TY - JOUR T1 - Fibromyalgia Assessment Screening Tool (FAST): clues to fibromyalgia on a multidimensional health assessment questionnaire (MDHAQ) for routine care. JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.190277 SP - jrheum.190277 AU - Kathryn A Gibson AU - Isabel Castrejon AU - Joseph Descallar AU - Theodore Pincus Y1 - 2019/09/01 UR - http://www.jrheum.org/content/early/2019/08/25/jrheum.190277.abstract N2 - Objective To develop feasible indices as clues to comorbid fibromyalgia (FM) in routine care of patients with various rheumatic diseases based only on self-report multidimensional health assessment questionnaire (MDHAQ) scores, which are informative in all rheumatic diagnoses studied. Methods All patients with all diagnoses complete an MDHAQ at each visit; the 2011 FM Criteria questionnaire was added to the standard MDHAQ between February 2013 and August 2016. The proportion of patients who met 2011 FM criteria or had a clinical diagnosis of FM was calculated. Individual candidate MDHAQ measures were compared to 2011 FM criteria using receiver-operating-characteristic (ROC) curves; cut-points to recognize FM were selected from the area under the curve (AUC) for optimal “trade-off” between sensitivity and specificity. Cumulative indices of 3 or 4 MDHAQ measures were analyzed as fibromyalgia assessment screening tools (FAST). Results In 148 patients, the highest AUC in ROC analyses versus 2011 FM criteria were seen for MDHAQ symptom checklist, self-report painful joint count, pain visual analogue scale (VAS), and fatigue VAS. The optimal cut-points were ≥16/60 for symptom checklist, ≥16/48 for self-report painful joint count, and ≥6/10 for both pain and fatigue VAS. Cumulative FAST indices of 2/3 or 3/4 MDHAQ measures correctly classified 76.2%-82.4% of patients who met 2011 FM criteria. Conclusion FAST3 and FAST4 cumulative indices from only MDHAQ scores, correctly identify most patients who meet 2011 FM criteria. FAST indices can assist clinicians in routine care as clues to FM with a general rheumatology, rather than FM-specific, questionnaires. ER -