- Widespread Pain Index
- Symptom Severity Scale
2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview
The 2010 ACR Criteria require the assessment of 3 key elements:
- Presentation of widespread pain and symptoms for 3 months or more.
- Widespread Pain Index that assesses the number of painful body areas (HCP-administered questionnaire).
- Symptom Severity Scale that assesses the severity of fatigue, waking unrefreshed, and cognitive symptoms, as well as the extent of other somatic symptoms (HCP-administered questionnaire).
- Wolfe F, Clauw DJ, Fitzcharles M-A, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62:600-610.
Part 1: Widespread Pain Index (WPI)
- The WPI is the total number of areas where the patient felt pain over the past week.
- After identifying the areas, add up the total number and write it in the space provided. The WPI score is between 0 and 19.
- The front/back body diagrams are included to help you and the patient identify areas of pain.
Part 2a: Symptom Severity (SS) Scale: levels of severity
- The SS score is measured by indicating the levels of SS over the past week for fatigue, waking unrefreshed, and cognitive symptoms.
- Choose only 1 level of severity for each category. The score for Part 2a is the sum of the numbers that correspond to the severity levels.
- Please note that after you calculate the score for Part 2b, you will add the scores for Parts 2a and 2b for a total SS score.
Part 2b: Symptom Severity (SS) Scale: other somatic symptoms
- The SS score is used to determine the extent of other somatic symptoms the patient may have experienced over the past week.
- After determining the quantity of somatic symptoms, use your best judgment to calculate the score that matches the quantity of those symptoms.
- After you have completed Part 2b, you add the scores for Parts 2a and 2b for a total SS score.
If the patient’s WPI (Part 1) was 9 and SS score (Parts 2a and 2b) was 6, then the patient would meet the ACR Preliminary Diagnostic Criteria for Fibromyalgia.
If the patient’s WPI (Part 1) was 5 and SS score (Parts 2a and 2b) was 7, then the patient would not meet the ACR Preliminary Diagnostic Criteria for Fibromyalgia.
What the patient’s score means
A patient meets the Diagnostic Criteria for Fibromyalgia if the following 3 conditions are met:
ORa.The WPI score (Part 1) is greater than or equal to 7 and the SS score (Parts 2a and 2b) is greater than or equal to 5.1.b.The WPI score (Part 1) is from 3 to 6 and the SS score (Parts 2a and 2b) is greater than or equal to 9.
- Symptoms have been present at a similar level for at least 3 months.
- The patient does not have a disorder that would otherwise explain the pain.