Comparison of SF-36 vitality scale and Fatigue Symptom Inventory in assessing cancer-related fatigue
Abstract
Purpose Cancer-related fatigue (CRF) is an important symptom in clinical practice and research. The best way to measure it, however, remains unsettled. The SF-36 vitality scale, a general measure of energy/fatigue, is a frequently cited measure. With only four items, however, its ability to adequately represent multiple CRF facets has been questioned. The 13-item Fatigue Symptom Inventory (FSI) was developed to assess multidimensional aspects of CRF. Our objectives were to assess the convergent validity and to compare the sensitivity to change of the two scales.Methods We administered both scales at 1 month (n = 68) and 6 months (n = 96) to a subset of heterogeneous patients receiving treatment in 16 cancer centers who were enrolled in a clinical trial of pain and depression. Distributions of standardized response means (SRMs) were compared to assess sensitivity to change. Results of both scales were compared to scores on a single fatigue item from the Patient Health Questionnaire (PHQ).Results Mean scores for both the FSI and the vitality scale demonstrated clinically significant fatigue in the sample. The vitality scale was strongly correlated with all three FSI scales (r = -0.68 to -0.77). The vitality and FSI scales also correlated strongly with the PHQ fatigue item. Moreover, distributions of SRMs for both scales were approximately normal.Conclusions Both the FSI and the vitality scale are supported as valid measures of CRF. Both demonstrated sensitivity to change across a range of effect sizes. The vitality scale may be an excellent choice when brevity is paramount; the FSI may be more appropriate when tapping specific dimensions is warranted.
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The SF-36 Vitality Scale has been validated as a measure of energy/fatigue levels in cancer populations.
“This measure has been validated as a measure of energy/fatigue levels in cancer populations [84].”
Another study found evidence of the FSI's responsiveness to change by calculating effect sizes and SRMs for a trial targeting pain and depression during cancer treatment.
“Another study found evidence of the FSI’s responsiveness to change by calculating effect sizes and SRMs for a trial targeting pain and depression during cancer treatment [32].”
From Comparative responsiveness and minimally important difference of fatigue symptom inventory (FSI) scales and the FSI-3 in trials with cancer survivors (2022) · cites this paper as [32]
The SF-36 Vitality subscale has established responsiveness to change.
“Given the measure’s established responsiveness to change [32, 64], it was used as an anchor when calculating responsiveness to change for fatigue measures in the current study.”
From Comparative responsiveness and minimally important difference of fatigue symptom inventory (FSI) scales and the FSI-3 in trials with cancer survivors (2022) · cites this paper as [32]
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- Authors
- Brown, L. F., Kroenke, K., Theobald, D. E., & Wu, J.
- Affiliations
- Regenstrief Institute (US)
- Community Health Network (US)
- Corresponding author
- Brown, Linda F.
- Venue
- Supportive Care in Cancer
- Published
- 2011-04-10
- Volume
- 19
- Issue
- 8
- Pages
- 1255-1259
- ISSN
- 0941-4355 (ISSN-L)
- 1433-7339
- OpenAlex
- W2089999284
- Cited by
- 98
- References
- 22
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 10 · 2023: 5 · 2022: 12 · 2021: 12 · 2020: 8 · 2019: 9 · 2018: 6 · 2017: 2 · 2016: 7 · 2015: 7 · 2014: 2 · 2013: 4 · 2012: 5
- FWCI
- 1.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Supportive Care in Cancer (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (2r25ca117865-06)
- National Cancer Institute (R25 – CA117865, R25 CA 117865-01A11, R01CA115369)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- cancer-related fatigue, fatigue measurement, convergent validity, sensitivity to change, standardized response mean, Patient Health Questionnaire, multidimensional fatigue, cancer patients
- MeSH terms
- Adaptation, Psychological, Fatigue, Health Status Indicators, Health Surveys, Humans, Longitudinal Studies, Neoplasms, Psychometrics, Statistics as Topic, Stress, Psychological
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