Validation of the Fibromyalgia Survey Questionnaire within a cross-sectional survey

Winfried Häuser, Eva Jung, Brigitte Erbslöh-Möller, Mechthild Gesmann, Hedi Kühn-Becker, Franz Petermann, Jost Langhorst, Thomas Weiss, Andreas Winkelmann, Frederick Wolfe, Winfried Häuser, Eva Jung, Brigitte Erbslöh-Möller, Mechthild Gesmann, Hedi Kühn-Becker, Franz Petermann, Jost Langhorst, Thomas Weiss, Andreas Winkelmann, Frederick Wolfe

Abstract

The Fibromyalgia Survey Questionnaire (FSQ) assesses the key symptoms of fibromyalgia syndrome. The FSQ can be administrated in survey research and settings where the use of interviews to evaluate the number of pain sites and extent of somatic symptom intensity and tender point examination would be difficult. We validated the FSQ in a cross-sectional survey with FMS patients. In a cross-sectional survey, participants with physician diagnosis of FMS were recruited by FMS-self help organisations and nine clinical institutions of different levels of care. Participants answered the FSQ (composed by the Widespread Pain Index [WPI] and the Somatic Severity Score [SSS]) assessing the Fibromyalgia Survey Diagnostic Criteria (FSDC) and the Patient Health Questionnaire PHQ 4. American College of Rheumatology 1990 classification criteria were assessed in a subgroup of participants. 1,651 persons diagnosed with FMS were included into analysis. The acceptance of the FSQ-items ranged between 78.9 to 98.1% completed items. The internal consistency of the items of the SSS ranged between 0.75-0.82. 85.5% of the study participants met the FSDC. The concordance rate of the FSDC and ACR 1990 criteria was 72.7% in a subsample of 128 patients. The Pearson correlation of the SSS with the PHQ 4 depression score was 0.52 (p<0.0001) and with the PHQ anxiety score was 0.51 (p<0.0001) (convergent validity). 64/202 (31.7%) of the participants not meeting the FSDC criteria and 152/1283 (11.8%) of the participants meeting the FSDC criteria reported an improvement (slightly too very much better) in their health status since FMS-diagnosis (Chi(2) = 55, p<0.0001) (discriminant validity). The study demonstrated the feasibility of the FSQ in a cross-sectional survey with FMS-patients. The reliability, convergent and discriminant validity of the FSQ were good. Further validation studies of the FSQ in clinical and general population settings are necessary.

Conflict of interest statement

Competing Interests: The authors have read the journal's policy and have the following conflicts: Dr. Häuser received honoraria for education lectures from Eli-Lilly, Pfizer and Janssen-Cilag and a congress travel grant by Eli-Lilly. Dr Weiss and Dr. Winkelmann were investigators in a study of pregabalin in FMS, sponsored by Pfizer. The other authors have no conflicts of interest to declare. This does not alter the authors' adherence to all PLOS ONE policies on sharing data and materials.

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