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.

Citation

Nicklin, J. K., Cramp, F. A., Hewlett, S. E., Dures, E. K., Dures, E., Hewlett, S., …Kirwan, J. R. (2013). Reliability and sensitivity to change of the bristol rheumatoid arthritis fatigue scales. Rheumatology, 52(10), 1832-1839. https://doi.org/10.1093/rheumatology/ket218

• 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