Rethinking the criteria for fibromyalgia in 2019: the ABC indicators.

Stewart, Julian A.; Mailler-Burch, Simone; Müller, Darius; Studer, Martina; von Känel, Roland; grosse Holtforth, Martin; Schwegler, Kyrill; Egloff, Niklaus (2019). Rethinking the criteria for fibromyalgia in 2019: the ABC indicators. Journal of pain research, 12, pp. 2115-2124. Dove Medical Press 10.2147/JPR.S205299

Stewart, 2019, Rethinking the criteria for fibromyalgia.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC).

Download (1MB) | Preview


Diagnostic criteria for fibromyalgia have been subject to debate and controversy for many years. The preliminary diagnostic criteria introduced in 2010 and 2011 have been criticized for different reasons, including questionable diagnostic specificity and a lack of an etiopathogenetic foundation. The "ABC indicators" presented in this study reflect a further development of the 2011 criteria and refer to (A) algesia, (B) bilateral, axial-symmetric pain distribution, and (C) chronic distress.

Patients and methods

We compared the diagnostic performance of the ABC indicators with that of the 2011 criteria by analyzing the data of 409 inpatients with chronic functional pain divided into two subgroups of pain patients: Those with whole-body pain and those with pain not involving the whole body. Under the premise that FM phenotypically represents a whole-body pain disorder, sensitivity, specificity, correct classification and diagnostic odds ratios were calculated.


The 2011 criteria demonstrated a specificity of 68.1%, a sensitivity of 75.5%, a correct classification of 71.0% and a diagnostic odds ratio of 6.56 (CI: 4.17-10.31). The ABC indicators achieved a specificity of 88.3%, a sensitivity of 62.3%, a correct classification of 78.6%, and a diagnostic odds ratio of 12.47 (CI: 7.30-21.28).


The ABC fibromyalgia indicators demonstrated better specificity, lower sensitivity, and better overall diagnostic effectiveness than the original 2011 criteria.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology > Centre of Competence for Psychosomatic Medicine
07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DCR Unit Sahli Building > Forschungsgruppe Neurologie
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Stewart, Julian Anthony Wharton, Studer, Martina (B), von Känel, Roland, Grosse Holtforth, Martin, Schwegler, Kyrill, Egloff, Niklaus


600 Technology > 610 Medicine & health




Dove Medical Press




Chantal Kottler

Date Deposited:

04 Dec 2019 15:20

Last Modified:

29 Mar 2023 23:36

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Complex Generalized Pain Syndrome (CGPS) chronic pain diagnostic criteria hyperalgesia psychological distress widespread pain




Actions (login required)

Edit item Edit item
Provide Feedback