Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Simplifying Fibromyalgia Assessment: The VASFIQ Brief Symptom Scale.

S. Boomershine,  Chad, Zlateva,  Gergana, Wang,  Yi, Whalen,  Ed, Emir,  Birol

Background:

Fibromyalgia (FM) is a complex disorder of chronic widespread pain and tenderness associated with symptoms of fatigue, poor sleep, depression, and anxiety. Due to its complexity, identifying clinically significant symptoms and monitoring treatment response in FM is difficult. While the Fibromyalgia Impact Questionnaire (FIQ) can quantify global disease severity, scoring complexity, length and the inability to identify patients with significant symptoms limit its clinical utility. We hypothesized a more clinically useful FM scale could be formed from the 7 FIQ visual analogue scales (the VASFIQ), with the sum of VASFIQ scores providing a global disease severity measure and cut-off scores for individual VASs derived to identify clinically significant symptoms of fatigue, poor sleep, depression and anxiety.

Methods:

Data from 2229 patients enrolled in 3 pregabalin FM treatment trials (LIFT1, RELIEF2 and 11003) were analyzed including scores from the FIQ, the Hospital Anxiety and Depression Scale (HADS), the Medical Outcomes Study (MOS) Sleep Problems Index 9 (SLP) and the Multidimensional Assessment of Fatigue Global Fatigue Index (MAF). Spearman rank correlations compared scores. Receiver operating characteristic (ROC) analysis identified cut-off scores on individual FIQ VASs with corresponding validated questionnaires used to define cases.

Results:

VASFIQ global scores correlated with FIQ global scores at baseline (r=0.94, p<0.0001) and study endpoints (r=0.97, p<0.0001). Change in VASFIQ and FIQ global scores at study endpoints correlated (r=0.96, p<0.0001). Individual FIQ VAS scores correlated with all corresponding validated questionnaire scores at baseline (VASfatigue with MAF r=0.67; VASsleep with SLP r=0.50; VASdepressed with HADS-D r=0.57; VASanxiety with HADS-A r=0.64, all with p<0.0001) and study endpoints (VASfatigue with MAF r=0.76; VASsleep with SLP r=0.67; VASdepressed with HADS-D r=0.62; VASanxiety with HADS-A r=0.67, all with p<0.0001). Change in individual FIQ VAS scores correlated with change in corresponding validated questionnaire scores at study endpoints (VASfatigue with MAF r=0.64; VASsleep with SLP r=0.57; VASdepressed with HADS-D r=0.43; VASanxiety with HADS-A r=0.47, all with p<0.0001). ROC analyses showed a VASfatigue score of >=7.5 was 76.0% sensitive and 82.2% specific for fatigue defined as a >=30 score on the MAF [ROC area 0.87, 95% confidence interval (CI) 0.85–0.89], a VASsleep score of >=7.9 was 68.7% sensitive and 71.2% specific for poor sleep defined as a >=50 score on the SLP (ROC area 0.76, 95% CI 0.74–0.79), a VASdepression score of >=5.8 was 71.3% sensitive and 72.6% specific for depression defined as a >=11 score on the HADS-D (ROC area 0.80, 95% CI 0.77, 0.82) and a VASanxiety score of >=6 was 71.2% sensitive and 77.7% specific for anxiety defined as a >=11 score on the HADS-A (ROC area 0.83, 95% CI 0.81, 0.84).

Conclusions:

The VASFIQ is a brief FM scale to assess global disease severity and identify patients with clinically significant symptoms of fatigue, poor sleep, depression and anxiety.

1)Mease,  et al. J Rheumatol. 2008; 35: 502–14

2)Arnold,  et al. J Pain. 2008; 9: 792–805

3)Pauer,  et al. Ann Rheum Dis. 2008; 67(Suppl2): 256

To cite this abstract, please use the following information:
S. Boomershine, Chad, Zlateva, Gergana, Wang, Yi, Whalen, Ed, Emir, Birol; Simplifying Fibromyalgia Assessment: The VASFIQ Brief Symptom Scale. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :813
DOI: 10.1002/art.28581

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