Revised Fibromyalgia Impact Questionnaire

Last Updated

March 26, 2023

Purpose

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

Instrument Details

Acronym FIQR

Area of Assessment

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

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Actual Cost

$0.00

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)

Chronic Pain

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

21 items

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

Paper & Pencil
Fillable PDF via internet

1-5 minutes

Required Training

No Training

Adult

18 - 65

years

Instrument Reviewers

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

Spencer Brodsky, MD

ICF Domain

Activity
Participation

Measurement Domain

Activities of Daily Living
Participation & Activities
General Health
Emotion
Cognition
Motor

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.

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
Remission	≤23
Mild	>23 and ≤40
Moderate	>40 and ≤63
Severe	>63 and ≤82
Very severe	>82

Normative Data

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

	Visit 1 Mean (SD)	Visit 2 Mean (SD)
FIQR_A Total	52.62 (20.67)	48.74 (22.30)
FIQR_A Function	13.06 (6.50)	11.01 (7.27)
FIQR_A Overall Impact	11.74 (5.38)	11.44 (5.82)
FIQR_A Symptoms	27.32 (11.12)	27.32 (11.16)

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

	Mean (SD)
FIQR Total	56.6 (20.0)
FIQR Function	15.6 (7.7)
FIQR Overall Impact	11.0 (5.4)
FIQR Symptoms	30.0 (8.8)

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)

	Mean (SD)
FIQR Total	56.93 (19.83)
FIQR Function	15.64 (7.84)
FIQR Overall Impact	9.56 (6.25)
FIQR Symptoms	31.51 (8.94)

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)

	Visit 1 Mean (SD)	Visit 2 Mean (SD)
FIQR Total Score	55.22 (21.96)	57.16 (22.48)
FIQR Function	14.94 (6.52)	15.15 (7.24)
FIQR Overall Impact	11.26 (5.34)	11.44 (5.52)
FIQR Symptoms	29.44 (9.17)	30.73 (9.36)

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

	Visit 1 Mean (SD)	Visit 2 Mean (SD)
FIQR Total Score	49.77 (18.27)	45.52 (19.83)
FIQR Function	13.20 (6.80)	12.64 (6.71)
FIQR Overall Impact	9.88 (6.51)	8.79 (6.13)
FIQR Symptoms	25.58 (8.84)	24.10 (9.10)

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

	Mean (SD)
JFIQR Total	59.5 (23.9)
JFIQR Function	15.1 (8.6)
JFIQR Overall Impact	12.6 (6.3)
JFIQR Symptoms	31.8 (10.7)

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)

	Sample 1	Sample 2
	Mean (SD)	Mean (SD)
FIQR Total	68.2 (17.5)	66.2 (20.7)
FIQR Function	18.9 (6.7)	18.7 (7.2)
FIQR Overall Impact	11.8 (5.6)	11.7 (6.2)
FIQR Symptoms	37.5 (8.7)	35.8 (10.5)

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

	Mean (CI 95%)
FIQR-Br Total	72.20 (68.74 – 75.66)
FIQR-Br Function	20.37 (19.07 – 21.66)
FIQR-Br Overall Impact	14.66 (13.67 – 15.65)
FIQR-Br Symptoms	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)

	Mean (SD)
FIQR Total Score	61.2 (24.3)
FIQR Function	15.7 (8.6)
FIQR Overall Impact	12.0 (6.4)
FIQR Symptoms	33.5 (11.0)

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)

	Visit 1 Mean (SD)	Visit 2 Mean (SD)
FIQR Total	68.2 (17.5)	67.4 (19.9)
FIQR Function	18.9 (6.7)	19.2 (6.8)
FIQR Overall Impact	11.8 (5.6)	12.0 (5.9)
FIQR Symptoms	37.5 (8.7)	36.1 (9.6)

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)

	Mean (SD)
FIQR Total Score	55.7 (18.7)
FIQR Function	13.6 (6.6)
FIQR Overall Impact	10.0 (5.5)
FIQR Symptoms	32.1 (8.5)

Fibromyalgia: Srifi et al, 2013

	Visit 1 Mean (SD)	Visit 2 Mean (SD)
FIQR Total Score	65 (14.5)	63.2 (16.6)
FIQR Function	17.6 (6.52)	16.27 (7.9)
FIQR Overall Impact	19.76 (7.43)	21.66 (7.76)
FIQR Symptoms	27.64 (11.3)	25.27 (14.8)

