Four-item fatigue screen: replacing the Brief Fatigue Index

Area of Science:

• Oncology
• Psychometrics
• Clinical Assessment

Background:

• Cancer-related fatigue (CRF) significantly impacts patient quality of life.
• Existing CRF questionnaires can be lengthy and burdensome for patients.
• There is a need for shorter, valid instruments to measure CRF.

Purpose of the Study:

• To evaluate the validity of the Four-Item Fatigue Scale (FIFS) as a measure of cancer-related fatigue.
• To compare the FIFS with the established Brief Fatigue Index (BFI).
• To assess the reliability and correlation of FIFS with BFI in a patient cohort.

Main Methods:

• The study enrolled 79 cancer patients, with 65 completing the FIFS and BFI on two separate occasions (day 1 and day 7).
• Patients completed the FIFS and BFI in a randomized order.
• Spearman correlation was used to compare FIFS and BFI scores, with Bonferroni corrections for multiple comparisons against ICD-10 fatigue criteria.

Main Results:

• A modest to strong Spearman correlation was observed between FIFS and BFI scores (Day 1: 0.69, Day 7: 0.73).
• Fatigue severity, as measured by either questionnaire, did not predict patient survival.
• Specific International Classification of Diseases, Tenth Revision (ICD-10) fatigue criteria showed varying correlations with both FIFS and BFI scores over time.

Conclusions:

• The Four-Item Fatigue Scale (FIFS) exhibits concurrent validity for assessing cancer-related fatigue when compared to the Brief Fatigue Index (BFI).
• The FIFS provides a reliable and less burdensome alternative for measuring CRF.
• The study highlights the utility of FIFS in clinical settings for monitoring cancer patient fatigue.