Revised Fibromyalgia Impact Questionnaire

The purpose of the Revised Fibromyalgia Impact Questionnaire is to evaluate function, overall impact and symptoms of fibromyalgia over the last 7 days. It was developed specifically for use in patients with fibromyalgia, and the questionnaire is intended to be completed by the patient.

Link to Instrument

Area of Assessment

Activities of Daily Living
Quality of Life
Functional Mobility
Life Participation
Pain
Sleep
Mental Health

Assessment Type

Administration Mode

Cost

Actual Cost

Cost Description

The FIQR is free for academic and clinical use. Commercial use requires a license, which can be obtained from Mapi Research Trust.

CDE Status

CDE Status as of March 2023:

Supplemental – Highly Recommended: Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)

Populations

Key Descriptions

• Developed in response to scoring and content problems with the Fibromyalgia Impact Questionnaire, which was first published in 1991 and later revised in 2009 by Bennett et al.
• The questionnaire consists of 21 items with 3 subscales/domains: Function, Overall Impact, and Symptoms
• Each item is rated on a scale from 0 – 10, and the raw scores on each subscale are added then normalized. To normalize scores, the score on the function subscale is divided by 3, the overall impact subscale divided by 1, and the symptoms subscale divided by 2. These normalized scores from each subscale are then added up for the total FIQR score
• The total score can range from 0 -100. Higher scores indicate more severe impact The FIQR is administered by self-report; the patient may either fill out the form or complete the form online.
• The FIQR is a disease-specific questionnaire, designed for use in patients with fibromyalgia.
• Multiple translations are available, including Arabic, Brazilian Portuguese, Chinese, Danish, Italian, Korean, Spanish, and Turkish.

Number of Items

• Function – 9 Items
• Overall Impact – 2 Items
• Symptoms – 10 Items

Equipment Required

• Paper & Pencil
• Fillable PDF via internet

Time to Administer

Required Training

Age Ranges

Instrument Reviewers

Nicole DiCubellis MSOT, Rachel Parroco MS, OTR/L, OTD, and Brocha Stern, PhD, OTD (New York University)

Spencer Brodsky, MD

ICF Domain

Measurement Domain

Considerations

If you wish to use the FIQ-R in commercial ventures, or obtain a translated version of the FIQR, please contact Mapi Research Trust: trust@mapi.fr

Some limitations include:

• No clear norms available.
• Since originally developed for fibromyalgia, items may have gender bias.
• Difficulties with aggregating data across studies, related to variable use of scoring mechanisms.

Chronic Pain

Standard Error of Measurement (SEM)

Women with Fibromyalgia: (Abu-Dahab et al., 2013; n = 92; mean age = 48.66 (9.9) years; all women; mean fibromyalgia syndrome duration = 48.7 (59.3) months; mean symptoms duration = 77.6 (69.32) months; Jordanian Arabic sample)

• SEM for entire group: 5.469 (calculated from Excel spreadsheet)

Women with Fibromyalgia: (Ghavidel Parsa et al., 2014; n = 77; mean age= 38 (10) years; all females; mean disease duration = 10.73 (26.05) months; Persian sample)

• SEM for entire group: 7.751 (calculated from Excel spreadsheet)

Fibromyalgia: (Isomura et al., 2015; n = 105; mean age = 46.7 (9.4) years; female n = 76 (72.4%); mean duration of fibromyalgia symptoms = 5.2 (3.8) years; Japanese sample)

• SEM for entire group: 7.170 (calculated from Excel spreadsheet)

Females with Fibromyalgia: (Lupi et al., 2016; n = 100; mean age = 47.78 (11.75) years; all female; Brazilian Portuguese sample)

• SEM for entire group for FIQR total score: 2.50
• SEM for entire group for function domain score: 1.15
• SEM for entire group for overall impact domain score: 1.34
• SEM for entire group for symptom domain score: 1.10

Fibromyalgia: (Salgueiro et al., 2013; n = 113; mean age = 51.6 (9.6) years; 109 females (96.5%) and 4 males (3.5%); mean disease duration = 8.5 (7.6) years; Spanish sample)

• SEM for entire group: 7.425 (calculated from Excel spreadsheet)

Fibromyalgia: (Srifi et al., 2013; n = 80; mean age = 53.6 (7.3) years; 63 females (78.5%); mean disease duration = 64.8 (33.6) months; Moroccan sample)

• SEM for entire group: 5.800 (calculated from data in Srifi et al.)

