What is the Fibromyalgia Rapid Screening Tool (FiRST)?

Updated: Apr 23, 2020
  • Author: Chad S Boomershine, MD, PhD, CPI, CPT; Chief Editor: Herbert S Diamond, MD  more...
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A self-administered questionnaire developed by French researchers, the Fibromyalgia Rapid Screening Tool (FiRST) consists of six questions regarding the presence or absence of the following dimensions of fibromyalgia:

  • Widespread pain
  • Fatigue
  • Pain characteristics
  • Nonpainful abnormal sensations
  • Functional somatic symptoms
  • Sleep and cognitive problems

Questions require only a "yes" or "no" answer, with each "yes" answer worth 1 point. A score of 5 or more has the highest sensitivity and specificity for fibromylagia. [98, 99]

Although initially used only to discriminate between fibromyalgia and other painful conditions, FiRST has also proved useful in helping detect concomitant fibromyalgia in patients with inflammatory rheumatic disorders. In a study of patients presenting for treatment of rheumatoid arthritis, spondyloarthritis, or connective tissue disease, and whose pain had persisted for at least 3 months, FiRST screening detected concomitant fibromyalgia in 143 of 586 patients (24.4%). [98, 99]

By comparison, use of American College of Rheumatology 1990 criteria detected only 52 cases of fibromyalgia (8.6%), and assessment by a rheumatologist, 93 cases (15.4%). The study authors conclude that FiRST can be used by rheumatologists in clinical practice to rule out fibromyalgia as a possible explanation for apparent treatment failure in other rheumatologic disorders. [98, 99]

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