Paediatric Rheumatology
A novel approach to the clinical assessment of juvenile fibromyalgia syndrome: the Juvenile Fibromyalgia Multidimensional Assessment Report
E. Drago1, C. Lavarello2, A. Alongi3, A. Ronchetti4, E. Pescio5, M. Mazzoni6, L. Chiarella7, L. Nobili8, S. Kotzeva9, B. Gily10, M. Gattorno11, A. Ravelli12, C. Malattia13
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Italy; and Gene Therapy Program, Dana Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA.
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova, Italy.
- School of Medicine and Surgery, Milano-Bicocca University, Monza, Italy.
- UOC Medicina Fisica e Riabilitazione, IRCCS Istituto G. Gaslini, Genova, Italy.
- UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto G. Gaslini, Genova; and UOSD Centro di Psicologia, IRCCS Istituto G. Gaslini, Genova, Italy.
- UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto G. Gaslini, Genova, Italy.
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova; and UOC Neuropsichiatria infantile, IRCCS Istituto G. Gaslini, Genova, Italy.
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova; and UOC Neuropsichiatria infantile, IRCCS Istituto G. Gaslini, Genova, Italy.
- UOC Anestesiologia e Terapia del Dolore Acuto Procedurale, IRCCS Istituto G. Gaslini, Genova, Italy.
- UOSD Anestesia ed Analgesia Ostetrico Ginecologica, IRCCS Istituto G. Gaslini, Genova, Italy.
- UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto G. Gaslini, Genova, Italy.
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova; and Direzione Scientifica, IRCCS Istituto G. Gaslini, Genova, Italy.
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genova; and UOC Reumatologia e Malattie Autoinfiammatorie, IRCCS Istituto G. Gaslini, Genova, Italy. claramalattia@gaslini.org
CER19094
Paediatric Rheumatology
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PMID: 42024553 [PubMed]
Received: 12/07/2025
Accepted : 09/10/2025
In Press: 23/04/2026
Abstract
OBJECTIVES:
Development and psychometric evaluation of a disease-specific, paediatric-targeted multidimensional questionnaire for the assessment of juvenile fibromyalgia syndrome (JFS) in routine clinical practice.
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 functioning (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 patient’s 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 improve 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.
CONCLUSIONS:
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.