Minimal Detectable Change (MDC)

(Calculated from Abu-Dahab et al., 2013)

• MDC for entire group (n = 92): 15.16

(Calculated from Ghavidel Parsa et al., 2014)

• MDC for entire group (n = 77): 21.49

(Calculated from Isomura et al., 2015)

• MDC for entire group (n = 105): 19.87

(Lupi et al., 2016)

• Smallest detectable change (SDC) = 6.91

(Calculated from Salgueiro et al., 2013)

• MDC for entire group (n =113): 20.58

(Calculated from Srifi et al., 2013)

• MDC for entire group (n = 80): 16.08

Cut-Off Scores

Fibromyalgia: (Salaffi et al., 2021; n = 2339; mean age = 51.9 years (SD 11.5); 2181 women (93.2%) and 158 men (6.8%); mean disease duration = 7.3 years (SD 6.9); Italian sample)

Fibromyalgia Disease Severity

FIQR Cut-Off Values

Normative Data

Fibromyalgia: (Abu-Dahab et al., 2013; Arabic version of the Revised Fibromyalgia Impact Questionnaire [FIQR-A])

FIQR_A Overall Impact

Fibromyalgia: (Bennett et al., 2009; n = 202; mean age = 51 (10.5) years; gender ratio female/male = 16/1)

FIQR Overall Impact

Women with Fibromyalgia: (Costa et al., 2016; n = 103; mean age = 47.32 (10.63); all women; mean age at disease onset = 35.82 (11.57); Portuguese sample)

FIQR Overall Impact

Women with Fibromyalgia: (Ediz et al., 2011; n = 87; mean age = 34.3 (10.2) years; all female; mean disease duration = 53.4 (38.2) months; Turkish sample)

FIQR Total Score

FIQR Overall Impact

Fibromyalgia: (Ghavidel Parsa et al., 2014; n = 50, sub-sample from original n = 77)

FIQR Total Score

FIQR Overall Impact

Fibromyalgia: (Isomura et al., 2015; Japanese version of the Revised Fibromyalgia Impact Questionnaire (JFIQR))

JFIQR Overall Impact

Fibromyalgia: (Luciano et al., 2013; Sample 1: n = 113; mean age = 51.5 (9.6) years; women n = 109 (88.5%); mean years since fibromyalgia diagnosis = 8.5 (7.7); Spanish sample; Sample 2: n = 179; mean age = 51 (8.5) years; women n = 175 (97.8%); mean years since fibromyalgia diagnosis = 7.1 (4.8); Spanish sample)

FIQR Overall Impact

Fibromyalgia: (Lupi et al., 2016; Brazilian Portuguese version of the Revised Fibromyalgia Impact Questionnaire (FIQR-Br))

72.20 (68.74 – 75.66)

20.37 (19.07 – 21.66)

FIQR-Br Overall Impact

14.66 (13.67 – 15.65)

37.32 (35.79 – 38.84)

Women with fibromyalgia: (Paiva et al., 2013; n = 106; mean age = 44.45 (12.56) years; all females; mean disease duration = 4.73 (4.28) years; Brazilian Portuguese sample)

FIQR Total Score

FIQR Overall Impact

Women with fibromyalgia: (Salaffi et al., 2013; n = 503; mean age = 51.3 (10.1) years; women n = 423; mean duration of symptoms = 11.1 (8.7) years; Italian sample)

• Rasch analysis - Average person ability with 5-point rating scale:
  • Function: -0.90 (1.80)
  • Symptoms: 0.03 (1.36)
  • Overall impact: Not assessed

  Mean (SD)
  FIQR Total	47.32 (18.09)
  FIQR Function	12.32 (6.90)
  FIQR Overall Impact	7.98 (5.24)
  FIQR Symptoms	27.17 (8.29)

  Fibromyalgia: (Salgueiro et al., 2013)

  FIQR Overall Impact

  Fibromyalgia: (Seo et al., 2016; n = 79; mean age= 45.9 (10.3) years; 75 females (94%); mean disease duration= 2.7 (2.6) years; Korean sample)

