Identifying and prioritising clinical domains in Fibromyalgia Syndrome

A research study found that clinicians and patients mostly agreed on the domains affected by Fibromyalgia Syndrome and their priority, with pain consistently being the highest ranked domain.¹

The aim of the study was to identify and prioritise the key domains impacted by Fibromyalgia Syndrome that should be evaluated as outcome measures in clinical trials relating to Fibromyalgia Syndrome, and to also approach consensus among clinicians and patients on the priority of those domains to be assessed in clinical care and research.¹

Group consensus was achieved using the Delphi method, a structured process of consensus building via questionnaires together with systematic and controlled opinion feedback.

For this study, the Delphi exercises involved 23 clinicians with expertise in Fibromyalgia Syndrome and 100 patients with Fibromyalgia Syndrome as defined by American College of Rheumatology criteria. .¹

The study revealed that clinicians and patients ranked similar domains highly.¹

Pain was consistently ranked highest by both clinicians and patients. Fatigue, impact on sleep, health-related quality of life, comorbid depression, and cognitive difficulty were also ranked highly. However, stiffness was ranked highly by patients but not clinicians and side effects were important to clinicians but not so much to patients.¹

The researchers concluded that:

"The clinician and patient Delphi exercises identified and ranked key domains that need to be assessed in [Fibromyalgia Syndrome] research. Based on these results, a conceptual framework for measuring patient-reported outcomes is proposed."

Pain is the most commonly used primary outcome measure for research trials into Fibromyalgia Syndrome and it is also what many clinicians concentrate on when treating patients. However, it is important that the other domains are taken into account. The Fibromyalgia Impact Questionnaire is sometimes used as a secondary outcome measure to pain in research studies in an attempt to address this issue.

References:

1. Mease PJ et al. Identifying the clinical domains of fibromyalgia: contributions from clinician and patient Delphi exercises. Arthritis Rheum. 2008 Jul 15;59(7):952-60.