Evaluating the Effect of Delayed Diagnosis on Disease Outcome in Fibromyalgia: A Multi-Center Cross-Sectional Study

Abstract

Background

The impact of delayed diagnosis (DD) on fibromyalgia (FM) patients’ symptomatology and disease outcome has not yet been systematically studied.

Objective

To analyze the predictors of DD and the influence of DD on FM aggravation and disease evaluation measures.

Methods

370 FM patients were interviewed prospectively for this study. The following information was obtained: DD, widespread pain index (WPI), symptom severity scale (SSS), polysymptomatic distress scale (PDS) scale (SSS + WPI), and tender points. We identified three groups of patients: early diagnosis (ED: 2 years; 83 patients), late diagnosis (LD: > 2–7 years; 198 patients), and very late diagnosis (VLD: > 7 years; 89 patients).

Results

The patients’ average age was 33.9 (9.8) years, and 79% were female. The SSS, PDS, and tender point means were 7.8 (1.6), 16.46 (4.1), and 14.31 (2.3), respectively. The correlation between DD and SSS (r = 0.14), the PDS scale (r = 0.37), and FM tender points (r = 0.16) was significant, but not with WPI (r = 0.06). When the three groups were examined, the SSS mean was 7.54 (1.6), 7.73 (1.4), and 8.25 (1.7), respectively (P 0.008), while the PDS mean was 15 (3.8), 15.95 (3.8), and 18.96 (4.4), respectively (P 0.008). (P 0.001).

Conclusion

Early FM diagnosis is associated with lower SSS, total severity scale, and FM tender points, indicating a less severe condition.

Keywords:

• fibromyalgia
• early diagnosis
• diagnostic delay
• widespread pain
• tender points

Data Sharing Statement

Data or materials are available from the authors upon request.

Ethical Approval

The study was approved by the ethical committee of Al Azhar University School of Medicine (Az 063-12-019) in May 2017, all participants were informed about the study procedures and signed an informed consent form. The study was conducted in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 1983. No financial support was received for this study.

Acknowledgment

The abstract of the study was presented in EULAR 2020 Virtual Annual Meeting. The poster’s abstract was published in “Poster Abstracts” in Annals of the Rheumatic Diseases 81(Suppl 1):1721.1–1721, DOI: 10.1136/annrheumdis-2022-eular.5146. The article processing charge for this paper was funded by NewBridge Pharmaceuticals FZ LLC.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no conflicts of interest with respect to the authorship and/or publication of this article.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.