  FIQR Total Score

  FIQR Overall Impact

  Fibromyalgia: Srifi et al, 2013

  FIQR Total Score

  FIQR Overall Impact

  Fibromyalgia: (Vaidya et al., 2020; n = 130; mean age= 38.28 (10.63); 118 females (90.7%) and 12 males (9.3%); median disease duration= 12.0 months; Nepali sample)

  • Mean (SD) FIQR Total Score
    • Visit 1: 29.4 (18.8)
    • Visit 2: 28.5 (21.4)

    Test/Retest Reliability

    Fibromyalgia:

    (Abu-Dahab et al., 2013; n = 30 (sub-sample from original n = 92))

    • Excellent test-retest reliability for FIQR_A total score with 7 – 10 days between administration (ICC = 0.93)
    • Acceptable test-retest reliability for FIQR_A function domain score with 7 – 10 days between administration (ICC = 0.83)
    • Poor test-retest reliability for FIQR_A overall impact domain score with 7 – 10 days between administration (ICC = 0.57)
    • Excellent test-retest reliability for FIQR_A symptoms domain score with 7 – 10 days between administration (ICC = 0.95)

    (Costa et al., 2016; n = 24 (sub-sample from original n = 103))

    • Acceptable test-retest reliability for FIQR total score with 6 weeks between administration (r = 0.835)
    • Poor test-retest reliability for FIQR function domain score with 6 weeks between administration (r_s = 0.641)
    • Poor test-retest reliability for FIQR overall impact domain score with 6 weeks between administration (r_s = 0.617)
    • Acceptable test-retest reliability for FIQR symptoms domain score with 6 weeks between administration (r = 0.886)

    (Ediz et al., 2011)

    • Acceptable test-retest reliability of the Turkish FIQR items with 1 week between administration (r_s ranged from 0.714 - 0.898)
    • Acceptable test-retest reliability for total FIQR score with 1 week between administration (r_s = 0.835)

    (Ghavidel Parsa et al., 2014)

    • Acceptable test-retest reliability for total FIQR score with 7 days between administration (ICC = 0.82)

    (Isomura et al., 2015; n = 65 (sub-sample from original n = 115))

    • Excellent test-retest reliability for JFIQR total score with 1-week between administration (ICC = 0.91)
    • Acceptable test-retest reliability for JFIQR function domain score with 1-week between administration (ICC = 0.84)
    • Acceptable test-retest reliability for JFIQR overall impact domain score with 1-week between administration (ICC = 0.85)
    • Acceptable test-retest reliability for JFIQR symptoms domain score with 1-week between administration (ICC = 0.90)

    (Li et al., 2023; n = 200; mean age = 48.7 years (SD 13.4); 174 women (87.0%) and 26 men (13.0%); mean disease duration = 24.0 months (range 6–84); Chinese population; Chinese version [CFIQR])
    

    • Excellent test-retest reliability for CFIQR total score with 7–14 days between administration (ICC = 0.90)
    • Excellent test-retest reliability for CFIQR function subscale with 7–14 days between administration (ICC = 0.91)
    • Excellent test-retest reliability for CFIQR overall impact subscale with 7–14 days between administration (ICC = 0.86)
    • Excellent test-retest reliability for CFIQR symptoms subscale with 7–14 days between administration (ICC = 0.87)

    (Lupi et al., 2016; n = 85 (sub-sample from original n = 100))

    • Excellent test-retest reliability for FIQR-Br total score with 3 hours between administration (ICC = 0.99)
    • Excellent test-retest reliability for FIQR-Br function domain score with 3 hours between administration (ICC = 0.98)
    • Excellent test-retest reliability for FIQR-Br overall impact domain score with 3 hours between administration (ICC = 0.93)
    • Excellent test-retest reliability for FIQR-Br symptom domain score with 3 hours between administration (ICC = 0.98)

    (Salgueiro et al., 2013)

    • Acceptable test-retest reliability for total score with 1-week between administration: (ICC = 0.82)

    (Seo et al., 2016; n = 55 (sub-sample from original n = 79)

    • Acceptable test-retest reliability for total FIQR score with 1 week between administration (r_s = 0.777)

    (Srifi et al., 2013)

