Abstract
To evaluate the psychometric properties of the Patient-Reported Outcome Measurement Information System® Fatigue Short Form 7a (PROMIS F-SF) among people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Analyses were conducted using data from the Multi-Site Clinical Assessment of ME/CFS study, which recruited participants from seven ME/CFS specialty clinics across the US. Baseline and follow-up data from ME/CFS participants and healthy controls were used. Ceiling/Floor effects, internal consistency reliability, differential item functioning (DIF), known-groups validity, and responsiveness were examined. The final sample comprised 549 ME/CFS participants at baseline, 386 of whom also had follow-up. At baseline, the sample mean of PROMIS F-SF T-score was 68.6 (US general population mean T-score of 50 and standard deviation of 10). The PROMIS F-SF demonstrated good internal consistency reliability (Cronbach's α = 0.84) and minimal floor/ceiling effects. No DIF was detected by age or sex for any item. This instrument also showed good known-groups validity with medium-to-large effect sizes (η2 = 0.08-0.69), with a monotonic increase of the fatigue T-score across ME/CFS participant groups with low, medium, and high functional impairment as measured by three different variables (p < 0.01), and with significantly higher fatigue T-scores among ME/CFS participants than healthy controls (p < 0.0001). Acceptable responsiveness was found with small-to-medium effect sizes (Guyatt's Responsiveness Statistic = 0.28-0.54). Study findings support the reliability and validity of PROMIS F-SF as a measure of fatigue for ME/CFS and lend support to the drug development tool submission for qualifying this measure to evaluate therapeutic effect in ME/CFS clinical trials.
Highlights
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating long-term illness [1,2]
Data Source and Study Sample Data were obtained from the Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM) study [19]
We examined the possibility of differential item functioning (DIF) by sex and age for each PROMIS F-SF item using the Wald test [31,32]
Summary
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating long-term illness [1,2]. A distinctive characteristic of the illness is post-exertional malaise, which is a worsening of ME/CFS symptoms following physical or mental exertion that may require an extended recovery period [3]. Several populationbased studies estimated the prevalence of ME/CFS among the United States (US) population at more than 1 million [4,5,6]. Costs associated with ME/CFS are estimated at $18–$51 billion annually in the US ($9–$14 billion in medical costs and $9–$37 billion in lost productivity) with about one-quarter of medical expenses paid directly out-of-pocket [7,8,9]
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