Determining the minimal clinically important difference criteria for the Multidimensional Fatigue Inventory in a radiotherapy population

Purcell, Amanda; Fleming, Jennifer; Bennett, Sally; Burmeister, Bryan; Haines, Terrence Peter

doi:10.1007/s00520-009-0653-z

Cited by 74 publications

(87 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An earlier study by this research team which examined fatigue with identical assessments and time-points in the same radiotherapy population (n=220) [22] found that fatigue increased significantly from baseline to end of treatment and then decreased significantly by 6-week follow-up echoing findings of similar research [3,36]. This discrepancy may be explained by potential compensatory rivalry between groups aware of the aim of the study or by sample bias.…”

Section: Discussionmentioning

confidence: 67%

“…Each fatigue subscale has a potential score range from 4 to 20, where higher scores indicate more fatigue. The MFI subscales have previously been reported to have good internal consistency (average Cronbach's Alpha=0.81) [22] and overall has been demonstrated to be a valid instrument for use amongst people with cancer [26].…”

Section: Primary Outcome Measurementioning

confidence: 98%

“…A sample size of 110 participants was estimated to have 80% power to detect a previously identified minimally clinically significant difference of 2.1 units of the Multidimensional Fatigue Inventory (MFI) general fatigue subscale [22] between intervention and control groups. This analysis is based on examination of the main effect of the pre-or posttreatment interventions, not the simple effects of the complete CAN-FIT programme compared with no treatment (assuming a standard deviation of 4.8, one pre-intervention and two post-intervention measures and correlation between pre and post measures of r=0.7 using a two-tailed alpha of 0.05).…”

Section: Subjectsmentioning

confidence: 99%

See 2 more Smart Citations

Is education an effective management strategy for reducing cancer-related fatigue?

Purcell

Fleming

Burmeister

et al. 2010

Support Care Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 67%

Section: Primary Outcome Measurementioning

confidence: 98%

Section: Subjectsmentioning

confidence: 99%

See 1 more Smart Citation

Is education an effective management strategy for reducing cancer-related fatigue?

Purcell

Fleming

Burmeister

et al. 2010

Support Care Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

“…In our trial, we observed significant improvements at discharge and at the end of the exercise intervention. Regarding the minimal clinically important differences in cancer-related fatigue scores reported for the different MFI subscales in cancer patients by Purcell et al, 39 our fatigue findings concerning "general fatigue" and "physical fatigue" can be regarded as clinically important and relevant. Previous studies on exercise and cancer-related fatigue have shown benefits in some, although not all, settings.…”

Section: Discussionmentioning

confidence: 93%

Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation

Wiskemann

Dreger

Schwerdtfeger³

et al. 2011

Blood

247

283

View full text Add to dashboard Cite

Before, during, and after allogeneic hematopoietic stem cell transplantation (allo-HSCT), patients experience considerable physical and psychologic distress. Besides graft-versus-host disease and infections, reduced physical performance and high levels of fatigue affect patients' quality of life. This multicenter randomized controlled trial examined the effects of a partly self-administered exercise intervention before, during, and after allo-HSCT on these side effects. After randomization to an exercise and a social contact control group 105 patients trained in a homebased setting before hospital admission, during inpatient treatment and a 6-to 8-week period after discharge. Fatigue, physical performance, quality of life, and physical/psychologic distress were measured by standardized instruments at baseline, admission to, and discharge from hospital and 6 to 8 weeks after discharge. The exercise group showed significantly improvement in fatigue scores (up to 15% improvement in exercise group vs up to 28% deterioration in control; P < .01-.03), physical fitness/ functioning (P ‫؍‬ .02-.03) and global distress (P ‫؍‬ .03). All effects were at least detectable at one assessment time point after hospitalization or repeatedly. Physical fitness correlated significantly with all reported symptoms/variables. In conclusion, this partly supervised exercise intervention is beneficial for patients undergoing allo-HSCT. Because of low personnel requirements, it might be valuable to integrate such a program into standard medical care. (Blood. 2011;117(9):2604-2613)

show abstract

“…The MFI measures general, physical, and mental fatigue as well as reduced activity and motivation. A clinically meaningful difference in MFI scores is 10 points based on studies of cancer patients (Purcell et al, 2010). …”

Section: Methodsmentioning

confidence: 99%

Epigenetic changes associated with inflammation in breast cancer patients treated with chemotherapy

Smith

Conneely

Pace

et al. 2014

Brain, Behavior, and Immunity

View full text Add to dashboard Cite

Inflammation has been associated with fatigue during and after various types of breast cancer treatments. We examined whether prior chemotherapy was associated with DNA methylation patterns that could explain persisting inflammation and/or fatigue in women treated for breast cancer. Prior to breast radiation therapy, DNA was extracted from peripheral blood mononuclear cells (PBMCs) of 61 Stage 0-IIIA breast cancer patients who had received partial mastectomy with or without chemotherapy. DNA methylation was assessed at >485,000 CpG sites across the genome along with fatigue and plasma inflammatory markers previously associated with fatigue. Compared to non-chemotherapy-treated, women who had received chemotherapy exhibited significantly decreased methylation at eight CpG sites (p < 1.03 × 10−7) including four in exon 11 of transmembrane protein 49 (TMEM49), which demonstrated the largest decreases in methylation. Lower methylation at each identified CpG site was associated with increased plasma soluble tumor necrosis factor receptor 2 (sTNFR2) and interleukin (IL)-6 and mediated the relationship between chemotherapy and increases in these inflammatory biomarkers adjusting for multiple clinical and treatment characteristics. sTNFR2, but not CpG methylation status, was correlated with fatigue. Six months after breast radiation therapy, DNA methylation, inflammatory biomarkers and fatigue assessments were repeated in a subset of subjects (N = 39). Reduced methylation in 4 of the 8 identified CpG sites was still observed in chemotherapy versus non-chemotherapy-treated patients, albeit with some decay indicating the dynamic and potentially reversible nature of the changes. Reduced methylation in these 4 CpG sites also continued to correlate with either increased sTNFR2 or IL-6, but not fatigue. In conclusion, prior chemotherapy treatment was associated with decreased methylation of CpG sites in DNA from PBMCs of breast cancer patients, which correlated with increased inflammatory markers prior to and 6 months after radiation therapy. Persisting epigenetic changes secondary to chemotherapy may be one factor that contributes to inflammation and its consequences including cancer-related fatigue in vulnerable breast cancer patients.

show abstract

Determining the minimal clinically important difference criteria for the Multidimensional Fatigue Inventory in a radiotherapy population

Abstract: MCIDs validated in this study allow better interpretation of changes in MFI sub-scale scores and allow effect size calculations for determining sample size in future studies.

Cited by 74 publications

References 25 publications

Is education an effective management strategy for reducing cancer-related fatigue?

Is education an effective management strategy for reducing cancer-related fatigue?

Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation

Epigenetic changes associated with inflammation in breast cancer patients treated with chemotherapy

Contact Info

Product

Resources

About