    • Acceptable test-retest reliability for total FIQR score with 3 days between administration (ICC = 0.84)
    • Acceptable test-retest reliability for each Moroccan FIQR item with 3 days between administration (ICC = 0.72- 0.87)

    (Vaidya et al., 2020)

    • Acceptable test-retest reliability for total score with 48 hours between administration (ICC = 0.89)
    • Acceptable test-retest reliability for all items except for question 1 of function domain (ICC > 0.7)
    • Questionable test-retest reliability for question 1 of function domain (ICC = 0.65)

    Internal Consistency

    Fibromyalgia:

    (Abu-Dahab et al., 2013)

    • Excellent internal consistency for FIQR_A total score (Cronbach’s alpha = 0.91)

    (Bennett et al., 2009)

    • Excellent internal consistency for FIQR (Cronbach’s Alpha = 0.95)

    (Costa et al., 2016)

    • Excellent internal consistency for FIQR total score (Cronbach’s Alpha = 0.94)
    • Excellent internal consistency for FIQR function domain score (Cronbach’s Alpha = 0.92)
    • Excellent internal consistency for FIQR overall impact domain score (Cronbach’s Alpha = 0.88)
    • Excellent internal consistency for FIQR symptoms domain score (Cronbach’s Alpha = 0.87)

    (Ediz et al., 2011)

    • Excellent internal consistency for FIQR Visit 1 (Cronbach’s alpha = 0.89)
    • Excellent internal consistency for FIQR Visit 2 (Cronbach’s alpha = 0.91)

    (Ghavidel Parsa et al., 2014)

    • Excellent internal consistency for FIQR Visit 1 (Cronbach’s alpha= 0.88)

    (Isomura et al., 2015)

    • Excellent internal consistency for JFIQR total score (Cronbach’s alpha = 0.90)
    • Excellent internal consistency for JFIQR function domain score (Cronbach’s alpha = 0.83)
    • Excellent internal consistency for JFIQR overall impact domain score (Cronbach’s alpha = 0.85)
    • Excellent internal consistency for JFIQR symptoms domain score (Cronbach’s alpha = 0.85)
    • Excellent internal consistency for CFIQR total score (Cronbach’s alpha = 0.93)
    • Excellent internal consistency for CFIQR function subscale (Cronbach’s alpha = 0.90)
    • Excellent internal consistency for CFIQR overall impact subscale (Cronbach’s alpha = 0.88)
    • Excellent internal consistency for CFIQR symptoms subscale (Cronbach’s alpha = 0.88)

    (Luciano et al., 2013)

    • Excellent internal consistency for FIQR total score (Cronbach’s alpha = 0.93) – Sample 1 (n = 113)
    • Excellent internal consistency for FIQR total score (Cronbach’s alpha = 0.95) – Sample 2 (n = 179)
    • Excellent internal consistency for FIQR function domain score (Cronbach’s alpha = 0.90) – Sample 1 (n = 113)
    • Excellent internal consistency for FIQR function domain score (Cronbach’s alpha = 0.92) – Sample 2 (n = 179)
    • Excellent internal consistency for FIQR overall impact domain score (Cronbach’s alpha = 0.81) – Sample 1 (n = 113)
    • Excellent internal consistency for FIQR overall impact domain score (Cronbach’s alpha = 0.89) – Sample 2 (n = 179)
    • Excellent internal consistency for FIQR symptoms domain score (Cronbach’s alpha = 0.89) – Sample 1 (n = 113)
    • Excellent internal consistency for FIQR symptoms domain score (Cronbach’s alpha = 0.91) – Sample 2 (n = 179)

    (Lupi et al., 2016)

    • Excellent internal consistency for FIQR function domain score (Cronbach’s alpha = 0.92)
    • Excellent internal consistency for FIQR overall impact domain score (Cronbach’s alpha = 0.90)
    • Excellent internal consistency for FIQR symptoms domain score (Cronbach’s alpha = 0.84)

    (Paiva et al., 2013)

    • Excellent internal consistency for FIQR (Cronbach’s alpha= 0.96)

    (Salaffi et al., 2013)

    • Excellent internal consistency for FIQR total score (Cronbach’s alpha = 0.94)
    • Rasch analysis – Good person separation reliability ≥ 0.83
    • Excellent item separation reliability ≥0.98

