scholarly journals Fibromyalgia Assessment Screening Tool: Clues to Fibromyalgia on a Multidimensional Health Assessment Questionnaire for Routine Care

2019 ◽  
Vol 47 (5) ◽  
pp. 761-769 ◽  
Author(s):  
Kathryn A. Gibson ◽  
Isabel Castrejon ◽  
Joseph Descallar ◽  
Theodore Pincus
Keyword(s):  
Health Assessment Questionnaire ◽  
Health Assessment ◽  
Area Under The Curve ◽  
Routine Care ◽  
Self Report ◽  
Screening Tools ◽  
Symptom Checklist ◽  
Painful Joint ◽  
Multidimensional Health ◽  
Assessment Questionnaire

Objective.To develop feasible indices as clues to comorbid fibromyalgia (FM) in routine care of patients with various rheumatic diseases based only on self-report multidimensional Health Assessment Questionnaire (MDHAQ) scores, which are informative in all rheumatic diagnoses studied.Methods.All patients with all diagnoses complete an MDHAQ at each visit; the 2011 FM criteria questionnaire was added to the standard MDHAQ between February 2013 and August 2016. The proportion of patients who met 2011 FM criteria or had a clinical diagnosis of FM was calculated. Individual candidate MDHAQ measures were compared to 2011 FM criteria using receiver-operating characteristic (ROC) curves; cutpoints to recognize FM were selected from the area under the curve (AUC) for optimal tradeoff between sensitivity and specificity. Cumulative indices of 3 or 4 MDHAQ measures were analyzed as fibromyalgia assessment screening tools (FAST).Results.In 148 patients, the highest AUC in ROC analyses versus 2011 FM criteria were seen for MDHAQ symptom checklist, self-report painful joint count, pain visual analog scale (VAS), and fatigue VAS. The optimal cutpoints were ≥ 16/60 for symptom checklist, ≥ 16/48 for self-report painful joint count, and ≥ 6/10 for both pain and fatigue VAS. Cumulative FAST indices of 2/3 or 3/4 MDHAQ measures correctly classified 89.4–91.7% of patients who met 2011 FM criteria.Conclusion.FAST3 and FAST4 cumulative indices from only MDHAQ scores correctly identify most patients who meet 2011 FM criteria. FAST indices can assist clinicians in routine care as clues to FM with a general rheumatology rather than FM-specific questionnaire.

scholarly journals A Self-Report Multidimensional Health Assessment Questionnaire (MDHAQ) for Face-To-Face or Telemedicine Encounters to Assess Clinical Severity (RAPID3) and Screen for Fibromyalgia (FAST) and Depression (DEP)

2021 ◽  
Author(s):  
Kathryn A. Gibson ◽  
Theodore Pincus
Keyword(s):  
Health Assessment Questionnaire ◽  
Medical Information ◽  
Clinical Status ◽  
Health Assessment ◽  
Self Report ◽  
Clinical Severity ◽  
Pain Patient ◽  
Clinical Value ◽  
Multidimensional Health ◽  
Assessment Questionnaire

Abstract Purpose of Review To update the clinical value of a patient self-report multidimensional health assessment questionnaire (MDHAQ). Recent Findings The MDHAQ includes 10 individual quantitative scores for physical function, pain, patient global assessment, fatigue, sleep, anxiety, depression, morning stiffness, change in status, and exercise status, and 5 indices, RAPID3 (routine assessment of patient index data) to assess clinical status in all diseases studied, FAST3 (fibromyalgia assessment screening tool) and MDHAQ-Dep (depression) to screen for fibromyalgia and/or depression, RADAI self-report of specific painful joints and joint count, and a symptom checklist for review of systems, and recognition of flares and medication adverse events. The MDHAQ also uniquely queries traditional “medical” information concerning comorbidities, falls, trauma, new symptoms, illnesses, surgeries, hospitalizations, emergencies, medication changes, and medication side effects. Three MDHAQ versions include long for new patients, short for new and return patients, and telemedicine. An electronic MDHAQ (eMDHAQ) has been developed with software that can interface with any electronic medical record (EMR) through the HL7 FHIR standard. However, EMR collaboration and implementation have proven difficult. Summary An MDHAQ provides a quantitative overview of patient status with far more information and documentation than an interview, involving minimal extra work for the physician.

Self-report Functioning According to the ICF Model in Elderly Patients with Rheumatoid Arthritis and in Population Controls Using the Multidimensional Health Assessment Questionnaire

2009 ◽  
Vol 36 (2) ◽  
pp. 246-253 ◽  
Author(s):  
ARJA HÄKKINEN ◽  
MARJA ARKELA-KAUTIAINEN ◽  
TUULIKKI SOKKA ◽  
PEKKA HANNONEN ◽  
HANNU KAUTIAINEN
Keyword(s):  
Rheumatoid Arthritis ◽  
Elderly Patients ◽  
Health Assessment Questionnaire ◽  
Health Assessment ◽  
The Self ◽  
Self Report ◽  
Exercise Frequency ◽  
Multidimensional Health ◽  
Population Controls ◽  
Assessment Questionnaire

Objective.To assess disability and functioning of elderly patients with rheumatoid arthritis (RA) and population controls by linking the items included in the self-report Multidimensional Health Assessment Questionnaire (MDHAQ) with components of the WHO International Classification of Functioning, Disability and Health (ICF) instrument.Methods.In total, 1439 patients with RA (mean age 66 yrs, men 29%) and 957 population controls (65 yrs, men 27%) completed a mailed questionnaire. Functioning was recorded by the Finnish version of MDHAQ. Data included comorbidity, subjective health, education level, employment, exercise habits, self-report joint pain/tenderness, and, for patients, the disease duration.Results.Patients had lower levels of functioning compared to controls in all ICF domains, with the exception that male patients functioned comparably to male controls in the “general tasks and demands” domain. In patients, disease activity, education, exercise frequency, and comorbidities were expectedly associated with lower functioning in the body structure and function component, while male sex and subjectively perceived health were associated with more favorable functioning. In the activity and participation components, disease activity, exercise frequency, and comorbidities were associated with impaired functioning, while better health on self-report was associated with better functioning.Conclusion.There is an extra burden of disability in elderly patients with RA compared to the reference population. With a large patient and control population sample, our study shows that use of the self-report MDHAQ identifies all 3 main components of the ICF framework, thus covering a wide spectrum of functioning. Elderly patients with RA, in comparison to population controls, encounter more difficulties in daily activities and their social life.

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