The Original FIQ was subdivided into 3 domains; the "functional" domain, the "overall" domain and the "symptom" domain; these 3 domains have been retained in the FIQR. However, since the publication of the FIQ in 1991, several issues regarding ethocultural usage, symptom relevance and arcane scoring became apparent. These issues have been addressed in the FIQR.

1. The original functional domain was originally devised with middle class Caucasian women in mind (as this was the predominant group seen in the OHSU clinic). Therefore, with the help of a patient focus group, a completely new and more generic set of 9 questions were developed for the functional domain of the FIQR:

1. Brush or comb your hair
2. Walk continuously for 20 minutes
3. Prepare a homemade meal
4. Vacuum, scrub or sweep floors
5. Lift and carry a bag full of groceries
6. Climb one flight of stairs
7. Change bed sheets
8. Sit in a chair for 45 minutes
9. Go shopping for groceries

2. The original overall domain asked a question regarding whether patients could work, including housework. This introduced a an interpretation dilemma, as it assumed that doing housework involved the same time constraints and effort as holding down a full time job. Therefore, the 2 overall domain questions were phrased in terms as to the extent that fibromyalgia interfered with the patient's goals for the week and the extent that the patient felt overwhelmed by their fibromyalgia symptoms:

1. Fibromyalgia prevented me from accomplishing goals for the week
2. I was completely overwhelmed by my fibromyalgia symptoms

3. The original symptom domain did not contain some feature of fibromyalgia that became recognized as clinically relevant after its introduction in 1991. Therefore the FIQR was modified by adding 4 new questions to take into account the contemporary clinical spectrum of fibromyalgia. These additional questions are related to memory, balance, tenderness and environmental sensitivity. here are the 10 symptom domain questions: Tenderness is a universal feature of fibromyalgia patients; but has not been incorporated into fibromyalgia  related questionnaires.This omission is corrected in the FIQR; with this question it should be possible to compare objective measures of tenderness (e.g. the myalgic score) against the patient's report of this symptom.  Here are the 10 symptom domain questions:

1. Please rate your level of pain
2. Please rate your level of energy
3. Please rate your level of stiffness
4. Please rate the quality of your sleep
5. Please rate your level of depression
6. Please rate your level of memory problems
7. Please rate your level of anxiety
8. Please rate your level of tenderness to touch
9. Please rate your level of balance problems
10. Please rate your level of sensitivity to loud noises, bright lights, odors and cold

4. The scoring of the original FIQ was cumbersome and time-consuming. The FIQR has all questions rated on a 0 -10 scale, and scoring is simply a matter of adding the score for each domain and applying a "normalization" factor to each of the 3 domain scores. The functional domain score is divided by 3, the overall domain score is divided by 1 (i.e. it is left unchanged), and the symptom domain score is divided by 2. The total FIQR score is the sum of the 3 normalized domain scores.

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