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Original Article| Volume 61, ISSUE 7, P705-713, July 2008

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Determination of the minimal clinically important difference for seven fatigue measures in rheumatoid arthritis

  • Jacques Pouchot
    Correspondence
    Corresponding author. Département de Médecine Interne, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75908 Paris Cedex 15, France. Tel.: +33-1-56-09-33-30; fax: +33-1-56-09-38-16.
    Affiliations
    Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada

    Department of Internal Medicine, Hôpital Européen Georges Pompidou, Université René Descartes – Paris V, Paris, France
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  • Raheem B. Kherani
    Affiliations
    Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada
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  • Rollin Brant
    Affiliations
    Centre for Community Child Health Research, Child and Family Research Institute, University of British Columbia, Vancouver, BC, Canada
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  • Author Footnotes
    1 Dr. Lacaille is a Canadian Institutes of Health Research/Arthritis Society of Canada New Investigator.
    Diane Lacaille
    Footnotes
    1 Dr. Lacaille is a Canadian Institutes of Health Research/Arthritis Society of Canada New Investigator.
    Affiliations
    Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada
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  • Author Footnotes
    2 Mr. Lehman holds a doctoral fellowship award from the Canadian Institutes of Health Research, the Michael Smith Foundation for Health Research, and the Canadian Arthritis Network.
    Allen J. Lehman
    Footnotes
    2 Mr. Lehman holds a doctoral fellowship award from the Canadian Institutes of Health Research, the Michael Smith Foundation for Health Research, and the Canadian Arthritis Network.
    Affiliations
    Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada

    Department of Educational Studies, University of British Columbia, Vancouver, BC, Canada
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  • Stephanie Ensworth
    Affiliations
    Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada
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  • Author Footnotes
    3 Dr. Kopec is a Senior Scholar of the Michael Smith Foundation for Health Research.
    Jacek Kopec
    Footnotes
    3 Dr. Kopec is a Senior Scholar of the Michael Smith Foundation for Health Research.
    Affiliations
    Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada

    Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC, Canada
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  • John M. Esdaile
    Affiliations
    Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada
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  • Author Footnotes
    4 Dr. Liang is the Molson Foundation Arthritis Scholar.
    Matthew H. Liang
    Footnotes
    4 Dr. Liang is the Molson Foundation Arthritis Scholar.
    Affiliations
    Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada

    Division of Rheumatology, Immunology, and Allergy, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
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  • Author Footnotes
    1 Dr. Lacaille is a Canadian Institutes of Health Research/Arthritis Society of Canada New Investigator.
    2 Mr. Lehman holds a doctoral fellowship award from the Canadian Institutes of Health Research, the Michael Smith Foundation for Health Research, and the Canadian Arthritis Network.
    3 Dr. Kopec is a Senior Scholar of the Michael Smith Foundation for Health Research.
    4 Dr. Liang is the Molson Foundation Arthritis Scholar.

      Abstract

      Objective

      To estimate the minimal clinically important difference (MCID) of seven measures of fatigue in rheumatoid arthritis.

      Study Design and Setting

      A cross-sectional study design based on interindividual comparisons was used. Six to eight subjects participated in a single meeting and completed seven fatigue questionnaires (nine sessions were organized and 61 subjects participated). After completion of the questionnaires, the subjects had five one-on-one 10-minute conversations with different people in the group to discuss their fatigue. After each conversation, each patient compared their fatigue to their conversational partners on a global rating. Ratings were compared to the scores of the fatigue measures to estimate the MCID. Both nonparametric and linear regression analyses were used.

      Results

      Nonparametric estimates for the MCID relative to “little more fatigue” tended to be smaller than those for “little less fatigue.” The global MCIDs estimated by linear regression were: Fatigue Severity Scale, 20.2; Vitality scale of the MOS-SF36, 14.8; Multidimensional Assessment of Fatigue, 18.7; Multidimensional Fatigue Inventory, 16.6; Functional Assessment of Chronic Illness Therapy–Fatigue, 15.9; Chalder Fatigue Scale, 9.9; 10-point numerical Rating Scale, 19.7, for normalized scores (0–100). The standardized MCIDs for the seven measures were roughly similar (0.67–0.76).

      Conclusion

      These estimates of MCID will help to interpret changes observed in a fatigue score and will be critical in estimating sample size requirements.

      Keywords

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