Bennett, R. M. et al. The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Res. Ther. 11, R120 (2009).

...the FIQR took less time for patients to complete and physicians to score than the FIQ

The Fibromyalgia Impact Questionnaire (FIQ) is widely used to assess patients with fibromyalgia in clinical research, but several shortcomings have become apparent since it came into use in 1991. A newly developed and validated revised version of the questionnaire, the FIQR, could improve the utility of this tool in both fibromyalgia research and clinical practice.

The FIQR retains the main characteristics and structure of the FIQ, including the three domains of function, pain and symptoms. Specific questions in the function domain were revised to generalize the questions and make them more applicable to patients other than middle-class white women, for whom the FIQ was originally developed. In addition, the FIQR gives more weight to function in the total score of the FIQR than the FIQ (30% vs 10%). Other revisions reflect changes in the understanding of fibromyalgia symptomatology.

The changes to the FIQ were developed with the aid of a focus group of 10 fibromyalgia patients, who subsequently completed various versions of the FIQ and proposed FIQR that varied in scoring systems and mode of administration (that is, on paper or online). The responses indicated the feasibility of converting from Likert scoring and visual analog scales to 0–10 numerical box scoring, which enables online data collection.

To validate the revised version, 202 patients with fibromyalgia, 51 patients with either rheumatoid arthritis or systemic lupus erythematosus, 11 with major depression and 213 healthy controls completed online versions of the FIQR, the FIQ and the SF-36. Overall, the FIQR discriminated between the patient groups, and its domain scores correlated well with the corresponding domains of the FIQ and the SF-36. In addition, the FIQR took less time for patients to complete and physicians to score than the FIQ.

The developers of the FIQR now await its independent verification and use in fibromyalgia research by other researchers. “The FIQ was seldom used in routine clinical practice, mainly due to its arcane scoring,” adds Rob Bennett, who led the project, “so we also look forward to learning if the FIQR is found to be useful in the everyday clinical setting.”