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Validation of New Symptom-Based Fibromyalgia Criteria for Irritable Bowel Syndrome Co-morbidity Studies
Ami D Sperber1, Smadar Akiva, Moshe Leshno
1Department of Gastroenterology, Soroka Medical Center, Beer-Sheva, Israel.
Background/Aims:
There is significant co-morbidity between irritable bowel syndrome (IBS) and fibromyalgia syndrome (FMS). However, FMS is diagnosed by physical examination, which limits the conduct of co-morbidity studies in a large population-based study. The purpose of this study was to determine the diagnostic validity of a new symptom-based criteria in patients with FMS and/or IBS using the American College of Rheumatology (ACR) criteria as a gold standard.
Methods:
The study participants consisted of women with FMS (n = 30), IBS (n = 27) and controls (n = 28). A new symptom-based diagnostic criteria for FMS comprised a regional pain scale and a visual analogue scale for fatigue. All subjects underwent a physical examination for FMS (ACR criteria) and structured questionnaires of regional pain scale and visual analogue scale for fatigue. A fibromyalgia intensity score was calculated and thresholds of tenderness were determined by a dolorimeter.
Results:
The number of participants diagnosed with FMS in the entire study population (n = 85) was 31 by the new criteria. Compared to the ACR, the sensitivity of the new criteria was 82.9%, specificity 96.0%, positive predictive value 93.5% and negative predictive value 88.9%. In addition, new criteria were useful for the diagnosis of FMS among the subjects with IBS. A fibromyalgia intensity score was significantly correlated with the threshold of tenderness (r = -0.62, P < 0.001).
Conclusions:
The new symptom-based diagnostic criteria for the diagnosis of FMS can be used in large-scale clinical and epidemiological co-morbidity studies, in which physical examination is unfeasible. Gastroenterologists investigating the effects of co-morbid FMS in IBS patients can use these new ciriteria with confidence.
Insights
A new symptom-based criteria accurately diagnoses fibromyalgia syndrome (FMS) in patients with irritable bowel syndrome (IBS). This method is valuable for large-scale studies where physical exams are impractical.
Area of Science:
- Rheumatology
- Gastroenterology
- Clinical Diagnostics
Background:
- Irritable bowel syndrome (IBS) and fibromyalgia syndrome (FMS) frequently co-occur.
- Diagnosing FMS typically requires physical examination, limiting population-based co-morbidity research.
- A validated symptom-based approach is needed for large-scale FMS and IBS co-morbidity studies.
Purpose of the Study:
- To evaluate the diagnostic accuracy of a novel symptom-based criteria for FMS.
- To compare the new criteria against the established American College of Rheumatology (ACR) criteria for FMS diagnosis.
- To assess the utility of the new criteria in patients with co-morbid IBS and FMS.
Main Methods:
- Recruited women with FMS (n=30), IBS (n=27), and controls (n=28).
- Developed new FMS criteria using a regional pain scale and visual analogue scale for fatigue.
- Administered physical examinations (ACR criteria) and structured questionnaires, calculating a fibromyalgia intensity score.
Main Results:
- The new criteria identified 31 FMS cases in the study population (n=85).
- Achieved high diagnostic performance: 82.9% sensitivity, 96.0% specificity, 93.5% positive predictive value, and 88.9% negative predictive value compared to ACR.
- Demonstrated utility in diagnosing FMS among IBS patients, with significant correlation between fibromyalgia intensity score and tenderness thresholds (r=-0.62, P<0.001).
Conclusions:
- The new symptom-based criteria are suitable for large-scale clinical and epidemiological studies where physical examination is not feasible.
- Gastroenterologists can confidently use these criteria to assess co-morbid FMS in IBS patients.
- This approach facilitates research into the complex relationship between FMS and IBS.
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