Temel Jennifer S, Pirl William F, Recklitis Christopher J, Cashavelly Barbara, Lynch Thomas J
Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
J Thorac Oncol. 2006 Jun;1(5):454-9.
Fatigue is one of the most common symptoms in patients with advanced cancers. Despite its high prevalence, it is often unrecognized and undetected. This study assessed the feasibility and validity of a one-item fatigue scale (OIFS) in an outpatient oncology clinic.
Over a 3-month trial period, all patients in a thoracic oncology clinic were screened for fatigue with a one-item, 0 to 10 scale. Over a second trial period, an additional sample of 100 clinic patients completed validated measures of fatigue, including the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F) and Fatigue Symptom Inventory (FSI), in addition to the OIFS.
During the initial trial period, more than 95% of patients (574 of 600) had a documented OIFS score on their first clinic visit. Data from the second cohort of patients revealed that the OIFS had good test-retest reliability (r = 0.88) and was highly correlated with the FSI severity scale (0.87) and the FACIT-F (-0.75). Receiver operating characteristic analysis showed the OIFS had good discrimination compared with the FACIT-F (area under the curve = 0.87). Sensitivity and specificity of several OIFS cutoff scores were compared, and scores between 3 and 5 were found to be optimal.
The use of a one-item scale to screen for fatigue is feasible in an ambulatory clinic setting. This scale had convergent validity with other measures of fatigue and was able to identify cases of fatigue that met criteria on the FACIT-F. These data support the recommendations in the National Comprehensive Cancer Network guidelines for cancer-related fatigue screening.
疲劳是晚期癌症患者最常见的症状之一。尽管其发生率很高，但往往未被认识和检测到。本研究评估了单项疲劳量表（OIFS）在肿瘤门诊的可行性和有效性。
在为期3个月的试验期内，对胸科肿瘤门诊的所有患者使用0至10分的单项量表进行疲劳筛查。在第二个试验期，除OIFS外，另外100名门诊患者还完成了包括慢性病治疗功能评估-疲劳量表（FACIT-F）和疲劳症状量表（FSI）在内的疲劳验证测量。
在初始试验期，超过95%的患者（600例中的574例）在首次门诊就诊时记录了OIFS评分。第二批患者的数据显示，OIFS具有良好的重测信度（r = 0.88），与FSI严重程度量表（0.87）和FACIT-F（-0.75）高度相关。受试者工作特征分析显示，与FACIT-F相比，OIFS具有良好的区分度（曲线下面积 = 0.87）。比较了几个OIFS临界值分数的敏感性和特异性，发现3至5分是最佳分数。
在门诊环境中使用单项量表筛查疲劳是可行的。该量表与其他疲劳测量方法具有收敛效度，能够识别符合FACIT-F标准的疲劳病例。这些数据支持了美国国立综合癌症网络癌症相关疲劳筛查指南中的建议。