    (Salgueiro et al., 2013)

    • Excellent internal consistency (Cronbach’s alpha = 0.91) at visit 1
    • Excellent internal consistency (Cronbach’s alpha = 0.95) at visit 2
    • Excellent internal consistency for FIQR Visit 1 (Cronbach’s alpha= 0.948
    • Excellent internal consistency for FIQR Visit 2 (Cronbach’s alpha= 0.964

    (Srifi et al., 2013)

    • Excellent internal consistency for FIQR Visit 1 (Cronbach’s alpha = 0.91)
    • Excellent internal consistency for FIQR Visit 2 (Cronbach’s alpha= 0.92)

    (Vaidya et al., 2020)

    • Excellent internal consistency for function domain (Cronbach’s alpha = 0.905)
    • Excellent internal consistency for overall impact domain (Cronbach’s alpha = 0.714)
    • Excellent internal inconsistency for symptoms domain (Cronbach’s alpha = 0.863)

    Criterion Validity (Predictive/Concurrent)

    Fibromyalgia:

    (Isomura et al., 2015)

    • Excellent concurrent validity between JFIQR total score and Japanese version of the FIQ (JFIQ) total score (r = 0.89)
    • Excellent concurrent validity between JFIQR total score and Fibromyalgia Activity Scale-31 (FAS-31) total score (r = 0.61)
    • Excellent concurrent validity between JFIQR total score and physical function score on Medical Outcomes Study 36-Item Short-Form Health Survey version 2 (SF-36v2) (r = -0.74)
    • Excellent concurrent validity between JFIQR total score and role limitations-physical score on SF-36v2 (r = -0.66)
    • Excellent concurrent validity between JFIQR total score and bodily pain score on SF-36v2 (r = -0.76)
    • Adequate concurrent validity between JFIQR total score and general health perception score on SF-36v2 (r = -0.49)
    • Excellent concurrent validity between JFIQR total score and vitality score on SF-36v2 (r = -0.63)
    • Excellent concurrent validity between JFIQR total score and social function score on SF-36v2 (r = -0.66)
    • Excellent concurrent validity between JFIQR total score and role limitations-emotional score on SF-36v2 (r = -0.61)
    • Adequate concurrent validity between JFIQR total score and mental health score on SF-36v2 (r = -0.56)

    Construct Validity

    Fibromyalgia:

    (Abu-Dahab et al., 2013)

    • Excellent construct validity between FIQR_A total score and physical component score on Arabic Research and Development Short Form Health Survey (RAND SF-36) (r_s = -0.65)
    • Excellent construct validity between FIQR_A total score and mental component score on RAND SF-36 (r_s = -0.61)
    • Adequate construct validity between FIQR_A total score and physical functioning score on RAND SF-36 (r_s = -0.57)
    • Adequate construct validity between FIQR_A total score and role functioning difficulties caused by physical problems score on RAND SF-36 (r_s = -0.31)
    • Adequate construct validity between FIQR_A total score and bodily pain score on RAND SF-36 (r_s = -0.54)
    • Adequate construct validity between FIQR_A total score and general health score on RAND SF-36 (r_s = -0.33)
    • Adequate construct validity between FIQR_A total score and vitality score on RAND SF-36 (r_s = -0.54)
    • Adequate construct validity between FIQR_A total score and social functioning score on RAND SF-36 (r_s = -0.52)
    • Adequate construct validity between FIQR_A total score and role functioning difficulties caused by emotional problems score on RAND SF-36 (r_s = -0.48)
    • Adequate construct validity between FIQR_A total score and mental health score on RAND SF-36 (r_s = -0.43)
    • Adequate construct validity between FIQR_A total score and depression score on Arabic Hospital Anxiety and Depression Scale (HADS) (r_s = 0.49)
    • Adequate construct validity between FIQR_A total score and anxiety score on HADS (r_s = 0.57)

    Mixed Population: (Bennett et al., 2009)

