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Determination of the minimal clinically important difference for seven measures of fatigue in Swedish patients with systemic lupus erythematosus
Rheumatology Clinic, Karolinska University Hospital, Solna, Stockholm, Sweden; Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Rheumatology Clinic, Karolinska University Hospital, Solna, Stockholm, Sweden; Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.
4Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA, USA; Section of Rheumatology, VA Boston Healthcare System, Boston, MA, USA.
Faculty of Medicine, Paris Descartes University, the Public Assistance Hospitals of Paris (AH-HP), Georges Pompidou European Hospital, Paris, France.
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2015 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 44, no 3, p. 206-210Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To estimate the minimal clinically important difference (MCID) in seven self-administered measures assessing fatigue in Swedish patients with systemic lupus erythematosus (SLE).

METHOD: The participants (n = 51, women 98%, age 52.8 ± 12.1 years, disease duration 18.7 ± 13.6 years) met in groups of six to nine persons. After completing seven fatigue questionnaires [the Fatigue Severity Scale (FSS); the Multidimensional Assessment of Fatigue (MAF) scale; the 20-item Multidimensional Fatigue Inventory (MFI); the Chalder Fatigue Scale (CFS); the Short Form-36 Vitality subscale (VT); the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) scale; and the Numeric Rating Scale (NRS)], each respondent had a minimum of five face-to-face discussions, followed by an individual comparative assessment of their own level of fatigue (seven-grade scale). This method resulted in 260 contrasting assessments; MCIDs were first calculated using the paired differences and then established by a regression approach. Patients were asked to comment on their experience with the questionnaires and whether they captured their fatigue adequately.

RESULTS: The paired approach (using 'little more fatigue' as an anchor for MCID during the face-to-face comparative assessments) provided estimates of 4.6-17.0; the regression approach provided estimates of 4.3-10.8. Estimates using the regression approach were consistently lower than those using the paired model. The MCID estimates were least favourable and fewer respondents supported the use of the NRS compared to the other self-reported questionnaires.

CONCLUSIONS: All seven instruments detect MCIDs for fatigue in Swedish patients with SLE. However, the single-question measure was not supported by the MCID estimates or by comments from the respondents.

Place, publisher, year, edition, pages
Taylor & Francis, 2015. Vol. 44, no 3, p. 206-210
National Category
Medical and Health Sciences Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:oru:diva-70535DOI: 10.3109/03009742.2014.988173ISI: 000354392800005PubMedID: 25656604Scopus ID: 2-s2.0-84929321040OAI: oai:DiVA.org:oru-70535DiVA, id: diva2:1298536
Funder
Swedish Rheumatism AssociationSwedish Heart Lung FoundationSwedish Society for Medical Research (SSMF)The Karolinska Institutet's Research FoundationStockholm County Council
Note

Funding Agencies:

King Gustaf V 80th Birthday Fund

Åke Wiberg Foundation 

Alex and Eva Wallströms Foundation 

Foundation in memory of Clas Groschinsky

Available from: 2019-03-24 Created: 2019-03-24 Last updated: 2019-04-08Bibliographically approved

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