Using the Fatigue Severity Scale to inform healthcare decision-making in multiple sclerosis: mapping to three quality-adjusted life-year measures (EQ-5D-3L, SF-6D, MSIS-8D)

Abstract

Background Fatigue has a major influence on the quality of life of people with multiple sclerosis. The Fatigue Severity Scale is a frequently used patient-reported measure of fatigue impact, but does not generate the health state utility values required to inform cost-effectiveness analysis, limiting its applicability within decision-making contexts. The objective of this study was to use statistical mapping methods to convert Fatigue Severity Scale scores to health state utility values from three preference-based measures: the EQ-5D-3L, SF-6D and Multiple Sclerosis Impact Scale-8D. Methods The relationships between the measures were estimated through regression analysis using cohort data from 1056 people with multiple sclerosis in South West England. Estimation errors were assessed and predictive performance of the best models as tested in a separate sample ( n = 352). Results For the EQ-5D and the Multiple Sclerosis Impact Scale-8D, the best performing models used a censored least absolute deviation specification, with Fatigue Severity Scale total score, age and gender as predictors. For the SF-6D, the best performing model used an ordinary least squares specification, with Fatigue Severity Scale total score as the only predictor. Conclusions Here we present algorithms to convert Fatigue Severity Scales scores to health state utility values based on three preference-based measures. These values may be used to estimate quality-adjusted life-years for use in cost-effectiveness analyses and to consider the health-related quality of life of people with multiple sclerosis, thereby informing health policy decisions. Electronic supplementary material The online version of this article (10.1186/s12955-019-1205-y) contains supplementary material, which is available to authorized users.

Evaluating fatigue in patients recovering from COVID-19: validation of the fatigue severity scale and single item screening questions

“…Furthermore, the FSS also demonstrated construct validity. Similar to what has been reported in other health conditions, there was a moderate negative correlation with EQ-5D health utility and VAS scores [ 27 , 40 , 49 ]. As expected, the FSS was higher in individuals with greater impairment of their usual activities and in those who screened positive for depression [ 25 , 27 , 40 ].…”

“…For other disease populations, the construct validity of the FSS has been assessed through its comparison with patient-reported symptoms of depression and EQ-5D scores [ 33 , 34 ]. One study also demonstrated that among the EQ-5D dimensions, FSS had the strongest negative correlation with the “usual activities” dimension [ 40 ]. In this study, we hypothesized that patients who screened positive for depression on the PHQ-2 would have higher FSS scores, that there would be inverse relationships between FSS and HRQOL, and between FSS and ability to perform usual activities.…”

Improving Health of People With Multiple Sclerosis From a Multicenter Randomized Controlled Study in Parallel Groups: Preliminary Results on the Efficacy of a Mindfulness Intervention and Intention Implementation Associated With a Physical Activity Program

“…After medical history screening, mobility, fatigue, quality of life and the impact of the disease on the patient's life were measured by 6 min Walking Test (6MWT) (Guyatt et al, 1985) Modified Fatigue Impact Scale (MFIS) (Téllez et al, 2005), Health-related quality of life measured with EuroQoL (EQ5D-3L) (Goodwin et al, 2019) and Multiple Sclerosis Impact Scale (MSIS-29) (Hobart, 2001), respectively.…”

Measures of Fatigue in Patients With Rheumatic Diseases: A Critical Review

“…In patients with FMS (n = 78) receiving cognitive‐behavioral therapy (CBT), the subjective fatigue CIS8R improved by a mean (SD) −10.6 (10.7) . In patients with RA who were started on anti–tumor necrosis factor (TNF) therapy (n = 126), the total CIS20R score improved from a median of 85 (IQR ) to a median of 69 (IQR ) over 6 months , whereas in a subset of 59 working‐age patients, CIS20R score improvement was 11.8% at 6 months . In distressed patients with early RA (n = 30), CBT gave a post‐treatment ES of 0.55 for the subjective fatigue CIS8R (0.48 at 6 months) .…”

“…The FAS has been frequently used in clinical trials of interventions for fatigue in subjects with MS, including carnitine, amantadine, aspirin, modafinil, and CBT .…”