scholarly journals Content validity and psychometric evaluation of Functional Assessment of Chronic Illness Therapy-Fatigue in patients with psoriatic arthritis

Author(s):  
David Cella ◽  
Hilary Wilson ◽  
Huda Shalhoub ◽  
Dennis A. Revicki ◽  
Joseph C. Cappelleri ◽  
...  
2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Daniel Eek ◽  
Cristina Ivanescu ◽  
Laura Corredoira ◽  
Oren Meyers ◽  
David Cella

Abstract Purpose Fatigue is a prominent symptom in individuals with chronic lymphocytic leukemia (CLL). This work evaluates the content validity and psychometric properties of the Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-Fatigue) in patients with CLL to determine if it is fit for purpose in CLL research. Methods The FACIT-Fatigue yields a 13-item total score from a five-item symptom subscale and an eight-item impact subscale. To evaluate content validity, cognitive debriefing interviews were conducted with 40 patients with CLL in the first-line or relapsed or refractory setting. Psychometric properties, including structural validity, internal consistency, construct and known-groups validity, were investigated using data from a phase 3 trial in relapsed or refractory CLL (NCT02970318). Results Interviewed patients considered the FACIT-Fatigue items relevant to their CLL experience, understood the terminology and agreed with response options. Confirmatory factor analysis confirmed the presence of symptom and impact subscales, but also supported unidimensionality of the FACIT-Fatigue. The FACIT-Fatigue total, symptom and impact subscales demonstrated good internal consistency (Cronbach’s coefficient α > 0.85 and McDonald’s omega ω > 0.90), and strong correlations with relevant EORTC QLQ-C30 scales (all Spearman’s r ≥ 0.5). Known-groups validity was shown by significant differences between groups defined by baseline performance status, hemoglobin level and constitutional symptoms (all p < .0001). Cluster analysis supported FACIT-Fatigue score thresholds of 30 and 34 to define a severe fatigue population. Conclusions Content validity and psychometric evaluation in patients with CLL demonstrated that the FACIT-Fatigue has good psychometric properties and is fit for purpose in CLL.


2020 ◽  
pp. jrheum.190857
Author(s):  
Samantha Sarabia ◽  
Chandra Farrer ◽  
Jensen Yeung ◽  
Dana Jerome ◽  
Ker-Ai Lee ◽  
...  

Objective To describe the pattern of musculoskeletal (MSK) symptoms and their correlation with clinical and sonographic findings among psoriasis patients with suspected psoriatic arthritis (PsA). Methods Patients with psoriasis and no prior diagnosis of PsA were referred for assessment of their MSK complaints. The study included the following steps: (1) assessment by an advanced practice physiotherapist, (2) targeted MSK ultrasound, and (3) assessment by a rheumatologist. In addition, patients were asked to complete questionnaires about the nature and duration of their MSK symptoms and to mark the location of their painful joints on a homunculus. Each patient was classified by a rheumatologist as “Not PsA,” “Possible PsA,” or “PsA”. MSK symptoms and patient-reported outcomes (PRO) were compared between patients with PsA and Possible/Not PsA. Agreement between modalities was assessed using κ statistics. Results Two hundred three patients with psoriasis and MK symptoms were enrolled (8.8% PsA, 23.6% Possible PsA). Patients classified as PsA had worse scores on the PsA Impact of Disease (P = 0.004) and Functional Assessment of Chronic Illness Therapy–Fatigue scale (P = 0.02). There was no difference between the 2 groups in the presence, distribution, and duration of MSK symptoms. Analysis of agreement in physical examination between modalities revealed the strongest agreement between the rheumatologist and physiotherapist (κ = 0.28). The lowest levels of agreement were found between ultrasound and patient (κ = 0.08) and physiotherapist and ultrasound (κ = 0.08). Conclusion The results of this study suggest that the intensity, rather than the type, duration, or distribution of MSK symptoms, is associated with PsA among patients with psoriasis.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1660-1660
Author(s):  
N. Aboeladl ◽  
N. Elsawy ◽  
M. Helal ◽  
M. Elshafei ◽  
N. Lewis

