Validation of the modified 2010 American College of Rheumatology diagnostic criteria for fibromyalgia in a Spanish population.
OBJECTIVE
The aim of this study was to validate the modified 2010 ACR preliminary criteria for FM in a Spanish population.


METHODS
Five hundred and seventy-nine (550 women) FM and 294 (240 women) control participants were enrolled in the study. FM patients were previously diagnosed by a rheumatologist. All participants underwent both the 1990 ACR criteria (1990c) and the modified 2010 ACR criteria (m-2010c).


RESULTS
The tender points count showed correlations of 0.69, 0.65 and 0.71 with the widespread pain index (WPI), symptoms severity (SS) and polysymptomatic distress (PSD) scales, respectively (all P < 0.001). The WPI, SS and PSD showed greater correlations with impact of FM health-related quality of life, general fatigue and depression than the tender points count. The 1990c showed sensitivity and specificity values of 84.1 and 97.6, respectively, whereas the m-2010c showed values of 88.3 and 91.8, respectively. Both criteria showed the same overall accuracy, with a value of 0.89. When the 1990c and m-2010c were combined and patients had to satisfy one of two criteria to be diagnosed with FM, the sensitivity, specificity and accuracy of questionnaires were 96.7, 89.8 and 0.94, respectively. The original cut-off points (WPI ≥ 7, SS ≥ 5 and PSD ≥ 12) showed the best test characteristics in the present study.


CONCLUSIONS
The m-2010c, with the same cut-off points as the original version, are a valid tool for the diagnosis of FM in our population. Whenever possible, the combination of the 1990c and m-2010c is recommended (patients have to meet one of the two criteria to be diagnosed), since this approach showed the best diagnostic characteristics.
Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Granada, Department of Physiology, Faculty of Pharmacy, University of Granada, Granada and Department of Physical Education, Faculty of Sciences Education, University of Cádiz, Cádiz, Spain. vsegura@ugr.es.
Víctor
V
Segura-Jiménez
Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Granada, Department of Physiology, Faculty of Pharmacy, University of Granada, Granada and Department of Physical Education, Faculty of Sciences Education, University of Cádiz, Cádiz, Spain. Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Granada, Department of Physiology, Faculty of Pharmacy, University of Granada, Granada and Department of Physical Education, Faculty of Sciences Education, University of Cádiz, Cádiz, Spain.
Virginia A
VA
Aparicio
Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Granada, Department of Physiology, Faculty of Pharmacy, University of Granada, Granada and Department of Physical Education, Faculty of Sciences Education, University of Cádiz, Cádiz, Spain.
Inmaculada C
IC
Álvarez-Gallardo
Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Granada, Department of Physiology, Faculty of Pharmacy, University of Granada, Granada and Department of Physical Education, Faculty of Sciences Education, University of Cádiz, Cádiz, Spain.
Alberto
A
Soriano-Maldonado
Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Granada, Department of Physiology, Faculty of Pharmacy, University of Granada, Granada and Department of Physical Education, Faculty of Sciences Education, University of Cádiz, Cádiz, Spain.
Fernando
F
Estévez-López
Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Granada, Department of Physiology, Faculty of Pharmacy, University of Granada, Granada and Department of Physical Education, Faculty of Sciences Education, University of Cádiz, Cádiz, Spain.
Manuel
M
Delgado-Fernández
Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Granada, Department of Physiology, Faculty of Pharmacy, University of Granada, Granada and Department of Physical Education, Faculty of Sciences Education, University of Cádiz, Cádiz, Spain.
Ana
A
Carbonell-Baeza
D000328:Adult; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011788:Quality of Life; D012219:Rheumatology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013030:Spain; D014481:United States
fatigue; impact of fibromyalgia; polysymptomatic distress scale; quality of life; questionnaire; sensitivity; specificity; symptom severity; tender points; widespread pain index