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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">El objetivo era conocer hasta qu&#233; punto la etiqueta de fibromialgia &#40;FM&#41; pod&#237;a determinar un peor desenlace a corto o largo plazo a los pacientes&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Revisi&#243;n sistem&#225;tica&#46; Se seleccionaron&#44; mediante una estrategia sensible&#44; todos los estudios publicados en PubMed &#40;desde 1961&#41;&#44; Embase &#40;desde 1991&#41; y Cochrane Library Plus hasta abril de 2005&#46; Se acept&#243; la inclusi&#243;n de ensayos cl&#237;nicos o estudios de pron&#243;stico&#46; Para ello&#44; se revisaron los t&#237;tulos y los res&#250;menes de los art&#237;culos resultado de la b&#250;squeda&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">De un total de 650 referencias proporcionadas por la b&#250;squeda&#44; solo 5 se analizaron en detalle&#46; Dos eran estudios longitudinales que cumpl&#237;an completamente los criterios de inclusi&#243;n&#44; realizados en escenarios distintos &#40;Canad&#225; y Reino Unido&#41; y con una muestra suficiente y representativa&#46; En ambos se evidencia un menor uso de recursos sanitarios tras el diagn&#243;stico de FM&#46; Los otros estudios se analizaron en detalle aunque no cumpl&#237;an criterios de inclusi&#243;n&#58; 1 estudio longitudinal para ver la evoluci&#243;n del diagn&#243;stico de FM&#44; 1 estudio cualitativo y 1 revisi&#243;n narrativa&#46; No se encontr&#243; ning&#250;n estudio en contra de la hip&#243;tesis&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">No existen indicios de que el diagn&#243;stico <span class="elsevierStyleItalic">per se</span> de FM pueda conllevar un peor pron&#243;stico a los pacientes con este problema&#46; De hecho&#44; la evidencia existente de calidad moderada-buena&#44; hace suponer que&#44; por el contrario&#44; el diagn&#243;stico reduce la presi&#243;n asistencial por parte de estos pacientes&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The aim of the present study was to determine the extent to which a label of fibromyalgia &#40;FM&#41; could have a harmful effect on short- and long-term prognosis&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We performed a systematic review using a sensitive search strategy&#46; All studies published in PubMed &#40;since 1961&#41;&#44; Embase &#40;since 1991&#41; and Cochrane Library Plus &#40;up to 2005&#41; were selected&#46; The titles and abstracts of articles retrieved from the search were reviewed and clinical trials and studies on prognosis were included&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of a total of 650 references retrieved&#44; only 5 were analyzed in detail&#46; Two were longitudinal studies that completely fulfilled the inclusion criteria&#46; These studies were performed in different countries &#40;Canada and the United Kingdom&#41; with sufficient and representative samples&#46; Both studies reported lower resource utilization after a diagnosis of FM&#46; The remaining studies were analyzed in detail&#44; although they did not fulfill the inclusion criteria&#58; there was one longitudinal study to determine the accuracy of the diagnosis of FM&#44; one qualitative study&#44; and a review article&#46; No studies against the hypothesis that a diagnosis of FM worsens prognosis were found&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">There is no evidence that a diagnosis of FM <span class="elsevierStyleItalic">per se</span> could worsen prognosis in patients with this condition&#46; Indeed&#44; the available evidence&#44; which is of moderate-good quality&#44; suggests that&#44; on the contrary&#44; diagnosis reduces healthcare utilization by patients&#46;</p>"
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Vol. 2. Núm. 2.
Páginas 52-57 (marzo - abril 2006)
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Vol. 2. Núm. 2.
Páginas 52-57 (marzo - abril 2006)
Originales
Acceso a texto completo
Revisión sistemática: ¿el diagnóstico en sí de fibromialgia tiene algún efecto deletéreo sobre el pronóstico?
Systematic review: does a diagnosis of fibromyalgia per se have a harmful effect on prognosis?
Visitas
8227
L. Carmona
Autor para correspondencia
lcarmona@ser.es

Correspondencia: Dra. L. Carmona. Recoletos, 9, 1.° A. 28001 Madrid. España.
Unidad de Investigación. Fundación Española de Reumatología. Madrid. España
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Bibliografía
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Estadísticas
Objetivo

El objetivo era conocer hasta qué punto la etiqueta de fibromialgia (FM) podía determinar un peor desenlace a corto o largo plazo a los pacientes.

Métodos

Revisión sistemática. Se seleccionaron, mediante una estrategia sensible, todos los estudios publicados en PubMed (desde 1961), Embase (desde 1991) y Cochrane Library Plus hasta abril de 2005. Se aceptó la inclusión de ensayos clínicos o estudios de pronóstico. Para ello, se revisaron los títulos y los resúmenes de los artículos resultado de la búsqueda.

Resultados

De un total de 650 referencias proporcionadas por la búsqueda, solo 5 se analizaron en detalle. Dos eran estudios longitudinales que cumplían completamente los criterios de inclusión, realizados en escenarios distintos (Canadá y Reino Unido) y con una muestra suficiente y representativa. En ambos se evidencia un menor uso de recursos sanitarios tras el diagnóstico de FM. Los otros estudios se analizaron en detalle aunque no cumplían criterios de inclusión: 1 estudio longitudinal para ver la evolución del diagnóstico de FM, 1 estudio cualitativo y 1 revisión narrativa. No se encontró ningún estudio en contra de la hipótesis.

Conclusiones

No existen indicios de que el diagnóstico per se de FM pueda conllevar un peor pronóstico a los pacientes con este problema. De hecho, la evidencia existente de calidad moderada-buena, hace suponer que, por el contrario, el diagnóstico reduce la presión asistencial por parte de estos pacientes.

Palabras clave:
Fibromialgia
Diagnóstico
Pronóstico
Objective

The aim of the present study was to determine the extent to which a label of fibromyalgia (FM) could have a harmful effect on short- and long-term prognosis.

Methods

We performed a systematic review using a sensitive search strategy. All studies published in PubMed (since 1961), Embase (since 1991) and Cochrane Library Plus (up to 2005) were selected. The titles and abstracts of articles retrieved from the search were reviewed and clinical trials and studies on prognosis were included.

Results

Of a total of 650 references retrieved, only 5 were analyzed in detail. Two were longitudinal studies that completely fulfilled the inclusion criteria. These studies were performed in different countries (Canada and the United Kingdom) with sufficient and representative samples. Both studies reported lower resource utilization after a diagnosis of FM. The remaining studies were analyzed in detail, although they did not fulfill the inclusion criteria: there was one longitudinal study to determine the accuracy of the diagnosis of FM, one qualitative study, and a review article. No studies against the hypothesis that a diagnosis of FM worsens prognosis were found.

Conclusions

There is no evidence that a diagnosis of FM per se could worsen prognosis in patients with this condition. Indeed, the available evidence, which is of moderate-good quality, suggests that, on the contrary, diagnosis reduces healthcare utilization by patients.

Key words:
Fibromyalgia
Diagnosis
Prognosis
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Bibliografía
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Is a diagnosis disabling or enabling?.
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Copyright © 2006. Elsevier España S.L Barcelona
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Reumatología Clínica
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