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====== Musculoskeletal pain (WPI) ======

The [[https://www.medscape.com/answers/329838-18859/what-is-the-widespread-pain-index-wpi-in-the-diagnostic-criteria-for-fibromyalgia|Widespread Pain Index]] quantifies the extent of bodily pain. The WPI is required to identify individuals that meet the diagnostic criteria of fibromyalgia in epidemiological studies ([[sections|section]]: [[Diseases & symptoms]]).\\
Note that pain was also assessed in [[start|Lifelines]] participants as a symptom of several specified medical conditions, for example [[musculoskeletal symptoms|here]].

===== Background =====

Lifelines repeatedly assessed the presence of fibromyalgia by [[musculoskeletal conditions|self-report]]. However, recent studies indicate that this method misses ~77% of fibromyalgia diagnoses((Warren JW, Clauw DJ (2012). Functional somatic syndromes: sensitivities and specificities of self-reports of physician diagnosis. Psychosomatic Medicine 74(9):891-895)). The WPI improves the identification of participants that meet the diagnostic criteria for fibromyalgia by assessing the presence of individual symptoms rather than the disease itself.\\
The WPI assesses bodily pain on a 0-19 scale by asking  participants if they have had pain or tenderness in 19 different body regions over the past week, with each painful or tender region scoring 1 point.\\
The instrument originated as a part of the Fibromyalgia Survey Questionnaire (FSQ) that sets diagnostic criteria for [[https://en.wikipedia.org/wiki/Fibromyalgia|fibromyalgia]]. The full FSQ also contains a symptom severity score (SSS) for the following symptoms: fatigue, waking unrefreshed, cognitive symptoms and somatic symptoms ((Wolfe F. et al. (2011) Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. Journal of Rheumatology 38(6): 1113–1122)). In Lifelines, this information can be derived from other variables (i.e. [[fatigue (general)]], [[symptoms (SCL-90)]], and various [[mental health|cognition]]-related variables).\\

===== Validity =====
A recent German study showed that the reliability, convergent and discriminant validity of the FSQ were good, however, the The WPI was not evaluated separately((Häuser W. et al. (2012). Validation of the Fibromyalgia Survey Questionnaire within a cross-sectional survey. PLoS One 7(5):e37504)). 

===== Variables =====
| **Questions English**                                                                                      | **Questions Dutch**                                                                               | **Code**                    | **Variable**  | **Assessment**                                                                                  | **Age**  |
| Please indicate whether the parts of the body listed below were painful and/or tender in the past 7 days:  | Geef aan of de onderstaande lichaamsdelen pijnlijk en/of gevoelig waren in de afgelopen 7 dagen:  |                             |               |                                                                                                 |          |
| Left shoulder                                                                                              | Linker schouder                                                                                   | wpi_shoulderleft_adu_q_01   | WPI1          | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Right shoulder                                                                                             | Rechter schouder                                                                                  | wpi_shoulderright_adu_q_02  | WPI2          | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Left hip                                                                                                   | Linker heup                                                                                       | wpi_hipleft_adu_q_03        | WPI3          | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Right hip                                                                                                  | Rechter heup                                                                                      | wpi_hipright_adu_q_04       | WPI4          | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Left upper arm                                                                                             | Linker bovenarm                                                                                   | wpi_upperarmleft_adu_q_05   | WPI5          | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Right upper arm                                                                                            | Rechter bovenarm                                                                                  | wpi_upperarmright_adu_q_06  | WPI6          | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Left lower arm                                                                                             | Linker onderarm                                                                                   | wpi_lowerarmleft_adu_q_07   | WPI7          | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Right lower arm                                                                                            | Rechter onderarm                                                                                  | wpi_lowerarmright_adu_q_08  | WPI8          | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Left upper leg                                                                                             | Linker bovenbeen                                                                                  | wpi_upperlegleft_adu_q_09   | WPI9          | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Right upper leg                                                                                            | Rechter bovenbeen                                                                                 | wpi_upperlegright_adu_q_10  | WPI10         | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Left lower leg                                                                                             | Linker onderbeen                                                                                  | wpi_lowerlegleft_adu_q_11   | WPI11         | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Right lower leg                                                                                            | Rechter onderbeen                                                                                 | wpi_lowerlegright_adu_q_12  | WPI12         | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Left side of jaw                                                                                           | Linker kaak                                                                                       | wpi_jawleft_adu_q_13        | WPI13         | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Right side of jaw                                                                                          | Rechter kaak                                                                                      | wpi_jawright_adu_q_14       | WPI14         | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Chest                                                                                                      | Borstkas                                                                                          | wpi_chest_adu_q_15          | WPI15         | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Abdomen                                                                                                    | Buik                                                                                              | wpi_abdomen_adu_q_16        | WPI16         | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Upper back                                                                                                 | Bovenrug                                                                                          | wpi_upperback_adu_q_17      | WPI17         | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Lower back                                                                                                 | Onderrug                                                                                          | wpi_lowerback_adu_q_18      | WPI18         | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
| Neck                                                                                                       | Nek                                                                                               | wpi_neck_adu_q_19           | WPI19         | [[2A Questionnaire 2|2A]] [[3A Questionnaire 1|3A]] [[4A Questionnaire Health 3| 4A]] [[NEXT]]  | 18+      |
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