The fatigue pictogram: psychometric evaluation of a new clinical tool

Fatigue is one of the most prevalent side effects of cancer, yet clinicians may not focus on it during busy clinic appointments. The purpose of this project was to evaluate the psychometric properties of a new two-item instrument designed to quickly identify patients experiencing difficulties with fatigue. The evaluation was conducted with 190 lung cancer patients attending ambulatory clinics. The Fatigue Pictogram had good reliability for test-retest over a 24-hour period (Weighted Kappa 0.71 for Question 1 and 0.72 for Question 2) and for equivalence of method (in person versus phone) (Weighted Kappa 0.64 for Question 1 and 0.65 for Question 2). Validity was assessed by comparing results of the new tool against the Multidimensional Fatigue Inventory and the SF-36. Overall, patients who indicated high fatigue levels did so on all respective scales. The new Fatigue Pictogram was easy to administer and score in a busy clinical setting. It provides a standardized reliable and valid instrument to identify patients experiencing difficulty with fatigue.