A Novel Approach to the Clinical Assessment of Juvenile Fibromyalgia Syndrome: The Juvenile Fibromyalgia Multidimensional Assessment Report (J-FiMAR)

Objectives To develop a disease-specific, pediatric-targeted multidimensional questionnaire for the assessment of juvenile fibromyalgia syndrome (JFS), and provide preliminary evidence of its validity. Methods: The Juvenile Fibromyalgia Multidimensional Assessment Report (J-FiMAR) includes three domains: numerical rating scales to measure the severity of JFS-related symptoms (widespread pain, fatigue, sleep quality, depression, anxiety, cognitive impairment, headache and abdominal pain); a self-report questionnaire to assess physical function (PF) and health-related quality of life (HRQoL); and patient rating of disease severity and course. Validation analyses included assessment of construct validity, discriminant validity and responsiveness to change. Results: the J-FiMAR was administer to 51 JFS patients (F 43, median age 16 years). Each patient completed the J-FiMAR at study entry and at each follow-up visit for a total of 194 visits. All patients found the questionnaire clear, easy to complete and quick. Correlations between J-FiMAR components and physician global assessment of patients health status, and validated instruments for mood and sleep disorders were at least moderate. J-FiMAR discriminated well between patients who exhibited improvement and those who did not improved at follow up visits. JFS patients reported worse pain, fatigue, mood disorders, PF and HRQoL than patients with juvenile idiopathic arthritis (p<0.05). The majority of the items included in the J-FiMAR exhibited satisfactory responsiveness to change, with standardised response mean values exceeding 0.6. Conclusion: the J-FiMAR is an accurate clinical tool for routine monitoring of disease course, and has the potential to be successfully integrated into both outpatient clinics and research settings.