Patient perceptions of post exertional malaise

Jason, Leonard A.; McManimen, Stephanie; Sunnquist, Madison; Holtzman, Carly S

doi:10.1080/21641846.2018.1453265

Cited by 5 publications

(10 citation statements)

References 30 publications

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“…As has been found in prior data sets, the first step involving five DSQ PEM items identifies the vast majority of patients (97%) in Jason et al [10] and 99% in the current sample. Using the supplementary five DSQ PEM items, and in particular the duration of symptoms, those with ME and CFS can be differentiated from those with at least two other fatiguing illnesses, MS and PPS.…”

Section: Discussionsupporting

confidence: 54%

“…Subsequently these items were included in the DePaul Symptom Questionnaire (DSQ) [8], and factor analyses of this questionnaire have consistently found a PEM factor score [7,9]. In another study, using these five PEM DSQ items, 97% of the sample ( n = 704) of patients with ME and CFS indicated that they experienced at least one of these PEM symptoms at least half the time and of a moderate or greater severity [10]. These five PEM DSQ items, therefore, provide an efficient and reliable screening mechanism for NIH/CDC CDE’s recommended first stage to identify PEM in patients with ME and CFS.…”

Section: Introductionmentioning

confidence: 99%

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A Brief Questionnaire to Assess Post-Exertional Malaise

et al. 2018

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Post-exertional malaise (PEM) is a key symptom of myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS). Currently, five PEM-items from the DePaul Symptom Questionnaire (DSQ) were recommended as a first step in measuring this symptom for patients with ME and CFS by the National Institutes of Health/Centers for Disease Control and Prevention (NIH/CDC) Common Data Elements’ (CDE) working group. The second step in this process, as recommended by the NIH/CDC CDE working group, involves assembling information from various sources to confirm the presence of PEM. There have not been any efforts, to date, to standardize this second-step process in the assessment of PEM. The current study examined whether five supplementary items on the DSQ could be used to operationalize the second step of the recommendations made by the NIH/CDC CDE working group. The five supplementary DSQ PEM duration items correctly categorized patients with ME or CFS 81.7% of the time, while incorrectly categorizing multiple sclerosis (MS) and post-polio syndrome (PPS) as ME or CFS only 16.6% of the time. The findings suggested that a PEM second-step process could be operationalized using supplementary DSQ items.

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Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

A Brief Questionnaire to Assess Post-Exertional Malaise

et al. 2018

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“…These items, sourced from Ramsay [18] emphasize the need for better understanding this symptom domain. Recent research has shown that the wording of Ramsay's item above, "worsening of symptoms after mild physical activity", was most liked by patients in describing post-exertional malaise [20].…”

Section: Discussionmentioning

confidence: 99%

The DePaul Symptom Questionnaire-2: a validation study

Bedree

Sunnquist

Jason

2019

Fatigue: Biomedicine, Health & Behavior

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Background-The DePaul Symptom Questionnaire (DSQ) was developed to assess the symptomatology and case definition fulfillment of individuals with myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS). The questionnaire was recently revised to improve its psychometric properties, increase its diagnostic reliability, and assess symptoms required by case definitions. The resulting instrument was named the DSQ-2. Purpose-The current study sought to evaluate the utility and reliability of the new and revised items in the DSQ-2. Method-A cross-sectional sample of 399 adults with ME or CFS was recruited to complete the DSQ-2. Results-Descriptive analyses of the DSQ-2 suggest that the new and revised items enhance the instrument's ability to assess certain symptom domains and evaluate recent case definitions. Additionally, an exploratory factor analysis resulted in an eight-factor solution: post-exertional malaise, cognitive impairment, fever and flu, pain, sleep disruption, orthostatic intolerance, genitourinary issues, and temperature intolerance. The items within each factor demonstrated strong internal consistency reliability (Cronbach's alphas = .73-.91). Conclusion-These analyses indicate that the DSQ-2 offers a more thorough and precise understanding ME and CFS symptomology and case definition fulfillment.

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“…However, these instruments have not captured some of the core symptoms of patients with ME and CFS, such as PEM. For example, individuals with other chronic illnesses do experience some version of PEM, but their exertion-induced symptoms are primarily within the fatigue domain, whereas those with ME and CFS have post-exertion symptoms that involve multiple domains, including immune functioning such as flu-like symptoms or swollen lymph nodes ( 24 ). In addition, the onset (sometimes delayed) and duration (frequently over 24 h) of their symptoms can vary, which is also not typical of other chronic illnesses.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the DSQ-1 did not have problems of ceiling effects that occurred with two other patient-reported symptom measures. In another study, Jason et al ( 24 ) found that the five PEM items from the DSQ-1 captured the widest group of patients (97%), which was higher than any other item or series of items from different scales designed to measure PEM. Strand et al ( 25 ) compared the agreement between a physician's diagnosis [using the Canadian ME/CFS criteria; ( 3 )] and the DSQ-1's, and found a sensitivity of 98% ( n = 55/56); while this study initially reported a specificity of 38% ( n = 3/8), a correction was made after subsequent analyses revealed that the five DSQ-1 “false positive” participants had documented exclusionary conditions in their DSQ-1 responses and therefore should have been classified as true negatives.…”

Section: Dsq-1mentioning

confidence: 94%

The Development of the DePaul Symptom Questionnaire: Original, Expanded, Brief, and Pediatric Versions

Jason

Sunnquist

2018

Front. Pediatr.

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One of the key requirements of a reliable case definition is the use of standardized procedures for assessing symptoms. This article chronicles the development of the DePaul Symptom Questionnaire (DSQ) to assess symptoms of the major chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME) case definitions. The original questionnaire has been modified and expanded over time to more fully capture symptoms from various adult case definitions, and a brief as well as pediatric version have also been developed. The DSQ has demonstrated very good psychometric properties in terms of test-retest reliability and sensitivity/specificity, as well as construct, predictive, and discriminant validity. The DSQ allows for a clear characterization of a patient's illness and allows scientists and clinicians to improve diagnostic reliability and validity when employing case definitions of ME and CFS.

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Patient perceptions of post exertional malaise

Cited by 5 publications

References 30 publications

A Brief Questionnaire to Assess Post-Exertional Malaise

A Brief Questionnaire to Assess Post-Exertional Malaise

The DePaul Symptom Questionnaire-2: a validation study

The Development of the DePaul Symptom Questionnaire: Original, Expanded, Brief, and Pediatric Versions

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