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Chalder fatigue scale
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== Background == === Origin === The Chalder fatigue scale was developed by the research team of Trudie Chalder at King's College London in 1993.<ref name=":0" /> The scale was based on a similar questionnaire that had been used in a hospital-based case study comparing [[ME/CFS]] patients to patients with neuromuscular and affective illnesses,<ref>{{Cite journal | last = Wessely | first = S | last2 = Powell | first2 = R | date = Aug 1989 | title = Fatigue syndromes: a comparison of chronic "postviral" fatigue with neuromuscular and affective disorders. | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1031831/ | journal = Journal of Neurology, Neurosurgery, and Psychiatry | volume = 52 | issue = 8 | pages = 940–948|issn=0022-3050|pmc=1031831|pmid=2571680}}</ref> and a study testing the efficacy of [[cognitive behavioral therapy]] (CBT) in ME/CFS patients.<ref>{{Cite journal | last = Butler | first = S | last2 = Chalder | first2 = T | last3 = Ron | first3 = M | last4 = Wessely | first4 = S | date = Feb 1991 | title = Cognitive behaviour therapy in chronic fatigue syndrome. | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1014351/ | journal = Journal of Neurology, Neurosurgery, and Psychiatry | volume = 54 | issue = 2 | pages = 153–158|issn=0022-3050|pmc=1014351|pmid=2019842}}</ref> === From 14 to 11 items === Three versions of the CFQ exist. Originally the scale had 14 questions but following a principal component analysis (PCA) and item discriminative properties based on receiver-operating characteristic (ROC) analysis, 3 items were excluded.<ref name=":0" /> While the 14-item scale was used in several studies in the 1990s, the 11-item version is the most used version, today. # Do you have problems with tiredness? # Do you need to rest more? # Do you feel [[Somnolence|sleepy]] or drowsy? # Do you have problems starting things? # Do you lack energy? # Do you have [[Muscle fatigability|less strength in your muscles]]? # Do you feel weak? # Do you have [[Cognitive dysfunction|difficulties concentrating]]? # Do you make [[Speech difficulties|slips of the tongue when speaking]]? # Do you find it more [[Word-finding problems|difficult to find the right word]]? # How is your [[Memory problems|memory]]? The deteled items from the 14-item scale are: * Do you start things without difficulty but get weak as you go on? * Do you think as clearly as usual? * Are you still interested in the things you used to do? === Likert or bimodal scoring === The Chalder fatigue has two scoring system. In the bimodal scoring system, respondents answer each question with a 1 or a 0 to indicate the questions apply to them or not. In the Likert scoring system, respondents can give a score of 0 to 3 to indicate how each statement applies to them, from “less than usual” to “much more than usual”.<ref name=":16">[http://www.goodmedicine.org.uk/files/assessment,%20chalder%20fatigue%20scale.pdf goodmedicine.org.uk. Chalder Fatigue Scale.]</ref> {| class="wikitable" | colspan="3" |'''Scoring schemes for the Chalder Fatigue Scale''' |- | |Bimodal score |Likert score |- |Less than usual |0 |0 |- |No more than usual |0 |1 |- |More than usual |1 |2 |- |Much more than usual |1 |3 |} While the first version counts the number of symptoms, the other weights the intensity of the symptoms. Some have argued that these changes should not be seen as merely different scoring schemes, but as different versions of the same scale.<ref name=":2" /> In the PACE trial both scoring schemes of the Chalder fatigue scale were recorded. The data showed that 22 participants showed improvement at the primary trial endpoint based on one scoring method, while the other scoring method showed a decline.<ref>Dataset available at <nowiki>https://sites.google.com/site/pacefoir/pace-ipd_foia-qmul-2014-f73.xlsx?attredirects=0</nowiki>, ‘readme’ file <nowiki>https://sites.google.com/site/pacefoir/pace-ipd-readme.txt?attredirects=0</nowiki></ref> === Physical and mental fatigue === The 11-item chalder fatigue scale is often divided into two components: one that measures physical fatigue (questions 1-7) and one that measures mental fatigue (questions 8-11).<ref name=":0" /> These components were confirmed by an analysis of a sample of 361 ME/CFS patients and 1615 healthy persons.<ref name=":1" /> Other analyses however found only 1<ref name=":4" /><ref name=":9">{{Cite journal | last = Chalder | first = Trudie | last2 = Ali | first2 = Sheila | last3 = Matcham | first3 = Faith | last4 = Norton | first4 = Sam | date = 2016-04-01 | title = 126 Psychometric Properties of Two Fatigue Scales in Rheumatology Outpatients: Unidimensional Scales Measuring Multifaceted Constructs |url =https://academic.oup.com/rheumatology/article/55/suppl_1/i113/1794176 | journal = Rheumatology|language=en | volume = 55 | issue = suppl_1| pages=i113–i114|doi=10.1093/rheumatology/kew130.010|issn=1462-0324}}</ref><ref name=":10">{{Cite journal | last = Jing | first = Meng-Juan | last2 = Lin | first2 = Wei-Quan | last3 = Wang | first3 = Qiang | last4 = Wang | first4 = Jia-Ji | last5 = Tang | first5 = Jie | last6 = Jiang | first6 = En-She | last7 = Lei | first7 = Yi-Xiong | last8 = Wang | first8 = Pei-Xi | date = Jan 2016 | title = Reliability and Construct Validity of Two Versions of Chalder Fatigue Scale among the General Population in Mainland China | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730538/ | journal = International Journal of Environmental Research and Public Health | volume = 13 | issue = 1|doi=10.3390/ijerph13010147|issn=1661-7827|pmc=4730538|pmid=26805863}}</ref> or more than two components<ref name=":5">{{Cite journal | last = Morriss | first = R.K. | last2 = Wearden | first2 = A.J. | last3 = Mullis | first3 = R. | date = Nov 1998 | title = Exploring the validity of the Chalder Fatigue scale in chronic fatigue syndrome | url =https://www.ncbi.nlm.nih.gov/pubmed/9835234 | journal = Journal of Psychosomatic Research | volume = 45 | issue = 5 | pages = 411–417|issn=0022-3999|pmid=9835234}}</ref><ref name=":6">{{Cite journal | last = Fong | first = Ted C.T. | last2 = Chan | first2 = Jessie S.M. | last3 = Chan | first3 = Cecilia L.W. | last4 = Ho | first4 = Rainbow T.H. | last5 = Ziea | first5 = Eric T.C. | last6 = Wong | first6 = Vivian C.W. | last7 = Ng | first7 = Bacon F.L. | last8 = Ng | first8 = S.M. | date = Sep 2015 | title = Psychometric properties of the Chalder Fatigue Scale revisited: an exploratory structural equation modeling approach | url = https://www.ncbi.nlm.nih.gov/pubmed/25688039 | journal = Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation | volume = 24 | issue = 9 | pages = 2273–2278|doi=10.1007/s11136-015-0944-4|issn=1573-2649|pmc=4529874|pmid=25688039}}</ref> in the 11-item Chalder fatigue scale.
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