183Fibrofatigue Scale
A self-administered questionnaire, the Fibrofatigue Scale (FFS), was designed to
measure the severity of symptoms in FMS as well as in chronic fatigue syndrome
patients [ 72 ]. Consisting of 12 items, the scale evaluates pain, muscular tension,
fatigue, concentration diffi culties, failing memory, irritability, sadness, sleep distur-
bances, autonomic disturbances, irritable bowel, headache, and subjective experi-
ence of infection. Scale developers were specifi cally interested in creating a tool
that could be used to monitor treatment outcomes. However, the scale requires a
trained administrator, making it potentially unsuitable for large-scale studies or
clinical practice [ 72 ].
Fibromyalgia Bladder Index
The Fibromyalgia Bladder Index (FBI) is a PRO specifi c for urinary symptoms in
FMS with two subscales: bladder urgency/pain and frequency/nocturia. It has eight
items, and the score ranges between 0 and 17. The main drawback is that it exists
only in its English version [ 73 ].
Combined Index of Severity of Fibromyalgia
The Combined Index of Severity of Fibromyalgia (ICAF) is a self-administered
questionnaire that evaluates FMS main symptoms through fi ve domains: emotional
(anxiety and depression), physical (pain, fatigue, sleep quality, and functional abil-
ity), active coping (positive coping strategies), passive coping, and global [ 74 ]
(Appendix 2). It has 59 items and the score ranges from 0 to 89; its psychometric
properties are very good; however, due to its length and complex scoring system,
and to the fact that is only available in Spanish, the ICAF seldom has been used.
Visual Analogue Scale FIQ
The Visual Analogue Scale FIQ (VASFIQ) is a 7-item scale modifi ed VAS of the
FIQR that quantifi es the severity of FMS. It enables rapid patient assessment and
informed treatment decisions in busy clinics [ 75 ]. It is widely used in clinical prac-
tice and research, and has no fl oor or ceiling effect. However, its psychometric prop-
erties are far from excellent and it needs initial training. The VASFIQ should not be
used isolatedly to make treatment decisions.
7 PROMs for Fibromyalgia