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Assessing fatigue in adults with Axial Spondyloarthritis : a systematic review of the quality and acceptability of patient-reported outcome measures
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Pearson, Nathan, Packham, Jonathan, Tutton, Elizabeth, Parsons, Helen and Haywood, Kirstie L. (2018) Assessing fatigue in adults with Axial Spondyloarthritis : a systematic review of the quality and acceptability of patient-reported outcome measures. Rheumatology Advances in Practice, 2 (2). rky017. doi:10.1093/rap/rky017
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Official URL: https://doi.org/10.1093/rap/rky017
Abstract
Objective
Evaluate the quality and acceptability of patient-reported outcome measures used to assess fatigue in patients with Axial Spondyloarthritis.
Methods
A two-stage systematic review of major electronic databases (1980-2017) to: 1) Identify measures; and 2) Identify evaluative studies. Study and measurement quality was evaluated following international standards. Measurement content was appraised against a conceptual model of RA-fatigue.
Results
From 387 reviewed abstracts, 23 articles provided evidence for nine fatigue-specific measures: six multi-item and three single-item. No axSpA-fatigue specific measure was identified. Evidence of reliability was limited, but acceptable for the Multi-dimensional Fatigue Inventory (internal consistency, test-retest) and Short Form 36-item Health Survey Vitality subscale (SF-36 VT) (internal consistency). Evidence of construct validity was moderate for the Functional Assessment of Chronic Illness Therapy-Fatigue and 10cm visual analogue scale, limited for the SF-36 VT, and not available for the remaining measures. Responsiveness was rarely evaluated. Evidence of measurement error, content validity or structural validity was not identified. Most measures provide a limited reflection of fatigue; the most comprehensive were the Multi-dimensional Assessment of Fatigue (MAF), MFI-20, FACIT-fatigue and Fatigue Severity Scale (FSS).
Conclusion
The limited content and often poor quality of the reviewed measures limits any clear recommendation for fatigue-assessment in this population; assessments should be applied with caution until further robust evidence is established. Well developed, patient-derived measures can provide essential evidence of the patient’s perspective to inform clinical research and drive tailored healthcare. The collaborative engagement of key stakeholders must seek to ensure that future fatigue assessment is relevant, acceptable and of high quality.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Warwick Research in Nursing | ||||||
| Library of Congress Subject Headings (LCSH): | Spondyloarthropathies -- Patients, Spine -- Diseases, Rheumatoid arthritis, Systematic reviews (Medical research) | ||||||
| Journal or Publication Title: | Rheumatology Advances in Practice | ||||||
| Publisher: | Oxford University Press | ||||||
| ISSN: | 2514-1775 | ||||||
| Official Date: | 29 May 2018 | ||||||
| Dates: |
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| Volume: | 2 | ||||||
| Number: | 2 | ||||||
| Article Number: | rky017 | ||||||
| DOI: | 10.1093/rap/rky017 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access | ||||||
| RIOXX Funder/Project Grant: |
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