Clinical Diagnosis to Remain the ‘Gold Standard’ for Diagnosing Fibromyalgia


Fibromyalgia is a chronic disease characterized by pain in all body parts in relation to headaches, fatigue, and increased sensitivity to the painful stimuli. Other common symptoms include anxiety, depression, poor sleep, and a problem with thinking or memory.

As per the Centers for Disease Control and Prevention (CDC), fibromyalgia hits more than 4 million adults in the U.S alone. This nearly equals about 2 percent of the total adult population.

To diagnose this problem, a physician is required to take the medical history from a person. They may also suggest a physical exam and other tests like X-rays and blood tests.

Fibromyalgia is considered as a prevalent disease, however, a new study has found that doctors might have misdiagnosed a lot of people as positive for it.

The findings of this study are present in a journal named Arthritis Care & Research and indicate how using the textbook criteria meant for fibromyalgia may lead to a completely different prognosis than the in-person assessment provided by the clinician.

Numerous Missed Diagnoses

In the given study, the researchers recruited 497 people coming to a rheumatology clinic. All of these people filled in a health assessment questionnaire and another one given by American College of Rheumatology for checking the symptoms of fibromyalgia.

The participants were also provided diagnosis and consultations provided by the rheumatology clinicians. Upon assessing the results, the investigators found that out of the 497 people, 121 received the diagnosis from a rheumatology doctor.

The researchers compared the evaluations provided by the clinicians with the results compiled from the questionnaires. They found that they matched in 79.2 percent of the cases.

However, the researchers also noticed that between the two kinds of assessment, the agreement beyond chance was fair only as doctors were missing almost 49.6 percent of the cases of fibromyalgia. Moreover, they were also misdiagnosing 11.4 percent of the people who did not match the criteria meant for the condition.

The lead researcher of the study told that he had recently studied a similar issue in over 3000 patients in the primary care and concluded the same results. This proves that their conclusions of the current study are secure.

Clinicians’ Diagnosis Remains the Gold Standard

An editorial that was published along with this paper, Dr Don Goldenberg belonging to the Oregon Health and Science University in Portland said that the findings of this study indicate how the published criteria for diagnosing fibromyalgia carries a high accuracy rate.

However, he has emphasized that the published criteria, no matter how accurate or well-developed, can definitely not replace the onion and clinical judgment of a physician who is checking the patient and evaluating them while correlating their assessments with different health variables.

The gold standard test for diagnosing fibromyalgia will always be the expert opinion given by a rheumatologist and not the classification criteria irrespective of how accurate, intentioned, or well-refined it is.

Relying on the physician’s judgment is the only way to record the severity of interrelated symptoms and their variability as they continue to play out over the time.


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Samantha Issac
Samantha is a graduate of Medicine with masters in Public Health. Most of her writings are in medicinal tools, technology, and treatments. In addition to that, she is a freelance healthcare writer based in the USA.


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