Mayo Clinic Organizational Study
Methods
Retrospective description and patient selection
This study was designed as a retrospective chart review. The Mayo Clinic Institutional Review Board approved the study and waived the requirement for informed consent. A database was compiled from electronic health records (EHRs), consisting of all patients who were evaluated at the Mayo Clinic Fibromyalgia and Chronic Fatigue Clinic (FCFC) from November 22, 2014, through December 31, 2015. Subsequently, an in-depth medical record review was performed. The patients’ EHRs were first assessed for the presence of a validated diagnosis of fibromyalgia, which had to be given by a physician or nurse practitioner in the FCFC via the 1990 and/or 2010 American College of Rheumatology Fibromyalgia …show more content…
Patients were considered to have celiac disease if pathologic findings on small bowel biopsy were consistent with celiac disease, if our institution’s celiac disease serology cascade was positive, or if the diagnosis from an outside institution had corresponding clinical features. If there was no information concerning celiac disease in the EHR, the patient was excluded. Our institution’s celiac disease serology cascade algorithm is shown in Figure 1.
Patients records were also assessed for age, sex, smoking status, employment status, current opioid use, current benzodiazepine use, fibromyalgia-specific clinical scores (Symptom Severity Score, Widespread Pain Index, and tender point count), Patient Health Questionnaire (PHQ)-9 depression score, Generalized Anxiety Disorder (GAD)-7 score, presence of GI symptoms, and various laboratory studies including, hemoglobin, erythrocyte sedimentation rate, 25-hydroxy vitamin D, thyroid stimulating hormone, cortisol, C-reactive protein, and antinuclear
Retrospective description and patient selection
This study was designed as a retrospective chart review. The Mayo Clinic Institutional Review Board approved the study and waived the requirement for informed consent. A database was compiled from electronic health records (EHRs), consisting of all patients who were evaluated at the Mayo Clinic Fibromyalgia and Chronic Fatigue Clinic (FCFC) from November 22, 2014, through December 31, 2015. Subsequently, an in-depth medical record review was performed. The patients’ EHRs were first assessed for the presence of a validated diagnosis of fibromyalgia, which had to be given by a physician or nurse practitioner in the FCFC via the 1990 and/or 2010 American College of Rheumatology Fibromyalgia …show more content…
Patients were considered to have celiac disease if pathologic findings on small bowel biopsy were consistent with celiac disease, if our institution’s celiac disease serology cascade was positive, or if the diagnosis from an outside institution had corresponding clinical features. If there was no information concerning celiac disease in the EHR, the patient was excluded. Our institution’s celiac disease serology cascade algorithm is shown in Figure 1.
Patients records were also assessed for age, sex, smoking status, employment status, current opioid use, current benzodiazepine use, fibromyalgia-specific clinical scores (Symptom Severity Score, Widespread Pain Index, and tender point count), Patient Health Questionnaire (PHQ)-9 depression score, Generalized Anxiety Disorder (GAD)-7 score, presence of GI symptoms, and various laboratory studies including, hemoglobin, erythrocyte sedimentation rate, 25-hydroxy vitamin D, thyroid stimulating hormone, cortisol, C-reactive protein, and antinuclear