FiRST Screening Positivity Among Patients Attending a Tertiary Chronic Pain service in Oman

To estimate the Fibromyalgia Rapid Screening Tool (FiRST) screening positivity and its sociodemographic associations among adults attending a tertiary chronic pain service in Oman.

This cross-sectional study recruited 401 adults with chronic pain at the Royal Hospital in Muscat between January 2023 and January 2025. Participants completed the six-item Arabic-Egyptian FiRST; scores ≥5/6 defined as positive screening. Descriptive statistics were used to summarize participant characteristics. Bivariate analyses used Pearson's chi-square test, with crude odds ratios (ORs) and 95% confidence intervals (CIs) for categorical predictors. Variables with P < 0.20 in bivariate analyses and clinically relevant variables selected a priori were included in the multivariable logistic regression. Adjusted ORs with 95% CIs were reported for the results.

Overall, 170/401 participants screened positive (42.4%; exact 95% confidence interval [CI] 37.5-47.4%). Female sex was associated with higher adjusted odds (OR 1.723, 95% CI 1.065-2.787; P=0.027), while participants aged 40-59 years had lower adjusted odds than those aged 18-39 years (OR 0.528, 95% CI 0.317-0.879; P=0.014). The estimate for participants aged ≥60 years was imprecise and not statistically significant (OR 0.535, 95% CI 0.273-1.049; P=0.069). Family relationships, marital status, and academic level were not significantly associated with screening positivity after adjustment.

FiRST screening positivity was common in this tertiary pain population in Oman. Female sex and age 40-59 years compared with 18-39 years were associated with screening positive. A positive FiRST screen requires further clinical assessment and does not establish fibromyalgia, central sensitization, or central pain syndrome.