Background:Fatigue is a prevalent and fundamental phenomenon in psoriatic arthritis (PsA) patients. It often interferes with physical and social functions and may lead to social withdrawal, long-standing sick leave, disability and loss of work productivity. Fatigue is a prevalent symptom in patients with chronic rheumatic diseases. Cytokines as interleukin IL-23/17 play a pivotal role in the pathogenesis of PsA.Objectives:To assess fatigue in PsA patients and determine its relation to serum IL 23 levels, disease activity, Skin severity, physical function and quality of life (QoL).Methods:Fifty PsA patients and 46 matched healthy controls were included in this study. Skin severity based on the Psoriasis Area and Severity Index (PASI), the Disease Activity index for Psoriatic Arthritis (DAPSA) and the Functional Assessment of Chronic Illness Therapy (FACIT-F) were assessed. Physical function was assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI) and health-related QoL was assessed using the Short Form Health Survey (SF-36), Psoriatic Arthritis QoL (PsAQoL) and the Dermatology Life Quality Index (DLQI). Serum IL-23 levels were measured in the studied groups.Results:The study included 23 (46%) females and 27 (54%) males with a mean age of 42.78±12.33 years. The mean serum IL-23 level was significantly higher in PsA patients (50.89 ±13.86 pg/ml) than in controls (43.88 ± 6.34 pg/ml) (p=0.006). The FACIT score ranged from 2-41. Severe fatigue (score <30) was reported in 27 (54%) PsA patients. There were significant correlations between FACIT-F and (DAPSA, PASI, HAQ-DI, PsAQoL, DLQI and SF-36). No significant correlations could be detected between FACIT-F and serum levels of IL-23 and CRP.Conclusion:Fatigue was a frequent complaint in PsA patients. There was a mutual negative impact between fatigue and each of PsA joint disease activity and physical function and it worsened the QoL. Fatigue was worsened with increased severity of skin PsO. Although serum level of IL-23 was significantly elevated in PsA patients than the controls, it wasn’t correlated with fatigue score. Hence IL-23 can’t be considered a biomarker for fatigue severity.References:[1]Chandran V, Bhella S, Schentag C, Gladman DD. Functional Assessment of Chronic Illness Therapy-Fatigue Scale is valid in patients with psoriatic arthritis. Ann Rheum Dis 2007; 66(7):936.[2]Mortada M, Abdul-Sattar A, Gossec L. Fatigue in Egyptian patients with rheumatic diseases: a qualitative study. Health Qual Life Outcomes 2015; 13:134.[3]Krajewska-Wlodarczyk M, Owczarczyk-Saczonek A, Placek W. Fatigue - an underestimated symptom in psoriatic arthritis. Reumatologia 2017; 55(3):125-30.[4]Strand V, Mease P, Gossec L, Elkayam O, van den Bosch F, Zuazo J, et al. Secukinumab improves patient-reported outcomes in subjects with active psoriatic arthritis: results from a randomised phase III trial (FUTURE 1). Ann Rheum Dis 2017; 76(1):203-7.[5]Reygaerts T, Mitrovic S, Fautrel B, Gossec L. Effect of biologics on fatigue in psoriatic arthritis: A systematic literature review with meta-analysis. Joint Bone Spine 2018; 85(4):405-10.Table.Correlation between FACIT-F score and different parameters in patients groupFACIT-FrspDAPSA-0.365*0.009*PASI-0.424*0.002*HAQ-DI-0.464*0.001*PsAQoL-0.633*<0.001*DLQI-0.492*<0.001*SF-360.600*<0.001*CRP-0.1670.247Serum IL-23 levels-0.1830.204rs: Spearman coefficient, *: Statistically significant at p ≤ 0.05Figure. Correlation between FACIT-F and DAPSA in the studied PsA patients.Acknowledgments:I am deeply indebted to my late Professor Abdelmoniem Helal for his expert guidance and keen interest throughout the work.Thanks to My parents and Husband.Disclosure of Interests:None declared


2018 ◽  
Author(s):  
Gabriela Šarníková ◽  
Klára Maliňáková ◽  
Jana Fürstová ◽  
Eva Dubovská ◽  
Peter Tavel

Author(s):  
Nienke Z Borren ◽  
Millie D Long ◽  
Robert S Sandler ◽  
Ashwin N Ananthakrishnan

Abstract Background Fatigue is a disabling symptom in patients with inflammatory bowel disease (IBD). Its prevalence, mechanism, and impact remain poorly understood. We determined changes in fatigue status over time and identified predictors of incident or resolving fatigue. Methods This was a prospective study nested within the IBD Partners cohort. Participants prospectively completed the Multidimensional Fatigue Inventory and the Functional Assessment of Chronic Illness Therapy-Fatigue at baseline, 6 months, and 12 months. A Functional Assessment of Chronic Illness Therapy-Fatigue score ≤43 defined significant fatigue. Multivariable regression models using baseline covariates were used to identify risk factors for incident fatigue at 6 months and to predict the resolution of fatigue. Results A total of 2429 patients (1605 with Crohn disease, 824 with ulcerative colitis) completed a baseline assessment, and 1057 completed a second assessment at 6 months. Persistent fatigue (at baseline and at 6 months) was the most common pattern, affecting two-thirds (65.8%) of patients. One-sixth (15.7%) of patients had fatigue at 1 timepoint, whereas fewer than one-fifth (18.5%) of patients never reported fatigue. Among patients not fatigued at baseline, 26% developed fatigue at 6 months. The strongest predictor of incident fatigue was sleep disturbance at baseline (odds ratio, 2.91; 95% confidence interval, 1.48–5.72). In contrast, only 12.3% of those with fatigue at baseline had symptom resolution by month 6. Resolution was more likely in patients with a diagnosis of ulcerative colitis, quiescent disease, and an absence of significant psychological comorbidity. Conclusions Fatigue is common in patients with IBD. However, only a few fatigued patients experience symptom resolution at 6 or 12 months, suggesting the need for novel interventions to ameliorate its impact.


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