Acquiring a diagnosis of fibromyalgia syndrome: The sociology of diagnosis

Madden, Sue; Sim, Julius

doi:10.1057/sth.2015.7

Cited by 27 publications

(37 citation statements)

References 62 publications

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“…First, despite the existence of criteria, "fibromyalgia has no binding definition … and no way of objectively testing for it" (12). Clinical diagnosis can "be a complex process, as medical diagnoses are 'contested, socially created, framed and/or enacted' and are influenced by 'social, political, technological, cultural and economic forces'" (13,14). Clinical diagnosis comes about "through a process of negotiation between patient and doctor, in which power is both wielded and ceded by each party" (14).…”

Section: Introductionmentioning

confidence: 99%

The Problematic Nature of Fibromyalgia Diagnosis in the Community

Srinivasan¹,

Maloney²,

Wright³

et al. 2019

ACR Open Rheumatology

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BackgroundRecently, some studies suggested that clinical diagnosis of fibromyalgia is inaccurate and does not reflect current definitions. However, this hypothesis has not been tested. We examined whether fibromyalgia was accurately diagnosed in the community.MethodsWe surveyed 3276 primary care patients to determine current fibromyalgia status by criteria (CritFM). We also determined whether the patients had a physician's diagnosis of fibromyalgia (MDFM) and the level of symptom severity as measured by the polysymptomatic distress scale (PSD).ResultsThe prevalence of MDFM and CritFM was 6.1% (95% confidence interval [CI] 5.3%, 6.9%) and 5.5% (95% CI 4.8%, 6.3%), respectively. However, only 32.2% with MDFM met 2016 criteria (CritFM), and only 35.4% with CritFM also had MDFM. The kappa statistic for diagnostic agreement was 0.296 (minimal agreement). The mean PSD score was 12.4 and 18.4 in MDFM and CritFM, respectively. The odds ratio for being a woman compared with being a man was 3.2 for MDFM versus 1.9 for CritFM, P = 0.023. Of the patients with MDFM, 68.3% received specific fibromyalgia pharmacotherapy.ConclusionsThere is little agreement between MDFM and CritFM. Only one‐third of MDFM satisfy fibromyalgia criteria, and only one‐third of patients who meet the criteria have a clinical diagnosis of fibromyalgia. Physician diagnosis is biased and more likely in women. Fibromyalgia treatment is common in MDFM (70.7%). Overall, MDFM appears subjective and unrelated to fibromyalgia criteria. There appears to be no common definition of fibromyalgia in the community.

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Section: Introductionmentioning

confidence: 99%

The Problematic Nature of Fibromyalgia Diagnosis in the Community

Srinivasan¹,

Maloney²,

Wright³

et al. 2019

ACR Open Rheumatology

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“…). The condition has perpetually been classified as ‘contested’, as there is a lack of clarity and consensus about the aetiology and manifestations of the illness that render it insecurely positioned in medical and social discourse (Madden & Sim ). A person with fibromyalgia, their practitioners, institutions, workplaces and social networks are continuously challenged to prove the existence of the condition as a serious and chronic illness (McMahon et al .…”

Section: Introductionmentioning

confidence: 99%

“…Fibromyalgia is a chronic musculoskeletal pain condition that is characterised by widespread pain, exhaustion, sleep disruption and myriad other symptoms that veer from the intangible to the concrete (Dennis et al 2013). The condition has perpetually been classified as 'contested', as there is a lack of clarity and consensus about the aetiology and manifestations of the illness that render it insecurely positioned in medical and social discourse (Madden & Sim 2016). A person with fibromyalgia, their practitioners, institutions, workplaces and social networks are continuously challenged to prove the existence of the condition as a serious and chronic illness (McMahon et al 2012, Chen 2015.…”

Section: Introductionmentioning

confidence: 99%

The role of ‘social support’ in the experience of fibromyalgia - narratives from South Africa

Cooper

Gilbert

2016

Health Soc Care Community

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This paper focuses on the role of 'social support' in the experience of fibromyalgia (a musculoskeletal pain disorder) in South Africa. In-depth semi-structured interviews were used to collect narratives from 15 participants. Sources of social support constitute important mechanisms for coping with the illness experience of fibromyalgia. In providing a space for consultation and validation of the diagnosis of fibromyalgia, and the person living with the condition, people giving support fulfil a critical role in shaping the experience. The findings show how support from family, partners, and peers plays an integral role in the process of accepting fibromyalgia diagnosis, adapting to the demands of the condition, and seeking help from healthcare providers. The findings also show the ways in which people with fibromyalgia provide support for others with the condition, and the importance of this peer network in shaping the paths and outcomes of this illness experience. The findings of this study corroborate existing evidence that show fibromyalgia to be a complex condition to manage, due to the multiplicity, uncertainty and contestation that feature in the experience of the illness. Additionally, this study presents the challenges related to the limitations of access to healthcare in the South African context, and the utility of narrative approaches in garnering insight into the ways in which social support is harnessed in this environment.

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“…Ranging from critiques of the concept of objectivity as ignoring the role of power and subjectivity in shaping what gets deemed truth to critiques focused on the dynamic nature of knowledge and social relations, objectivity and objective analysis are seen as snapshots of an ongoing process of meaning-making and becoming rather than ideal outcomes for research (Haraway, 1988;Kondo, 1990) For example, Madden and Sim (2016) discuss how, rather than passively take heed of doctors' warnings and diagnoses, patients often negotiate and contest information provided to them. Key in this view is that individuals are not automatically labeled (see Lemert, 1951) by doctors when diagnosed, as they maintain the capacity to reject diagnosis (Madden & Sim, 2016, p. 90).…”

Section: Pragmatically Intersectional: Critiquing Expertsmentioning

confidence: 99%

“…Together, these two line s of thought have provided philosophical grounds for critiquing the idea that sole groups of persons can have general expertise due to their shared claims regarding the situated and fundamentally subjective nature of knowledge and experience (Williams, 2017a). Thus, the reasons for negation that scholars such as Madden and Sim (2016) highlight are due to individuals having arrived at the conclusion that doctors' claims and judgments are not sacrosanct.…”

Section: Introductionmentioning

confidence: 99%

Doctor Distrust: Pragmatism, Intersectionality, and the Confluence of Expertise and Interests

Williams¹

2017

IJSSS

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The idea that only experts can be privy to knowledge about the world has been strongly contested throughout recent history. Using interviews with 39 British seniors tasked to discuss the role of doctors in matters of life and death, I argue that distrust for expert knowledge stems largely from the belief that knowledge is deeply shaped by personal experience. However, such distrust is not absolute as respondents still hold some faith in medical expertise due to their own perceived lack of medical knowledge and experiences with the medical field. As such, I assert that respondents demonstrate ambivalence towards medical expertise due to the confluence of expertise and interests that they find in the role that doctors play in assisting individuals with their health. I connect my findings to the theoretical traditions of American pragmatism and intersectionality to demonstrate how the ambivalence demonstrated by respondents signals their tacit use of a combination of these theories or what I term pragmatic intersectionality.

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Acquiring a diagnosis of fibromyalgia syndrome: The sociology of diagnosis

Cited by 27 publications

References 62 publications

The Problematic Nature of Fibromyalgia Diagnosis in the Community

The Problematic Nature of Fibromyalgia Diagnosis in the Community

The role of ‘social support’ in the experience of fibromyalgia - narratives from South Africa

Doctor Distrust: Pragmatism, Intersectionality, and the Confluence of Expertise and Interests

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