physician's perspective, the conditions and symptoms most relevant to the diagnosis of fibromyalgia (FM) for identifying International Classification of Diseases-diagnosis codes and prescription medications to evaluate FM-related healthcare resource utilization.
  
  
  METHODS
  A questionnaire was administered using an online physician network (SERMO™) from which responses of 102 physicians were evaluated: anesthesiologists (n = 6), neurologists (n = 18), primary care physicians (n = 16), pain specialists (n = 16), psychiatrists (n = 15), and rheumatologists (n = 31). Physicians scored the relative importance to a diagnosis of FM (0 = least relevant/important, 10 = most relevant/important) of 24 conditions and symptoms derived from a list provided by the National Data Bank for Rheumatic Diseases. Conditions and symptoms with mean scores ≥ 5 were considered the most relevant. Other survey questions included treatment goals, assessment of disease severity, medication use, and characterization of the physicians' experience and clinical practice.
  
  
  RESULTS
  Ten conditions and symptoms (mean score) were reported as most relevant: Muscle pain (8.7), Fatigue/tiredness (8.5), Insomnia (8.0), Depression (7.8), Thinking/remembering (6.7), Nervousness (6.0), Muscle weakness (5.9), Headache (5.7), Irritable bowel syndrome (5.5), and Pain/cramps in abdomen (5.1). Treatment goals, severity assessment, and use of medications were generally similar across physician specialties.
  
  
  CONCLUSIONS
  This survey identified 10 conditions and symptoms that physician respondents considered most relevant to a diagnosis of FM. Further evaluation to determine how these conditions and symptoms contribute to FM-associated healthcare resource utilization is warranted.
authors.affiliation: Department of Medicine, Cedars-Sinai/UCLA, Los Angeles, California 90211, USA. stuarts@omcresearch.org
authors.forename: Stuart L
authors.initials: SL
authors.lastname: Silverman
authors.forename: James
authors.initials: J
authors.lastname: Harnett
authors.forename: Gergana
authors.initials: G
authors.lastname: Zlateva
authors.forename: Jack
authors.initials: J
authors.lastname: Mardekian
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009862:Online Systems; D010820:Physicians; D058007:Physicians, Primary Care / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires