working-paperBRC-2026-W501
This article compares the 1990, 2010, and 2016 American College of Rheumatology fibromyalgia criteria with studies of quantitative sensory testing and the Revised Fibromyalgia Impact Questionnaire. The 1990 criteria combined widespread pain with tenderness at 11 or more of 18 sites; the 2010 criteria replaced that requirement with a combination of painful-site count and symptom severity; and the 2016 revision added generalized pain in four of five regions. This genealogy shows how a prespecified clinical pattern can support a positive judgment without a definitive biomarker. Meeting the criteria, however, does not establish pathophysiologic mechanism, the absence of other conditions, or the patient's whole condition. Quantitative sensory testing records responses to evoked stimuli, while the FIQR records function, overall impact, and symptoms over the previous seven days; neither tool alone determines cause or establishes an individual's diagnosis.
working-paperBRC-2026-W502
This article compares the 2010 and 2016 fibromyalgia criteria, a sleep-measurement study in adults with comorbid fibromyalgia and insomnia, an FIQR validation study, and a scoping review of QST. The evidence shows that widespread pain and the burden of sleep, fatigue, and cognitive symptoms are repeatedly assessed together, while function and responses to evoked stimuli form separate measurement layers. Sleep methods can produce different estimates, however; FIQR convergence is a group-level result between questionnaires; and QST protocols are highly heterogeneous. The current evidence therefore does not establish causal order among domains, a single mechanism, or an individual diagnostic biomarker. The next study needs to measure symptoms, sleep, activity and function, and sensory responses repeatedly in the same participants along a connected timeline.
working-paperBRC-2026-W503
This article compares what the Widespread Pain Index (WPI), Symptom Severity Scale (SSS), pressure pain threshold (PPT), quantitative sensory testing (QST), and Revised Fibromyalgia Impact Questionnaire (FIQR) measure. WPI and SSS combine pain distribution over the previous week with the burden of accompanying symptoms; PPT and QST record responses under specified stimulus conditions; and FIQR asks about function, overall impact, and symptoms over the previous seven days. Because the constructs, time windows, test sites, protocols, and decision rules differ, the same person can be classified differently across tools. Such disagreement does not make one value false, and no tool by itself establishes the cause of pain, the validity of symptoms, a single mechanism, or an individual's diagnosis. The different measurement layers should be read together without being collapsed, and future studies need to apply them repeatedly to the same people.
working-paperBRC-2026-W504
This article examines what fibromyalgia criteria, comparisons of sleep diaries, actigraphy, and polysomnography, FIQR, and QST record under different time windows and conditions. The criteria summarize pain distribution and symptom burden over the previous week; FIQR covers function, overall impact, and symptoms over seven days; the sleep methods observe one night or two weeks; and QST records evoked responses at a test encounter. This evidence does not establish the order in which pain, fatigue, disrupted sleep, cognitive difficulties, and worsening after activity unfold within one person's day. Disagreement among measurements or a single result within a normal range is not evidence that an unobserved relationship is absent. Studying actual temporal paths requires repeated, linked observations of sleep, time-stamped symptoms, activity, function, and recovery in the same people.
working-paperBRC-2026-W505
This article distinguishes the absence of a definitive biomarker from the absence of a basis for clinical judgment. The 2010 and 2016 fibromyalgia criteria structure patterns of pain distribution, symptom burden, and duration, but they do not establish a sole cause or define the entirety of a patient's condition. An individual's initial diagnosis requires a full medical evaluation that considers other and coexisting diagnoses, and a conclusion may be deferred when symptoms have been brief, are changing, or remain unclear. The current evidence does not provide a list of specific safety signals, a universal differential, a test panel, or a treatment rule. Nor can a particular negative test or QST result establish, beyond the target of the test, that pain is absent, an individual diagnosis is settled, or care is unnecessary.
working-paperBRC-2026-W506
This article distinguishes observation, explanation, and conclusion in research on sensory amplification in fibromyalgia. Multiple evoked-pain measures can be used to study the involvement of sensory facilitation and modulation, but they are not a single interchangeable test. The quality assessment in a 34-study review, protocol and site heterogeneity in a scoping review that included 126 of 2,512 records, and discordance between self-report and QST in a 22-participant comparison all limit mechanistic and individual-level conclusions. The current evidence does not establish central sensitization as a sole or exclusively central cause, an individual diagnostic criterion, a pain-validity test, or a stable temporal marker. Longitudinal designs that repeatedly measure standardized sensory responses alongside symptoms and function in the same people are needed to distinguish causal direction and subgroups.
working-paperBRC-2026-W507
This article distinguishes the observations denoted by pain, fatigue, sensitization, functional impairment, and post-activity worsening in discussions of fibromyalgia. The 2016 criteria structure painful sites, spatial distribution, and fatigue over the previous week, while the FIQR distinguishes difficulty with activities and overall impact over the past seven days from its symptom items. QST observes protocol-dependent psychophysical responses to controlled stimuli; it is not a sole mechanism, an individual diagnosis, or a test of whether pain is genuine. Because the current evidence does not align activity and symptoms on one time axis, it does not establish the onset, magnitude, duration, recovery, causal direction, or universality of post-activity worsening. Observations recorded together may be related, but they are neither identical nor causally ordered by that fact.
working-paperBRC-2026-W508
This article proposes a longitudinal fibromyalgia study that aligns symptom diaries, sleep, activity, FIQR function, quantitative sensory testing (QST), and treatment context on a shared person-level clock while preserving them as distinct measures. After a brief feasibility phase, frequency, windows, valid-day rules, retest intervals, and primary outcomes would be prespecified; within-person change would be separated from between-person differences; and rival explanations, including reverse direction, burden, and missingness, would be compared. Clinical safety signals, participant burden, and measurement- and study-level stopping rules remain separate. This is neither a validated optimal protocol nor a finding of causality or treatment effect: activity is not function, actigraphy is not sleep experience, and QST is not a sole mechanism, individual diagnosis, or pain-validity test.
working-paperBRC-2026-W301
Functional dyspepsia and accumulation (積) in classical medical texts share expressions such as epigastric discomfort, nausea, belching, and fullness. Rome IV, however, defines its diagnostic scope through four core symptoms, frequency and duration thresholds, and exclusion of structural disease, whereas selected passages in Jingui Gouxuan, Zabing Guangyao, and Donguibogam also record pulse findings, palpable form and movement, location, diarrhea, and changes after defecation. Shared symptom terms therefore do not establish diagnostic, mechanistic, or causal equivalence. No material reviewed here applies Rome IV and contemporary damjeok criteria to the same people, and the classical sources lack adequate edition, facsimile, character-variant, and translation controls. The article sets out these limits and proposes conditions for a future study that records the two sets of observations independently in the same participants at the same time. Another diagnostic vocabulary cannot replace clinical evaluation for structural disease.
working-paperBRC-2026-W001
When one person reports heat in the back and a deep chill in the hands at the same time, placing the experience on a single “cold or heat” axis erases its most clinically informative features: distribution and simultaneity. Replacing that experience with one thermographic image erases sensory coding, temporal delay, adaptation, and context. This problem-led critical synthesis reads Korean-medicine cold–heat questionnaires; Korean and Japanese work on cold hypersensitivity; thermosensory physiology; quantitative sensory testing; vascular provocation; objective–subjective discordance in hot flushes; neuropathic burning; and the regional, depth, and temporal distinctions preserved in the Donguibogam. Three recurrent reductions emerge: spatial reduction of whole-body cold–heat into a sum score; temporal reduction of a fluctuating event to resting skin temperature; and criterion circularity when groups defined by expert judgment or self-report are reclassified using closely related questions or images. We propose a “local thermal field” that records, for location l and time t, perceived quality and intensity P(l,t), skin temperature and its rate of change T(l,t), cold and warm detection Q(l,t), perfusion and rewarming V(l,t), provoking and relieving context C(t), and functional effect F(t). This is not a new diagnosis but a measurement grammar for separating competing explanations. The first study should not train an AI to guess disease or test treatment effectiveness. It should combine cognitive interviews, 14-day event-based body maps, ambient temperature, and standardized rest–provocation–recovery observations to test repeatability, added information, and feasibility. The contribution of Korean-medicine observation is not to replace biomedical measurement, but to preserve experiences in which different regions move in different directions and to make any added prognostic, functional, or treatment-selection value falsifiable.
working-paperBRC-2026-W004
Donguibogam passages on sleeplessness do not collapse experienced wakefulness, restless or unstable sleep, contexts of post-illness debility and age, and explanations such as phlegm and the spirit failing to return to its abode into one layer. Modern insomnia research likewise shows that self-report, sleep diaries, actigraphy, and polysomnography observe sleep through different rules and may disagree. We cross-analysed a normalized and facsimile-checked classical section with one full-text systematic review and two full-text observational studies across four axes: experience, time, recording instrument, and classificatory purpose. The traditions can be compared in their shared act of stratifying sleep problems, but their categories, mechanisms, and measures are not translatable. Classical 不寐 cannot be retrospectively diagnosed as sleep-state misperception, nor can modern device measurement validate 神不歸舍. Integrative research should keep observations apart from the explanations attached to them and clearly mark where the two traditions overlap, differ, or do not correspond.
protocolBRC-2026-P002
Some patients continue to experience symptoms and impaired daily function after receiving a diagnosis or completing multiple investigations. These experiences arise in different situations—including residual symptoms of established disease, an evolving differential diagnosis, functional syndromes, and changes after infection or treatment—and should not be collapsed into one cause or a new disorder. This protocol proposes a way to preserve those differences while observing features that diagnostic labels may miss: sequence of onset, symptoms that change together, daily context, loss of function, and response to treatment over time. Two paths remain active. One continues appropriate medical differential diagnosis and reassessment as symptoms, red flags, and trajectories change. The other records patient-important symptoms and function, treatment exposure, and harm without waiting for perfect diagnostic closure. Contemporary research and lived experience are read alongside East Asian primary texts, commentaries and cases, and Korean, Chinese, and Japanese clinical traditions without assuming that their concepts are equivalent. Whether Korean-medicine observations add value must be tested by asking if they improve reproducibility, prediction, or clinical decisions beyond diagnoses and standard measures alone. This is a research design, not a screening tool, treatment recommendation, or efficacy claim.
open-problemopenOP-2026-001
Asks for a language and study design that can investigate function and therapeutic possibilities when persistent, recurrent, multisystem, time-varying symptoms are not fully captured by one diagnosis—while continuing to guard against missed disease.
rationalepublishedRAT-2026-001
Diagnosis is essential but may not encode symptom timing, clustering, triggers, functional loss, or individual treatment response. Recurrent observations in Baekrokdam’s “other conditions” clinic generate questions; they are not evidence by themselves.
conjectureopenCON-2026-001
An unverified conjecture that sequences, coupled variation, triggers, relievers, functional recovery, and treatment-response networks may reveal patient subgroups and next decisions better than summed symptom lists.
protocolpublishedPRO-2026-001
A public v0.1 protocol that first separates terms and patient strata, combines red-flag reassessment with low-burden longitudinal observation, and constructs comparable phenomenon units across classical sources, cases, and contemporary research.
assessmentpublishedASM-2026-001
The problem, safety boundaries, disconfirmation routes, and Korean–English alignment are structured for public discussion. External terminology consensus, scientific validity, and clinical utility remain unreviewed and unverified.
clinical-bridgedraftLCB-2026-001
One track keeps red flags and differential diagnosis open; the other records symptom trajectories, function, life context, treatment exposures, and responses. Neither track closes the other.
