Minimally important difference of the fatigue severity scale and modified fatigue impact scale in people with multiple sclerosis

Scott Rooney, Angus McFadyen, Lesley Wood, Fiona Moffat, Lorna Paul

Research output: Contribution to journalArticle

Abstract

Background: Fatigue is a common and debilitating symptom of Multiple Sclerosis (MS); however, it is unknown what constitutes a clinically significant change in fatigue. Establishing the minimally important difference (MID) of fatigue outcome measures can inform the interpretation of changes in fatigue by estimating the level of change that is considered clinically relevant.
Aim: Determine the MID for the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS) in people with MS.
Methods: This cross-sectional study collected information on self-reported fatigue (FSS and MFIS) and quality of life (EQ-5D and MS Impact Scale 29) through an online survey. Anchor-based methods were used to estimate
MID, and ordinal logistic regression models were used to determine the difference in fatigue that would predict a significant effect on quality of life.
Results: 365 people with MS (81.9% female, 69.3% relapsing-remitting MS, mean age 46.2 ± 11.6 years, mean time since diagnosis 9.6 ± 8.7 years) responded to the survey. MID estimates for the FSS and MFIS ranged from 0.45–0.88 and 3.86–8.11 respectively, accounting for 6.4–12.6% of maximum FSS score and 4.6–9.7% of maximum MFIS score.
Conclusions: MID estimates derived from this study indicate that a difference of at least 0.45 points on the FSS or 4 points on the MFIS constitutes a clinically significant difference in fatigue. Therefore, these estimates represent a threshold value which can be used to interpret changes in the FSS and MFIS over time or in response to an
intervention.
Original languageEnglish
Pages (from-to)158-163
Number of pages6
JournalMultiple Sclerosis and Related Disorders
Volume35
Early online date28 Jul 2019
DOIs
Publication statusPublished - Oct 2019

Fingerprint

Multiple Sclerosis
Fatigue
Logistic Models
Quality of Life
Relapsing-Remitting Multiple Sclerosis

Keywords

  • Fatigue
  • Fatigue Severity Scale
  • Minimally important difference
  • Modified Fatigue Impact Scale
  • Multiple Sclerosis

Cite this

@article{7c34fa45f2954b15be701be722dbec43,
title = "Minimally important difference of the fatigue severity scale and modified fatigue impact scale in people with multiple sclerosis",
abstract = "Background: Fatigue is a common and debilitating symptom of Multiple Sclerosis (MS); however, it is unknown what constitutes a clinically significant change in fatigue. Establishing the minimally important difference (MID) of fatigue outcome measures can inform the interpretation of changes in fatigue by estimating the level of change that is considered clinically relevant.Aim: Determine the MID for the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS) in people with MS.Methods: This cross-sectional study collected information on self-reported fatigue (FSS and MFIS) and quality of life (EQ-5D and MS Impact Scale 29) through an online survey. Anchor-based methods were used to estimateMID, and ordinal logistic regression models were used to determine the difference in fatigue that would predict a significant effect on quality of life.Results: 365 people with MS (81.9{\%} female, 69.3{\%} relapsing-remitting MS, mean age 46.2 ± 11.6 years, mean time since diagnosis 9.6 ± 8.7 years) responded to the survey. MID estimates for the FSS and MFIS ranged from 0.45–0.88 and 3.86–8.11 respectively, accounting for 6.4–12.6{\%} of maximum FSS score and 4.6–9.7{\%} of maximum MFIS score.Conclusions: MID estimates derived from this study indicate that a difference of at least 0.45 points on the FSS or 4 points on the MFIS constitutes a clinically significant difference in fatigue. Therefore, these estimates represent a threshold value which can be used to interpret changes in the FSS and MFIS over time or in response to anintervention.",
keywords = "Fatigue, Fatigue Severity Scale, Minimally important difference, Modified Fatigue Impact Scale, Multiple Sclerosis",
author = "Scott Rooney and Angus McFadyen and Lesley Wood and Fiona Moffat and Lorna Paul",
note = "Acceptance in SAN AAM: 12m embargo ^Removed temp holding embargo for Pure migration ET 6-9-19",
year = "2019",
month = "10",
doi = "10.1016/j.msard.2019.07.028",
language = "English",
volume = "35",
pages = "158--163",
journal = "Multiple Sclerosis and Related Disorders",
issn = "2211-0348",
publisher = "Elsevier B.V.",

}

Minimally important difference of the fatigue severity scale and modified fatigue impact scale in people with multiple sclerosis. / Rooney, Scott; McFadyen, Angus; Wood, Lesley; Moffat, Fiona; Paul, Lorna.

