Reliability and sensitivity to change of the bristol rheumatoid arthritis fatigue scales

Dures, Emma K.; Hewlett, Sarah E.; Cramp, Fiona A.; Nicklin, Joanna K.; Dures, Emma; Hewlett, Sarah; Cramp, Fiona (Alice); Nicklin, Joanna Karen; Greenwood, Rosemary; Urban, Marie; Kirwan, John R.

Abstract

Objective. To examine the reliability (stability) and sensitivity of the Bristol Rheumatoid Arthritis Fatigue scales (BRAFs) and patient-reported outcome measures (PROMs) developed to capture the fatigue experience. The Multi-Dimensional Questionnaire (BRAF-MDQ) has a global score and four subscales (Physical Fatigue, Living with Fatigue, Cognitive Fatigue and Emotional Fatigue), while three numerical rating scales (BRAF-NRS) measure fatigue Severity, Effect and Coping. Methods. RA patients completed the BRAFs plus comparator PROMs. Reliability (study 1): 50 patients completed questionnaires twice. A same-day test-retest interval (minimum 60 min) ensured both time points related to the same 7 days, minimizing the capture of fatigue fluctuations. Reliability (study 2): 50 patients completed the same procedure with a re-worded BRAF-NRS Coping. Sensitivity to change (study 3): 42 patients being given clinically a single high dose of i.m. glucocorticoids completed questionnaires at weeks 0 and 2.Results. The BRAF-MDQ, its subscales and the BRAF-NRS showed very strong reliability (r = 0.82-0.95). BRAF-NRS Coping had lower moderate reliability in both wording formats (r = 0.62, 0.60). The BRAF-MDQ, its subscales and the BRAF-NRS Severity and Effect were sensitive to change, with effect sizes (ESs) of 0.33-0.56. As hypothesized, the BRF-NRS Coping was not responsive to the pharmaceutical intervention (ES 0.05). Preliminary exploration suggests a minimum clinically important difference of 17.5% for improvement and 6.1% for fatigue worsening. Conclusion. The BRAF scales show good reliability and sensitivity to change. The lack of BRAF-NRS Coping responsiveness to medication supports the theory that coping with fatigue is a concept distinct from severity and effect that is worth measuring separately. © The Author 2013. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.

• Journal Article Type: Article
• Publication Date: Oct 1, 2013
• Deposit Date: Aug 20, 2013
• Publicly Available Date: Feb 11, 2016
• Journal: Rheumatology (United Kingdom)
• Print ISSN: 1462-0324
• Electronic ISSN: 1462-0332
• Publisher: Oxford University Press (OUP)
• Peer Reviewed: Peer Reviewed
• Volume: 52
• Issue: 10
• Pages: 1832-1839
• DOI: https://doi.org/10.1093/rheumatology/ket218
• Keywords: rheumatoid arthritis, fatigue, patient-reported outcome; reliability, sensitivity, MCID
• Public URL: https://uwe-repository.worktribe.com/output/937830
• Publisher URL: http://dx.doi.org/10.1093/rheumatology/ket218
• Contract Date: Feb 11, 2016