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Definition, Klassifikation und Diagnose des Fibromyalgiesyndroms

Definition, classification and diagnosis of fibromyalgia syndrome

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Zusammenfassung

Hintergrund

Eine interdisziplinäre Leitlinie auf Entwicklungsstufe S3 der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF – systematische Literatursuche und -bewertung, Logikanalyse, formaler Konsensusprozess) zu Definition, Klassifikation, Diagnose, Verlauf und Prognose chronischer Schmerzen in mehreren Körperregionen („chronic widespread pain“, CWP) und des Fibromyalgiesyndroms (FMS) wurde in Kooperation von 10 medizinischen bzw. psychologischen Fachgesellschaften und 2 Patientenselbsthilfeorganisationen erstellt.

Methodik

Eine Literatursuche wurde unter Benutzung der Cochrane Library (1993–12/2006), Medline (1980–2006), PsychInfo (1966–12/2006) und Scopus (1980–12/2006) durchgeführt. Für die Vergabe von Evidenzklassen wurde das System des Oxford Centre for Evidence-Based Medicine herangezogen. Für die Vergabe von Empfehlungsgraden wurde die Empfehlungsgraduierung der nationalen Versorgungsleitlinien verwendet. Die Erstellung der Empfehlungen erfolgte in einem mehrstufigen nominalen Gruppenprozess.

Ergebnisse

Chronische Schmerzen in mehreren Körperregionen werden durch die Kriterien des Amerikanischen Kollegiums für Rheumatologie definiert (ACR – starker Konsens). Die klinische Diagnose des FMS kann sowohl symptombasiert (ohne klinische Untersuchung von Tenderpoints) als auch nach den ACR-Kriterien erfolgen (starker Konsens).

Abstract

Background

Interdisciplinary guidelines for the definition, classification and diagnosis of chronic widespread pain (CWP) and fibromyalgia syndrome (FMS) were developed by collaboration of 10 German medical and psychological associations and 2 patient self-help organizations.

Methods

A systematic literature search was performed in the Cochrane Library (1993–12/2006), Medline (1980–2006), PsychInfo (1966–12/2006), and Scopus (1980–12/2006). Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine. Grading of the strength of recommendation was done according to the German program for disease management guidelines. Standardized procedures to reach a consensus on recommendations were used.

Results

CWP is defined by the criteria of the American College of Rheumatology (ACR – strong consensus). FMS can be diagnosed for clinical purposes by symptom-based criteria (without tender point examination) as well as by the ACR criteria (strong consensus).

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Fa. Pfizer (Vortragshonorar), Fa. Ergonex, Schweiz (Multicenter-RCT, Pharmastudie).

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Authors and Affiliations

  1. Abteilung Innere Medizin II (Allgemeine Klinische und Psychosomatische Medizin), Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69210, Heidelberg, Deutschland

    W. Eich

  2. Zentrum für Schmerztherapie, Klinikum Saarbrücken gGmbH, Saarbrücken, Deutschland

    W. Häuser

  3. Fibromyalgie-Zentrum Bad Bocklet, Bad Bocklet, Deutschland

    E. Friedel

  4. Institut für Allgemeinmedizin, Otto-von-Guericke-Universität Magdeburg und Martin-Luther-Universität Halle, Magdeburg, Deutschland

    A. Klement & M. Herrmann

  5. Schmerzambulanz, Abteilung Anästhesie, Klinikum der Universität zu Köln, Köln, Deutschland

    F. Petzke

  6. GRP - Generation Research Program, Humanwissenschaftliches Zentrum, Bad Tölz, Ludwig-Maximilians-Universität München, Bad Tölz, Deutschland

    M. Offenbächer

  7. Sektion Schmerztherapie, Stiftung Orthopädische Universitätsklinik Heidelberg, Heidelberg, Deutschland

    M. Schiltenwolf

  8. Neurologische Klinik , Universität Würzburg, Würzburg, Deutschland

    C. Sommer

  9. Klinik für Neurologie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland

    T. Tölle

  10. Klinik und Poliklinik für Psychosomatische Medizin, Psychotherapie und Medizinische Psychologie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland

    P. Henningsen

  11. Psychosomatische Klinik Baden-Baden, Baden-Baden, Deutschland

    W. Eich

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Eich, W., Häuser, W., Friedel, E. et al. Definition, Klassifikation und Diagnose des Fibromyalgiesyndroms. Schmerz 22, 255–266 (2008). https://doi.org/10.1007/s00482-008-0671-7

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