Rasch analysis of the modified Fatigue Severity Scale in neuromuscular disorders and comparison between sex, age and diagnoses.

IF 2.8 3区 医学 Q2 CLINICAL NEUROLOGY
Muscle & Nerve Pub Date : 2024-09-01 Epub Date: 2024-07-02 DOI:10.1002/mus.28186
Joshua P J Fulton, James K L Holt, Roger J Mills, Carolyn A Young
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Abstract

Introduction/aims: Fatigue is a common and debilitating symptom encountered in the neuromuscular clinic. The 7-item Fatigue Severity Scale (FSS-7) is a Rasch-modified assessment validated in inflammatory neuropathies but not across a typical neuromuscular patient population. The aim of this study was to validate this measure in neuromuscular disorders and to compare between patient sex, age and diagnoses.

Methods: The modified FSS-7 was mailed to patients recruited from a specialist neuromuscular clinic at the Walton Centre. Responses were subjected to Rasch analysis and descriptive statistics were performed on the Rasch converted data.

Results: The mFSS-7 met the Rasch model expectations with an overall Chi-square probability of 0.4918, a strict unidimensional scale free from differential item functioning (DIF) that satisfied the model with substantial test-retest reliability using Lin's concordance correlation coefficient 0.71 (95% CI 0.63-0.77). A 15.7% ceiling effect was observed in this patient cohort. Post hoc analysis did not show any significant difference in fatigue between sex, age or neuromuscular diagnoses.

Discussion: The self-completed Rasch mFSS-7 showed acceptable test-retest reliability across patients with varied disorders under follow-up in a specialist neuromuscular clinic. The ceiling effect constrains its use for those with the most severe fatigue. Future considerations could include assessment of the benefits of clinical interventions, particularly multidisciplinary team input or dedicated fatigue clinics.

对神经肌肉疾病患者的改良疲劳严重程度量表进行拉施分析,并对性别、年龄和诊断进行比较。
导言/目的:疲劳是神经肌肉临床中常见的一种使人衰弱的症状。7 项疲劳严重程度量表(FSS-7)是一种经过 Rasch 修正的评估方法,已在炎症性神经病中得到验证,但尚未在典型的神经肌肉病患者中得到验证。本研究的目的是在神经肌肉疾病中验证该量表,并对患者的性别、年龄和诊断进行比较:方法:向从沃尔顿中心神经肌肉专科门诊招募的患者邮寄经修改的 FSS-7 测评表。结果:mFSS-7 符合 Rasch 分析的要求:mFSS-7符合Rasch模型的预期,总体奇偶概率为0.4918,是一个严格的单维量表,不存在差异项目功能(DIF),符合模型的要求,使用林氏一致性相关系数0.71 (95% CI 0.63-0.77),具有很高的测试-再测可靠性。在该患者队列中观察到了 15.7% 的上限效应。事后分析表明,不同性别、年龄或神经肌肉诊断之间的疲劳程度没有明显差异:讨论:在一家神经肌肉专科诊所接受随访的不同疾病患者中,自我填写的 Rasch mFSS-7 显示出了可接受的测试-再测可靠性。天花板效应限制了它对最严重疲劳患者的使用。未来的考虑可能包括评估临床干预措施的益处,特别是多学科团队的投入或专门的疲劳门诊。
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来源期刊
Muscle & Nerve
Muscle & Nerve 医学-临床神经学
CiteScore
6.40
自引率
5.90%
发文量
287
审稿时长
3-6 weeks
期刊介绍: Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.
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