Measurement Properties of Patient-Reported Outcome Measures for Measuring Fatigue in Individuals With Spinal Cord Injury: A Systematic Review

Abstract

Objective: To systematically review the measurement properties of patient-reported outcome measures (PROMs) for measuring fatigue in people with spinal cord injury (SCI) to recommend the most suitable PROM for use in research/clinical practice.

Data sources: This systematic review was conducted following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline for systematic reviews of PROMs version 2.0. PubMed, EMBASE, Web of Science, and SCOPUS were systematically searched up to September 2024.

Study selection: Two independent reviewers evaluated articles that examined any (subscale of) PROM that measure fatigue in people with SCI, and reported information about the development of the PROM or the evaluation of at least one measurement property.

Data extraction: Data were extracted following the COSMIN guideline. The methodological quality of the included studies was evaluated with the Risk of Bias checklist and the results for each study were rated with the Criteria for good measurement properties. The evaluation of each PROM was conducted by summarizing the results of all the studies per measurement property. The quality of evidence was analyzed per measurement property per PROM using the the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Data synthesis: Seventeen articles describing 18 (subscales of) PROMs for measuring fatigue were included. There were only 3 high quality studies on measurement properties of PROMs measuring fatigue in people with SCI. The Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue SF7a and 8a were rated as sufficient with moderate quality of evidence for content validity. Sufficient ratings with high quality evidence were obtained for structural validity and internal consistency for the PROMIS Fatigue SF8a. For measurement invariance sufficient ratings with low or very low quality evidence were obtained for PROMIS Fatigue SF7a and 8a, respectively. The other PROMs showed limited quality of evidence in the measurement properties studied.

Conclusions: The PROMIS Fatigue SF7a and 8a are the most suitable options to assess fatigue in adults with SCI in research and clinical practice.