title: Fatigue Scales and Chronic Fatigue Syndrome: Issues of Sensitivity and Specificity.
abstract: Few studies have explored issues of sensitivity and specificity for using the fatigue construct to identify patients meeting chronic fatigue syndrome (CFS) criteria. In this article, we examine the sensitivity and specificity of several fatigue scales that have attempted to define severe fatigue within CFS. Using Receiver Operating Characteristic (ROC) curve analysis, we found most scales and sub-scales had either significant specificity and/or sensitivity problems. However, the post-exertional subscale of the ME/CFS Fatigue Types Questionnaire (Jason, Jessen, et al., 2009) was the most promising in terms of specificity and sensitivity. Among the more traditional fatigue scales, Krupp, LaRocca, Muir-Nash, and Steinberg's (1989) Fatigue Severity Scale had the best ability to differentiate CFS from healthy controls. Selecting questions, scales and cut off points to measure fatigue must be done with extreme care in order to successfully identify CFS cases.
authors.affiliation: DePaul University.
authors.forename: Leonard A
authors.initials: LA
authors.lastname: Jason
authors.forename: Meredyth
authors.initials: M
authors.lastname: Evans
authors.forename: Molly
authors.initials: M
authors.lastname: Brown
authors.forename: Nicole
authors.initials: N
authors.lastname: Porter
authors.forename: Abigail
authors.initials: A
authors.lastname: Brown
authors.forename: Jessica
authors.initials: J
authors.lastname: Hunnell
authors.forename: Valerie
authors.initials: V
authors.lastname: Anderson
authors.forename: Athena
authors.initials: A
authors.lastname: Lerch