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Development of responder criteria for multicomponent non-pharmacological treatment in fibromyalgia
V.M. Vervoort1, J.E. Vriezekolk2, C.H. Van Den Ende3
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. v.vervoort@maartenskliniek.nl
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
CER10442
2017 Vol.35, N°3 ,Suppl.105
PI 0086, PF 0092
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PMID: 28681711 [PubMed]
Received: 24/03/2017
Accepted : 03/05/2017
In Press: 29/06/2017
Published: 29/06/2017
Abstract
OBJECTIVES:
There is a need to identify individual treatment success in patients with fibromyalgia (FM) who received non-pharmacological treatment. The present study described responder criteria for multicomponent non-pharmacological treatment in FM, and estimated and compared their sensitivity and specificity.
METHODS:
Candidate responder sets were 1) identified in literature; and 2) formulated by expert group consensus. All candidate responder sets were tested in a cohort of 129 patients with FM receiving multicomponent non-pharmacological treatment. We used two gold standards (both therapist’s and patient’s perspective), assessed at six months after the start of treatment.
RESULTS:
Seven responder sets were defined (three identified in literature and four formulated by expert group consensus), and comprised combinations of domains of 1) pain; 2) fatigue; 3) patient global assessment (PGA); 4) illness perceptions; 5) limitations in activities of daily living (ADL); and 6) sleep. The sensitivity and specificity of literature-based responder sets (n=3) ranged between 17%-99% and 15%-95% respectively, whereas the expert-based responder sets (n=4) performed slightly better with regard to sensitivity (range 41%-81%) and specificity (range 50%-96%). Of the literature-based responder sets the OMERACT-OARSI responder set with patient’s gold standard performed best (sensitivity 63%, specificity 75% and ROC area = 0.69). Overall, the expert-based responder set comprising the domains illness perceptions and limitations in ADL with patient’s gold standard performed best (sensitivity 47%, specificity 96% and ROC area = 0.71).
CONCLUSIONS:
We defined sets of responder criteria for multicomponent non-pharmacological treatment in fibromyalgia. Further research should focus on the validation of those sets with acceptable performance.