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_sranged 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)

(Li et al., 2023)

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

(Seo et al., 2016)

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 Mean (SD)
Fibromyalgia patients	56.6 (19.9)
Healthy Controls	12.1 (11.6)
Rheumatoid Arthritis or Systemic Lupus Erythematosus	28.6 (21.2)
Major Depressive Disorder	17.3 (11.8)

(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)

Good known-groups validity across the three groups (fibromyalgia, rheumatoid arthritis and no chronic pain) (F [2, 216] = 107.36, P < 0.0001). Difference in the JFIQR total score between any pairs of the three groups was statistically significant (Tukey’s HSD test P < 0.0001 for all three comparisons)

(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)

(Seo et al., 2016)

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)

There was a strong correlation between the FIQ and FIQR total scores (r = 0.88; p < 0.001) indicating that the patients’ standing on both scales is very similar. “a closer ICF correspondence [has been reported] between the FIQ and SF-36 compared with 14 other general health instruments; thus, the current finding showing a strong relation between FIQR and the SF-36 provides further confirmation of the content validity of the FIQR.”

(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

Bibliography

Abu-Dahab, S., AbuRuz, S. M., Mustafa, K., & Sarhan, Y. (2014). Validation of the Arabic version of the revised Fibromyalgia Impact Questionnaire (FIQR_A) on Jordanian females with fibromyalgia. Clinical Rheumatology, 33(3), 391–396. https://doi.org/10.1007/s10067-013-2347-7

Bennett, R. M., Friend, R., Jones, K. D., Ward, R., Han, B. K., & Ross, R. L. (2009). The Revised Fibromyalgia Impact Questionnaire (FIQR): Validation and psychometric properties. Arthritis Research & Therapy, 11(4), R120. https://doi.org/10.1186/ar2783

Costa, C., Pinto, A. M., Pereira, A. T., Marques, M., Macedo, A., & Pereira da Silva, J. A. (2016). Psychometric properties of the Revised Fibromyalgia Impact Questionnaire (FIQR)—A contribution to the Portuguese validation of the scale. Acta Reumatologica Portuguesa, 41(3), 240–250.

Duhn, P., Amris, K., Bliddal, H., & Wæhrens, E. (2022). The validity of the Danish version of the Fibromyalgia Impact Questionnaire – Revised applied in a clinical setting: a Rasch analysis. Scandinavian Journal of Rheumatology. Advance online publication https://doi.org/10.1080/03009742.2022.2098631

Ediz, L., Hiz, O., Toprak, M., Tekeoglu, I., & Ercan, S. (2011). The validity and reliability of the Turkish version of the Revised Fibromyalgia Impact Questionnaire. Clinical Rheumatology, 30(3), 339–346. https://doi.org/10.1007/s10067-010-1546-8

Ghavidel Parsa, B., Amir Maafi, A., Haghdoost, A., Arabi, Y., Khojamli, M., Chatrnour, G., & Bidari, A. (2014). The validity and reliability of the Persian version of the Revised Fibromyalgia Impact Questionnaire. Rheumatology International, 34(2), 175–180. https://doi.org/10.1007/s00296-013-2929-3

Isomura, T., Kawaguchi, M., Sato, E., Inuzuka, K., Nakamura, I., Osada, K., Nishioka, K., & Hayakawa, K. (2017). Psychometric assessment of the Japanese version of the Revised Fibromyalgia Impact Questionnaire: Reliability and validity. International Journal of Rheumatic Diseases, 20(9), 1088–1094. https://doi.org/10.1111/1756-185X.12574

Li, Y., Jiang, Q., Jia, Y., Zhang, Y., Xiao, Y., Wang, H., Zhao, Y., & Jiao, J. (2023). A Chinese version of the revised Fibromyalgia Impact Questionnaire: A validation study. International Journal of Rheumatic Diseases, 26(2), 242–249. https://doi.org/10.1111/1756-185X.14472

