TY - JOUR
T1 - Operationalizing Substantial Reduction in Functioning Among Young Adults with Chronic Fatigue Syndrome
AU - Gleason, Kristen D.
AU - Stoothoff, Jamie
AU - McClellan, Damani
AU - McManimen, Stephanie
AU - Thorpe, Taylor
AU - Katz, Ben Z.
AU - Jason, Leonard A.
N1 - Funding Information:
Funding Information Funding was provided by the National Institute of Allergy and Infectious Diseases (grant number AI105781).
Publisher Copyright:
© 2018, International Society of Behavioral Medicine.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Purpose: Chronic fatigue syndrome and myalgic encephalomyelitis are fatiguing illnesses that often result in long-term impairment in daily functioning. In reviewing case definitions, Thrope et al. (Fatigue 4(3):175–188, 2016) noted that the vast majority of case definitions used to describe these illnesses list a “substantial reduction” in activities as a required feature for diagnosis. However, there is no consensus on how to best operationalize the criterion of substantial reduction. Method: The present study used a series of receiver operating curve (ROC) analyses to explore the use of the Medical Outcomes Study Short-Form-36 Health Survey (SF-36), designed by Ware and Shelbourne for operationalizing the substantial reduction criterion in a young adult population (18–29 years old). We compared the sensitivity and specificity of various cutoff scores for the SF-36 subscales and assessed their usefulness in discriminating between a group of young adults with a known diagnosis of chronic fatigue syndrome or myalgic encephalomyelitis (n = 98) versus those without that diagnosis (n = 272). Results: The four top performing subscales and their associated cutoffs were determined: Physical Functioning ≤ 80, General Health ≤ 47, Role Physical ≤ 25, and Social Functioning ≤ 50. Used in combination, these four cutoff scores were shown to reliably discriminate between the patients and controls in our sample of young adults. Conclusion: The implications of these findings for employing the substantial reduction criterion in both clinical and research settings are discussed.
AB - Purpose: Chronic fatigue syndrome and myalgic encephalomyelitis are fatiguing illnesses that often result in long-term impairment in daily functioning. In reviewing case definitions, Thrope et al. (Fatigue 4(3):175–188, 2016) noted that the vast majority of case definitions used to describe these illnesses list a “substantial reduction” in activities as a required feature for diagnosis. However, there is no consensus on how to best operationalize the criterion of substantial reduction. Method: The present study used a series of receiver operating curve (ROC) analyses to explore the use of the Medical Outcomes Study Short-Form-36 Health Survey (SF-36), designed by Ware and Shelbourne for operationalizing the substantial reduction criterion in a young adult population (18–29 years old). We compared the sensitivity and specificity of various cutoff scores for the SF-36 subscales and assessed their usefulness in discriminating between a group of young adults with a known diagnosis of chronic fatigue syndrome or myalgic encephalomyelitis (n = 98) versus those without that diagnosis (n = 272). Results: The four top performing subscales and their associated cutoffs were determined: Physical Functioning ≤ 80, General Health ≤ 47, Role Physical ≤ 25, and Social Functioning ≤ 50. Used in combination, these four cutoff scores were shown to reliably discriminate between the patients and controls in our sample of young adults. Conclusion: The implications of these findings for employing the substantial reduction criterion in both clinical and research settings are discussed.
KW - CFS case definitions
KW - Chronic fatigue syndrome
KW - Myalgic encephalomyelitis
KW - Substantial reduction
KW - Young adults
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U2 - 10.1007/s12529-018-9732-1
DO - 10.1007/s12529-018-9732-1
M3 - Article
C2 - 29872989
AN - SCOPUS:85048055727
VL - 25
SP - 448
EP - 455
JO - International Journal of Behavioral Medicine
JF - International Journal of Behavioral Medicine
SN - 1070-5503
IS - 4
ER -