    • Excellent convergent validity between FIQR total score and physical functioning score on the 36 – Item Short Form Healthy Survey (SF-36) (r = -0.71)
    • Adequate convergent validity between FIQR total score and physical role score on the SF-36 (i = -0.54)
    • Adequate convergent validity between FIQR total score and emotional role score on the SF-36 (r = -0.39)
    • Adequate convergent validity between FIQR total score and vitality score on the SF-36 (i = -0.53)
    • Adequate convergent validity between FIQR total score and emotional health score on the SF-36 (r = -0.46)
    • Adequate convergent validity between FIQR total score and social functioning score on the SF-36 (r = -0.54)
    • Excellent convergent validity between FIQR total score and bodily pain score on the SF-36 (r = -0.68)
    • Adequate convergent validity between FIQR total score and general health score on the SF-36 (r = -0.57)
    • Excellent convergent validity between FIQR function domain score and Fibromyalgia Impact Questionnaire (FIQ) function domain score (r = 0.69)
    • Excellent convergent validity between FIQR overall impact domain score and FIQ overall impact domain score (r = 0.69)
    • Excellent convergent validity between FIQR symptoms domain score and FIQ symptoms domain score (r = 0.88)
    • Good discriminant validity with total FIQR score in fibromyalgia patients differing significantly from three other populations: rheumatoid arthritis/systemic lupus erythematosus, major depressive disorder and healthy controls. The total FIQR score in the fibromyalgia population was significantly higher compared to these three groups (Turkey HSD test p< 0.001 for all three comparisons)

    FIQR Total Score

    Rheumatoid Arthritis or Systemic Lupus Erythematosus

    Major Depressive Disorder

    (Costa et al., 2016)

    • Adequate convergent validity between FIQR total score and somatic-anxiety dimension score on the Beck Depression Inventory – II (BDI) (r_s = 0.530)
    • Adequate convergent validity between FIQR total score and cognitive affective dimension score on the BDI (r_s = 0.464)
    • Adequate convergent validity between FIQR total score and BDI total score (r_s = 0.508)
    • Adequate discriminant validity between FIQR total score and positive affect score on the Profile of Mood States (PoMS) (r_s = -0.371)
    • Adequate convergent validity between FIQR total score and negative affect score on the PoMS (r_s = 0.354)

    (Ediz et al., 2011)

    • Poor construct validity between the FIQR total score and Hospital Anxiety and Depression Scales (HADS) Depression (r_s = 0.28)
    • Poor construct validity between the FIQR total score and HADS Anxiety (r_s = 0.17)
    • Adequate construct validity between the FIQR total score and the tender-point count (TPC) (r_s = 0.46)
    • impact Excellent construct validity between the FIQR total score and physical component score of SF-36 (r_s = -0.63)
    • Adequate construct validity between the FIQR total score and mental component score of SF-36 (r_s = -0.51)

    (Ghavidel Parsa et al., 2014)

    • Excellent construct validity between FIQR total score and physical functioning component score of Short Form-12 (SF-12) (r_s = -0.63)
    • Poor construct validity between FIQR total score and mental health component score of SF-12 (r_s = -0.22)
    • Poor construct validity between FIQR total score and Tender-point count (TPC) (r_s = 0.08)

    (Isomura et al., 2015)

    (Luciano et al., 2013; n = 292 (combined samples n = 113 and n = 179)

    • Good known-groups validity, the FIQR total score (t-test = 2.38, 89.8 df, P = 0.02) distinguished between patients who were working outside the home and those on sick leave at the time of the study assessments

    (Lupi et al., 2016)

    • Adequate construct validity between FIQR-Br total score and Widespread Pain Index (WPI) score (r = 0.39)
    • Adequate construct validity between FIQR-Br total score and Symptom Severity Scale score (r = 0.59)

    (Paiva et al., 2013)

    • Excellent convergent validity between FIQR total score and SF-36 physical functioning subscale (r = -0.68)
    • Excellent convergent validity between FIQR total score and SF-36 physical role subscale (r = -0.66)
    • Adequate convergent validity between FIQR total score and SF-36 emotional role subscale (r = -0.48)
    • Adequate convergent validity between FIQR total score and SF-36 general health subscale (r = -0.52)

    (Salaffi et al., 2013)

    • Excellent convergent validity of FIQR total score with Fibromyalgia Assessment Scale (FAS) total score (r = 0.78)
    • Adequate to Excellent convergent validity of the FIQR and FAS subdomains (r ranging from 0.46 - 0.65)