Luciano, J. V., Aguado, J., Serrano-Blanco, A., Calandre, E. P., & Rodriguez-Lopez, C. M. (2013). Dimensionality, reliability, and validity of the revised fibromyalgia impact questionnaire in two Spanish samples. Arthritis Care & Research, 65(10), 1682–1689. https://doi.org/10.1002/acr.22034

Lupi, J. B., Carvalho de Abreu, D. C., Ferreira, M. C., Oliveira, R. D. R. de, & Chaves, T. C. (2017). Brazilian Portuguese version of the Revised Fibromyalgia Impact Questionnaire (FIQR-Br): Cross-cultural validation, reliability, and construct and structural validation. Disability and Rehabilitation, 39(16), 1650–1663. https://doi.org/10.1080/09638288.2016.1207106

OVERVIEW OF THE FIQR & SIQR. (n.d.). Retrieved May 1, 2022, from http://fiqrinfo.ipage.com/index.html

Paiva, E. S., Heymann, R. E., Rezende, M. C., Helfenstein, M., Martinez, J. E., Provenza, J. R., Ranzolin, A., de Assis, M. R., Pasqualin, V. D., & Bennett, R. M. (2013). A Brazilian Portuguese version of the Revised Fibromyalgia Impact Questionnaire (FIQR): A validation study. Clinical Rheumatology, 32(8), 1199–1206. https://doi.org/10.1007/s10067-013-2259-6

Salaffi, F., Ciapetti, A., Franchignoni, F., Giordano, A., Sarzi-Puttini, P., & Ottonello, M. (2013). Psychometric characteristics of the Italian version of the revised Fibromyalgia Impact Questionnaire using classical test theory and Rasch analysis. Clinical and Experimental Rheumatology, 31(6 Suppl 79), S41–49.

Salaffi, F., Di Carlo, M., Bazzichi, L., Atzeni, F., Govoni, M., Biasi, G., Di Franco, M., Mozzani, F., Gremese, E., Dagna, L., Batticciotto, A., Fischetti, F., Giacomelli, R., Guiducci, S., Guggino, G., Bentivegna, M., Gerli, R., Salvarani, C., Bajocchi, G., . . . Sarzi-Puttini, P. (2021). Definition of fibromyalgia severity: Findings from a cross-sectional survey of 2339 Italian patients. Rheumatology, 60(2), 728-736. https://doi.org/10.1093/rheumatology/keaa355

Salgueiro, M., García-Leiva, J. M., Ballesteros, J., Hidalgo, J., Molina, R., & Calandre, E. P. (2013). Validation of a Spanish version of the Revised Fibromyalgia Impact Questionnaire (FIQR). Health and Quality of Life Outcomes, 11, 132. https://doi.org/10.1186/1477-7525-11-132

Seo, S.-R., Park, D.-J., Kang, J.-H., Lee, J.-W., Lee, K.-E., Wen, L., Kim, T.-J., Park, Y.-W., & Lee, S.-S. (2016). Cross-cultural adaptation of the revised Korean version of the Fibromyalgia Impact Questionnaire: Its association with physical function and quality of life. International Journal of Rheumatic Diseases, 19(5), 459–464. https://doi.org/10.1111/1756-185X.12640

Srifi, N., Bahiri, R., Rostom, S., Bendeddouche, I., Lazrek, N., & Hajjaj-Hassouni, N. (2013). The validity and reliability of the Moroccan version of the Revised Fibromyalgia Impact Questionnaire. Rheumatology International, 33(1), 179–183. https://doi.org/10.1007/s00296-011-2331-y

Vaidya, B., Nakarmi, S., Bhochhibhoya, M., & Joshi, R. (2020). Translation, validation and cross-cultural adaptation of the Revised Fibromyalgia Impact Questionnaire (FIQR) in Nepali language. International Journal of Rheumatic Diseases, 23(7), 939–944. https://doi.org/10.1111/1756-185X.13886

Williams, D. A., & Arnold, L. M. (2011). Measures of fibromyalgia: Fibromyalgia Impact Questionnaire (FIQ), Brief Pain Inventory (BPI), Multidimensional Fatigue Inventory (MFI-20), Medical Outcomes Study (MOS) Sleep Scale, and Multiple Ability Self-Report Questionnaire (MASQ). Arthritis Care & Research, 63(S11), S86–S97. https://doi.org/10.1002/acr.20531

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