June 09, 2014
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Self-assessment scale developed for patients with IBD-fatigue

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Researchers from the United Kingdom have developed an inflammatory bowel disease fatigue patient self-assessment scale that is designed to more accurately and reliably measure the severity and impact of disease-associated fatigue.

The IBD-F scale was developed and validated in a five-phase process between September 2010 and May 2013, and involved 567 patients with Crohn’s disease or ulcerative colitis. Phase one entailed researcher-conducted interviews with patients (n=20) to qualitatively assess their experience with fatigue, its impact on their quality of life, and the efficacy of existing fatigue scales (Multidimensional Fatigue Inventory [MFI], Multidimensional Assessment of Fatigue [MAF]) in reflecting their specific experience and concerns. Phases two (n=16), three (n=30), four (n=36) and five (n=465) qualitatively and quantitatively assessed and refined the IBD-F scale. Participants completed drafts of the developing questionnaire, modifications were made based on commentary from subsequent interviews in phases two and three, and reliability was tested in phases four and five.

The final questionnaire entailed three sections, evaluating fatigue severity and frequency, its impact on daily activities, and duration of fatigue. The IBD-F scale was preferred over alternatives overall; patients interviewed reported it was “more attuned to their experience than the MAF and MFI.” Agreement between scores associated with individual questions, measured through test-retest in phase four, was “relatively poor,” but agreement between total scores was higher (ICC=0.74; 95% CI, 0.54-0.86).

Phase five revealed “moderate correlation” between sections one (ICC=0.73; P<.001) and two (ICC=0.78; P<.001) of the IBD-F scale and the MAF, along with the five MFI subscales (ICC=0.47-0.65; P<.001).

“The IBD-F scale consists of items generated specifically from the issues of importance to people with IBD fatigue,” the researchers concluded, “and it has been found on initial testing to be valid and reasonably reliable.”

Disclosure: See the study for a full list of relevant financial disclosures.