Thursday, April 26, 2012
This could lead to a LOT of confusion....
Got the link to these blog entries from the December 16th edition of the Fibromyalgia and Chronic Pain Awareness newsletter. I must have been living in a cave because I didn't even know of the criteria change:
No More Tender Points? Part 1
No More Tender Points? Part 2
The elimination of the tender point test from the criteria frankly makes me nervous as hell. Without the need for a physical exam, I suspect doctors will start diagnosing patients via telephone or e-mail using just the patient's description of symptoms. That would lead to over-diagnosis, and more of a stigma attached to fibromyalgia because no one is going to take the ailment seriously if practically everyone under the sun with pain is diagnosed with it. It would also lead to under-diagnosis of concurrent ailments. The verbiage in the criteria about the patient must not have any other pain-causing syndrome could cause physicians to stop at the diagnosis of fibromyalgia and not look further for anything else. It is VERY common for people to have multiple ailments with fibromyalgia just along for the ride.
No More Tender Points? Part 1
No More Tender Points? Part 2
The elimination of the tender point test from the criteria frankly makes me nervous as hell. Without the need for a physical exam, I suspect doctors will start diagnosing patients via telephone or e-mail using just the patient's description of symptoms. That would lead to over-diagnosis, and more of a stigma attached to fibromyalgia because no one is going to take the ailment seriously if practically everyone under the sun with pain is diagnosed with it. It would also lead to under-diagnosis of concurrent ailments. The verbiage in the criteria about the patient must not have any other pain-causing syndrome could cause physicians to stop at the diagnosis of fibromyalgia and not look further for anything else. It is VERY common for people to have multiple ailments with fibromyalgia just along for the ride.
Comments:
This happened to Chronic Fatigue Syndrome. The invention of weaker and weaker diagnostic criteria, especially the Oxford criteria, led to a ten fold increase in presumed prevalence, and by my guess a ten fold increase in scepticism about CFS. It also completely overshadowed other diagnostic criteria such as for ME.
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