In: Multiple Sclerosis and Related Disorders, Vol. 35, 10.2019, p. 158-163.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Minimally important difference of the fatigue severity scale and modified fatigue impact scale in people with multiple sclerosis

AU - Rooney, Scott

AU - McFadyen, Angus

AU - Wood, Lesley

AU - Moffat, Fiona

AU - Paul, Lorna

N1 - Acceptance in SAN AAM: 12m embargo ^Removed temp holding embargo for Pure migration ET 6-9-19

PY - 2019/10

Y1 - 2019/10

N2 - Background: Fatigue is a common and debilitating symptom of Multiple Sclerosis (MS); however, it is unknown what constitutes a clinically significant change in fatigue. Establishing the minimally important difference (MID) of fatigue outcome measures can inform the interpretation of changes in fatigue by estimating the level of change that is considered clinically relevant.Aim: Determine the MID for the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS) in people with MS.Methods: This cross-sectional study collected information on self-reported fatigue (FSS and MFIS) and quality of life (EQ-5D and MS Impact Scale 29) through an online survey. Anchor-based methods were used to estimateMID, and ordinal logistic regression models were used to determine the difference in fatigue that would predict a significant effect on quality of life.Results: 365 people with MS (81.9% female, 69.3% relapsing-remitting MS, mean age 46.2 ± 11.6 years, mean time since diagnosis 9.6 ± 8.7 years) responded to the survey. MID estimates for the FSS and MFIS ranged from 0.45–0.88 and 3.86–8.11 respectively, accounting for 6.4–12.6% of maximum FSS score and 4.6–9.7% of maximum MFIS score.Conclusions: MID estimates derived from this study indicate that a difference of at least 0.45 points on the FSS or 4 points on the MFIS constitutes a clinically significant difference in fatigue. Therefore, these estimates represent a threshold value which can be used to interpret changes in the FSS and MFIS over time or in response to anintervention.

AB - Background: Fatigue is a common and debilitating symptom of Multiple Sclerosis (MS); however, it is unknown what constitutes a clinically significant change in fatigue. Establishing the minimally important difference (MID) of fatigue outcome measures can inform the interpretation of changes in fatigue by estimating the level of change that is considered clinically relevant.Aim: Determine the MID for the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS) in people with MS.Methods: This cross-sectional study collected information on self-reported fatigue (FSS and MFIS) and quality of life (EQ-5D and MS Impact Scale 29) through an online survey. Anchor-based methods were used to estimateMID, and ordinal logistic regression models were used to determine the difference in fatigue that would predict a significant effect on quality of life.Results: 365 people with MS (81.9% female, 69.3% relapsing-remitting MS, mean age 46.2 ± 11.6 years, mean time since diagnosis 9.6 ± 8.7 years) responded to the survey. MID estimates for the FSS and MFIS ranged from 0.45–0.88 and 3.86–8.11 respectively, accounting for 6.4–12.6% of maximum FSS score and 4.6–9.7% of maximum MFIS score.Conclusions: MID estimates derived from this study indicate that a difference of at least 0.45 points on the FSS or 4 points on the MFIS constitutes a clinically significant difference in fatigue. Therefore, these estimates represent a threshold value which can be used to interpret changes in the FSS and MFIS over time or in response to anintervention.

KW - Fatigue

KW - Fatigue Severity Scale

KW - Minimally important difference

KW - Modified Fatigue Impact Scale

KW - Multiple Sclerosis

U2 - 10.1016/j.msard.2019.07.028

DO - 10.1016/j.msard.2019.07.028

M3 - Article

VL - 35

SP - 158

EP - 163

JO - Multiple Sclerosis and Related Disorders

JF - Multiple Sclerosis and Related Disorders

SN - 2211-0348

ER -