AB1370 Patient reported outcomes measuresfor fibromyalgia: a review
Authors: J.B. Negrón, L. Carmona
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Persons with fibromyalgia (FM) suffer from numerous symptoms with various levels of intensity, such as widespread pain, fatigue, cognitive dysfunction, non-restorative sleep, depression, and anxiety among others. The patient's perspective has been recognised by Outcome Measure in Rheumatology (OMERACT) as a key assessment in FM. For that reason, some patient reported outcomes measures (PROMs) have been developed. PROMs allow the comparison of a specific component of the disease in a patient through time, and also provide the opportunity to health professionals to compare patients between them in clinical trials. However, some PROMs are used over others despite a limited validation process. In addition, different versions of the same PROMs can co-exist, what can lead to uncertainty when selecting the adequate instrument. <h3>Objectives</h3> To identify the existing PROMs for FM and analyse their psychometric properties. <h3>Methods</h3> The authors performed a comprehensive search in electronic databases (Medline, Embase, and Cochrane) in order to identify validation studies of PROMs for FM. Studies published between <sup>January 1990</sup> and November 2017 were included. Generic PROMs and validation of diagnostic criteria and related screening tools were not considered as PROMs and were excluded. Information was gathered based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist manual. <h3>Results</h3> The electronic search produced 1832 records. After screening, a total of 48 studies containing 16 PROMs for FM were included. The PROMs included address different constructs of the disease, Fibromyalgia Impact Questionnaire (FIQ), Revised Fibromyalgia Impact Questionnaire (FIQR), Combined Index of Symptom Severity, Combined Index of Severity of Fibromyalgia, Comprehensive Rating Scale for Fibromyalgia Symptomatology, Fibromyalgia Assessment Status, Fibromyalgia Bladder Index, Fibromyalgia Burden Assessment, Fibromyalgia Health Assessment Questionnaire, Fibromyalgia Impact Questionnaire+Visual Analogue Scales, Fibromyalgia Participation Questionnaire, Fibromyalgia Sleep Diary, Multidimensional Inventory of Subjective Cognitive Impairment, Multidimensional Patient Reported Outcome Measures Questionnaire, PROMIS Fatigue FM Profile, and Multidimensional daily diary of fatigue-fibromyalgia-17 items. Almost all PROMs have adequate content validity. Three PROMs do not report construct validity; seven do not report reliability, and six do not report internal consistency. Only three PROMs evaluate criterion validity and three responsiveness. The FIQ and the FIQR are the PROMs more widely cross-cultural validated with 18 and 13 adaptations respectively. <h3>Conclusions</h3> PROMs for FM have, in general, only partial validation of their psychometric properties. Validation of an instrument is a continuous process in which quality is more important than quantity. Instead of creating new PROMs for FM, future works should focus on completing missing parts of the validation process of existing ones. In addition, cultural adaptations and translations of the available PROMs should be prioritised in order to offer researchers across the globe a toolbox of options in where they can choose the best PROMs to address their objectives in a highly subjective syndrome as FM. <h3>Disclosure of Interest</h3> None declared