A 7-item version of the fatigue severity scale has better psychometric properties among HIV-infected adults: an application of a Rasch model

Background: Rigorous testing of the original Fatigue Severity Scale (FSS—9) with modern psychometric methods is warranted. Objective: To determine the psychometric properties of the FSS—9 in multiple sclerosis (MS): internal scale validity; person response validity; unidimensionality; uniform differential item functioning; temporal stability of response patterns; and ability to separate people into distinct groups of fatigue. Methods: Rasch analyses were conducted on data from a Norwegian and a Swedish MS cohort followed for two years. Results: Item estimations in the FSS—9 did not differ between sex or levels of education but between the cohorts with regard to disability, disease course and time for evaluation, however, items 1 and 2 demonstrated unacceptable high outfit mean-square values in both cohorts. In an FSS—7 item version, items 3 and 4 in the Norwegian and 4 in the Swedish cohort demonstrated unacceptable goodness of fit but high separation indexes. In the FSS—7, the first unidimensional factor explained 87.5% (Norwegian cohort) and 86.4% (Swedish cohort) of the total variation. Conclusions: In MS, the FSS—7 demonstrates better psychometric properties than the FSS—9; items 1 and 2 neither empirically nor conceptually fit with the other seven items.

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Psychometric properties of the Fatigue Severity Scale in polio survivors

International Journal of Rehabilitation Research ◽

10.1097/mrr.0b013e32833d6efb ◽

2010 ◽

Vol 33 (4) ◽

pp. 290-297 ◽

Cited By ~ 7

Author(s):

Helena Burger ◽

Franco Franchignoni ◽

Nataša Puzić ◽

Andrea Giordano

Keyword(s):

Psychometric Properties ◽

Fatigue Severity Scale ◽

Severity Scale ◽

Fatigue Severity ◽

Polio Survivors

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Psychometric properties of an Arabic version of the fatigue severity scale in patients with stroke

Topics in Stroke Rehabilitation ◽

10.1080/10749357.2019.1628465 ◽

2019 ◽

Vol 26 (6) ◽

pp. 448-455 ◽

Cited By ~ 1

Author(s):

Fuad A. Abdulla ◽

Fahd A. Al-Khamis ◽

Abdulla A. Alsulaiman ◽

Ali M. Alshami

Keyword(s):

Psychometric Properties ◽

Fatigue Severity Scale ◽

Arabic Version ◽

Severity Scale ◽

Fatigue Severity

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Can the Fatigue Severity Scale 7-item version be used across different patient populations as a generic fatigue measure - a comparative study using a Rasch model approach

Health and Quality of Life Outcomes ◽

10.1186/1477-7525-12-24 ◽

2014 ◽

Vol 12 (1) ◽

pp. 24 ◽

Cited By ~ 30

Author(s):

Sverker Johansson ◽

Anders Kottorp ◽

Kathryn A Lee ◽

Caryl L Gay ◽

Anners Lerdal

Keyword(s):

Comparative Study ◽

Rasch Model ◽

Fatigue Severity Scale ◽

Severity Scale ◽

Fatigue Severity ◽

Model Approach

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Fatigue in the general population: A translation and test of the psychometric properties of the Norwegian version of the fatigue severity scale

Scandinavian Journal of Public Health ◽

10.1080/14034940410028406 ◽

2005 ◽

Vol 33 (2) ◽

pp. 123-130 ◽

Cited By ~ 172

Author(s):

Anners Lerdal ◽

Astrid K. Wahl ◽

Tone Rustoen ◽

Berit R. Hanestad ◽

Torbjorn Moum

Keyword(s):

General Population ◽

Psychometric Properties ◽

Fatigue Severity Scale ◽

Severity Scale ◽

Norwegian Version ◽

Fatigue Severity

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Rasch analysis of the Fatigue Severity Scale in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458508096215 ◽

2009 ◽

Vol 15 (1) ◽

pp. 81-87 ◽

Cited By ~ 60

Author(s):

RJ Mills ◽

CA Young ◽

RS Nicholas ◽

JF Pallant ◽

A Tennant

Keyword(s):

Multiple Sclerosis ◽

Rasch Model ◽

Social Impact ◽

Reliability And Validity ◽

Measurement Model ◽

Fatigue Severity Scale ◽

Test Theory ◽

Measurement Properties ◽

Severity Scale ◽

Fatigue Severity

Background The 9-item, Fatigue Severity Scale (FSS-9) has been widely used as an outcome measure in multiple sclerosis (MS). Modern psychometric theory, in the form of the Rasch measurement model, has set new quality standards for outcome measures by appraising a broad range of measurement properties in addition to the reliability and validity emphasized by classical test theory. Objective To appraise the FSS-9 by application of the Rasch model. Method The FSS-9 was posted to patients with clinically definite MS in two centers in the United Kingdom. Analysis was based on 416 records (55% response). Results The 9-item scale failed to meet Rasch model expectations. Two items had poor discrimination across the scale, and two further items showed bias for factors such as age. Removal of these four items provided a valid 5-item Rasch scale that satisfied strict tests of unidimensionality. Conclusion Summating the nine items of the FSS-9 is invalid. Five items (FSS-5), which seem to be measuring the social impact of fatigue, provide a strictly unidimensional Rasch scale. Studies using the FSS-9 may need to be re-evaluated using the FSS-5, preferably using the Rasch transformed scores.

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Reliability and Validity of the Persian Version of the Fatigue Severity Scale in Idiopathic Parkinson’s Disease Patients

Parkinson s Disease ◽

10.1155/2013/935429 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Seyed-Mohammad Fereshtehnejad ◽

Hasti Hadizadeh ◽

Farzaneh Farhadi ◽

Gholam Ali Shahidi ◽

Ahmad Delbari ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Psychometric Properties ◽

Disease Severity ◽

Internal Consistency ◽

Fatigue Severity Scale ◽

Severity Scale ◽

Persian Version ◽

Idiopathic Parkinson's Disease ◽

Fatigue Severity

As one of the most frequent symptoms, measurement of fatigue is an issue of interest in Parkinson’s disease (PD). The fatigue severity scale (FSS) is one of the recommended questionnaires for this purpose. The aim of our study was to evaluate psychometric properties of the Persian version of the FSS (FSS-Per) to assess fatigue in PD patients. Ninety nondemented idiopathic Parkinson’s disease (IPD) patients were consecutively recruited from an outpatient referral movement disorder clinic. In addition to the disease severity scales, the FSS-Per was used for fatigue measurement. The internal consistency coefficient was larger than 0.8 for all of the items with a total Cronbach’s alpha of 0.96 (95% CI: 0.95–0.97). The FSS-Per score correlated with the UPDRS score (, ) and the “Hoehn and Yahr” (HY) stage (, ). The total score of the FSS-Per significantly discriminated IPD patients with more severe disability (HY stage > 2) versus those with less severe disease (HY stage ) (AUC = 0.81 (95% CI: 0.72–0.90)). The FSS-Per fulfilled a high internal consistency and construct validity to measure the severity of fatigue in Iranian IPD patients. These acceptable psychometric properties were reproducible in subgroups of IPD patients regarding different levels of education, disease severity, sex and age groups.

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