An item bank was created to improve the measurement of cancer-related fatigue

Jin Shei Lai*, David Cella, Kelly Dineen, Rita Bode, Jamie Von Roenn, Richard C. Gershon, Daniel Shevrin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

64 Scopus citations


Cancer-related fatigue (CRF) is one of the most common unrelieved symptoms experienced by patients. CRF is underrecognized and undertreated due to a lack of clinically sensitive instruments that integrate easily into clinics. Modern computerized adaptive testing (CAT) can overcome these obstacles by enabling precise assessment of fatigue without requiring the administration of a large number of questions. A working item bank is essential for development of a CAT platform. The present report describes the building of an operational item bank for use in clinical settings with the ultimate goal of improving CRF identification and treatment. The sample included 301 cancer patients. Psychometric properties of items were examined by using Rasch analysis, an Item Response Theory (IRT) model. The final bank includes 72 items. These 72 unidimensional items explained 57.5% of the variance, based on factor analysis results. Excellent internal consistency (α = 0.99) and acceptable item-total correlation were found (range: 0.51-0.85). The 72 items covered a reasonable range of the fatigue continuum. No significant ceiling effects, floor effects, or gaps were found. A sample short form was created for demonstration purposes. The resulting bank is amenable to the development of a CAT platform.

Original languageEnglish (US)
Pages (from-to)190-197
Number of pages8
JournalJournal of Clinical Epidemiology
Issue number2
StatePublished - Feb 2005


  • Cancer-related fatigue (CRF)
  • Computerized adaptive testing (CAT)
  • Item bank
  • Item response theory (IRT)
  • Rasch analysis
  • Short form

ASJC Scopus subject areas

  • Epidemiology


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