I hope this hasn't been posted....it was dated the
10th of this month, but I've been so out of it lately, I
feel like the world is spinning right past me. I've got a
comment at the bottom
Lanelle
____________________________
Inaccuracy In The Diagnosis of Fibromyalgia Syndrome: Analysis of Referrals.
Fitzcharles MA, Boulos P.
Division of Rheumatology and McGill Pain Centre, Department of Medicine, Montreal General Hospital, McGill University Health Centre, Quebec, Canada. mary-ann.fitzcharles@muhc.mcgill.ca
OBJECTIVE: To examine prospectively the accuracy of an initial diagnosis for fibromyalgia (FM). METHODS: All patients newly referred for rheumatology consultation in a 6-month period were evaluated prospectively for either a preceding, current or subsequent diagnosis of FM. Clinical characteristics, previous and subsequent management and health care utilization were assessed. The final diagnosis at 6 months was verified and accuracy regarding the diagnosis of FM was assessed.
RESULTS: Seventy six (12%) of all new patients were either referred with a question of FM or finally diagnosed with FM. At the final evaluation the accuracy of the diagnosis regarding FM by either the referring physician or by the rheumatologist at the time of the initial visit was correct in 34% of patients. The FM group in comparison with those with some other rheumatological diagnosis had more tender points (12.5 vs 4) and were more fatigued. In contrast, prolonged early morning stiffness and limitation of lumbar spinal mobility in more than one plane was more common in the non-FM group.
CONCLUSION: There is a disturbing inaccuracy, mostly observed to be overdiagnosis, in the diagnosis of FM by referring physicians. This finding may help explain the current high reported rates of FM and caution physicians to consider other diagnostic possibilities when addressing diffuse musculoskeletal pain.
PMID: 12595620 [PubMed - indexed for MEDLINE]
____________________________________________________
Now for my comments:
When I read the following quote, I felt like screaming,
"Yoo-hoo - wake up and smell the coffee..."
But then I felt like the other shoe just dropped when the article says
"caution physicians to consider other diagnostic possibilities when addressing diffuse musculoskeletal pain."
Okay, does that mean we have to go back to the "all in your head" diagnosis ? I don't know why, but I've got a funny feeling that when you tell doctor's to not diagnose something, they do it just for spite. Or else blame the patient.
Lanelle
____________________________
Inaccuracy In The Diagnosis of Fibromyalgia Syndrome: Analysis of Referrals.
Fitzcharles MA, Boulos P.
Division of Rheumatology and McGill Pain Centre, Department of Medicine, Montreal General Hospital, McGill University Health Centre, Quebec, Canada. mary-ann.fitzcharles@muhc.mcgill.ca
OBJECTIVE: To examine prospectively the accuracy of an initial diagnosis for fibromyalgia (FM). METHODS: All patients newly referred for rheumatology consultation in a 6-month period were evaluated prospectively for either a preceding, current or subsequent diagnosis of FM. Clinical characteristics, previous and subsequent management and health care utilization were assessed. The final diagnosis at 6 months was verified and accuracy regarding the diagnosis of FM was assessed.
RESULTS: Seventy six (12%) of all new patients were either referred with a question of FM or finally diagnosed with FM. At the final evaluation the accuracy of the diagnosis regarding FM by either the referring physician or by the rheumatologist at the time of the initial visit was correct in 34% of patients. The FM group in comparison with those with some other rheumatological diagnosis had more tender points (12.5 vs 4) and were more fatigued. In contrast, prolonged early morning stiffness and limitation of lumbar spinal mobility in more than one plane was more common in the non-FM group.
CONCLUSION: There is a disturbing inaccuracy, mostly observed to be overdiagnosis, in the diagnosis of FM by referring physicians. This finding may help explain the current high reported rates of FM and caution physicians to consider other diagnostic possibilities when addressing diffuse musculoskeletal pain.
PMID: 12595620 [PubMed - indexed for MEDLINE]
____________________________________________________
Now for my comments:
When I read the following quote, I felt like screaming,
"Yoo-hoo - wake up and smell the coffee..."
But then I felt like the other shoe just dropped when the article says
"caution physicians to consider other diagnostic possibilities when addressing diffuse musculoskeletal pain."
Okay, does that mean we have to go back to the "all in your head" diagnosis ? I don't know why, but I've got a funny feeling that when you tell doctor's to not diagnose something, they do it just for spite. Or else blame the patient.
California US
we have a
real quagmire don't we? Plus, the patient is so happy to
finally have a name for their illness that they
thankfully grasp to it for life. A little scary huh? Back
to ground zero. Up goes the stats. Out goes the good
health care...the HMO docs, gladly hand you a handful of
meds, the latest pharmacutical salesman rendered, so to
lower the doctors amount of tests and prescripts...making
the corp very happy. Yep. everyone goes home happy and
well cared for.
USA
