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Perceived changes and minimum clinically important difference of the Neurological Fatigue Index for multiple
R J Mills1, M Calabresi, A Tennant
1Department of Neurology, Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerley, Liverpool, L9 7LJ, UK. rjm@crazydiamond.co.uk
Multiple Sclerosis (Houndmills, Basingstoke, England)
|August 25, 2012
Summary
The Neurological Fatigue Index for multiple sclerosis (NFI-MS) accurately measures fatigue changes in patients. This validated scale demonstrates small, clinically important differences, making it reliable for assessing MS fatigue.
Area of Science:
- Neurology
- Psychometrics
- Rehabilitation
Background:
- Assessing fatigue is crucial in multiple sclerosis (MS) management.
- Validated instruments are needed to quantify fatigue changes.
- The minimum clinically important difference (MCID) is key for interpreting scale results.
Purpose of the Study:
- To determine the MCID for the Neurological Fatigue Index for multiple sclerosis (NFI-MS).
- To evaluate the responsiveness of the NFI-MS to changes in fatigue in MS patients.
Main Methods:
- The NFI-MS was administered to 208 MS patients before and after periods of expected fatigue change or stability.
- Patient-perceived changes in fatigue were used to anchor the MCID determination.
- Interval-level NFI-MS scores were analyzed to calculate MCID values across different subscales.
Main Results:
- The NFI-MS change scores aligned with the perceived direction of change in fatigue.
- No significant change was detected when patients perceived no change in fatigue.
- Calculated MCID values were 2.49 (Summary), 2.36 (Physical), 0.84 (Cognitive), 0.97 (Diurnal Sleep), and 1.95 (Nocturnal Sleep) points.
Conclusions:
- The NFI-MS demonstrates expected responsiveness to fatigue fluctuations in MS.
- The NFI-MS exhibits desirably small MCID scores, indicating sensitivity to meaningful changes.
- The NFI-MS is a reliable tool for measuring fatigue in multiple sclerosis research and clinical practice.
