Comparing three fibromyalgia screening tools: diagnostic accuracy and clinical utility.

Area of Science:

• Rheumatology
• Diagnostic Accuracy
• Musculoskeletal Pain

Background:

• Fibromyalgia (FM) screening tools aid rapid recognition of symptoms.
• Brief, self-administered tools are crucial for efficient clinical practice.

Purpose of the Study:

• To evaluate the diagnostic performance of three common fibromyalgia screening tools.
• Compare the discriminative ability and clinical utility of SIFIS, FiRST, and NFF.

Main Methods:

• Cross-sectional study of 205 female patients with chronic multisite pain.
• Administered Fibromyalgia Rapid Screening Tool (FiRST), Nociplastic-Based Fibromyalgia Features (NFF), and Self-Administered Fibromyalgia Screening (SIFIS) questionnaire.
• Used Area Under the Receiver Operating Characteristic Curve (AUC-ROC) and Decision Curve Analysis (DCA) for evaluation.

Main Results:

• SIFIS demonstrated the highest diagnostic performance (AUC=0.941) with 86.8% accuracy.
• FiRST (AUC=0.827) and NFF (AUC=0.829) showed lower discriminative ability.
• SIFIS provided the greatest net clinical benefit across various probability thresholds.

Conclusions:

• SIFIS exhibits superior diagnostic accuracy and clinical utility for fibromyalgia screening in patients with chronic pain.
• The integration of ROC and DCA supports SIFIS as a practical tool for routine clinical practice.
• SIFIS effectively discriminates fibromyalgia and offers meaningful clinical benefit.