    (Salgueiro et al., 2013)

    • Excellent construct validity between total scores of the FIQR and FIQ (r = 0.83)
    • Excellent construct validity between FIQR total score and HADS total score (r = 0.69)
    • Excellent construct validity between FIQR total score and HADS anxiety subscale score (r = 0.66)
    • Excellent construct validity between FIQR total score and HADs depression subscale score (r = 0.62)
    • Excellent construct validity between FIQR total score and BPI severity (r = 0.70)
    • Excellent construct validity between FIQR total score and BPI interference (r = 0.84)
    • Adequate construct validity between FIQR total score and SF-36 physical component score (r = -0.53)
    • Excellent construct validity between FIQR total score and SF-36 mental component score (r = -0.65)
    • Excellent construct validity between FIQR total score and pain rating on Visual Analogue Scale (VAS) (r_s = 0.724)
    • Excellent construct validity between FIQR total score and fatigue rating on Visual Analogue Scale (VAS) (r_s = 0.755)
    • Excellent construct validity between FIQR total score and Multidimensional Health Assessment Questionnaire (MD-HAQ) (r_s = 0.736)
    • Adequate construct validity between FIQR total score and Rheumatology Attitudes Index (RAI) (r_s = 0.492)
    • Adequate construct validity between FIQR total score and physical component of Medical Outcome Study Short-Form 36 (SF-36) (r_s = -0.523)
    • Adequate construct validity between FIQR total score and mental component of SF-36 (r_s = -0.502)

    (Srifi et al., 2013)

    • Excellent construct validity between FIQR total score and VAS pain (r_s = 0.63)
    • Adequate construct validity between FIQR total score and VAS fatigue (r_s = 0.59)
    • Excellent construct validity between FIQR total score and VAS disability (r_s = 0.70)
    • Adequate construct validity between FIQR total score and TPC (r_s = 0.58)
    • Excellent construct validity between FIQR total score and physical component score of SF-36 (r_s = -0.69)
    • Adequate construct validity between FIQR total score and mental component score of SF-36 (r_s = -0.56)

    (Vaidya et al., 2020)

    • Good discriminant validity between the FMS group and the other cases of rheumatoid arthritis, lupus
    • Adequate construct validity between question number 1 of symptom domain (pain) on FIQR (FIQR 3-1) and VAS for pain (0.546)
    • Adequate construct validity between FIQR 3-1 and SF-36 Q. 21 (r = 0.385)
    • Poor construct validity between question number 2 of symptom domain of FIQR (energy) (FIQR 3-2) and SF-36 Q. 27 (r = 0.289)

    Fibromyalgia and/or Chronic Widespread Pain:

    (Duhn et al., 2022; n = 924; median age = 47.4 years (range 17–79); 868 women (93.9%) and 56 men (6.1%); n = 903 (97.7%) diagnosed with fibromyalgia; n = 21 (2.3%) diagnosed with chronic widespread pain; median tender point count = 16.0 (range 0–18); Danish population; Danish version)

    • Performed a principal component analysis (PCA) to determine whether the FIQR defined a single uniform construct.
    • PCA of residuals explained 51.1% of the variance.
    • Unexplained variance by first contrast was 2.8 eigenvalue units, indicating a multidimensional construct.
    • As such, the authors cautioned against using the total FIQR score to measure a single unidimensional construct, such as fibromyalgia disease severity.

    Content Validity

    Fibromyalgia:

    (Bennett et al., 2009)

    (Salaffi et al., 2013)

    • An exploratory factor analysis identified two subscales (Function and Symptoms), but the subscale of Overall Impact was not confirmed. A confirmatory factor analysis indicated borderline fit of the two-factor model. A Rasch analysis was performed and identified challenges with the 11-point rating scales. Collapsing the rating scales into 5-points improved the fit, but several items continued to have poor fit.

    Face Validity

    Fibromyalgia:

    (Bennett et al., 2009)

    • When the authors were developing the FIQR, they received input for face validity from fibromyalgia individuals in a focus group

    Floor/Ceiling Effects

    Fibromyalgia:

    (Isomura et al., 2015)

    • No floor or ceiling effects noted for JFIQR total or subscale scores

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