Systematic review: patient-reported outcome measures of fatigue in inflammatory bowel disease

Abstract

ABSTRACT Background Fatigue is common in inflammatory bowel disease (IBD) patients, however, there is no consensus on the optimal measurement tool to assess fatigue. Aim To identify standardised patient-reported outcome measures (PROMs) of fatigue that are used in adults with IBD, to evaluate their psychometric properties, and recommend PROM(s) that are psychometrically robust and feasible for research and clinical use. Methods Eight databases were first searched from 2015–2020 to identify fatigue PROMs used in IBD clinical research. Studies on each PROM’s psychometric properties were then searched in MEDLINE, EMBASE, CINAHL, and PsycINFO from inception to September 2020. The study quality, psychometric robustness of the PROMs, and quality of evidence were evaluated following the Consensus-based Standards for the Selection of Health Measurement Instruments guideline. Results The first search included 111 articles and identified 16 PROMs. The second search identified 9 articles on psychometric properties for 8 PROMs only. Content validity (with high quality evidence) was demonstrated only for the IBD-Fatigue scale (IBD-F) (English). All 8 PROMs demonstrated construct validity (with moderate to high quality evidence) and 5 PROMs demonstrated reliability (intraclass correlation coefficient: 0.65–0.98; with very low to low quality evidence). Responsiveness (with high quality evidence) and minimal clinically important changes were only demonstrated in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). Evidence on content validity, structural validity, cross-cultural validity, internal consistency, and responsiveness of PROMs was lacking for most PROMs. Conclusion The IBD-F(English) is recommended for research and clinical use. Further research is required to establish responsiveness and minimal clinically important change.