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Int J Behav Med. 2018 Aug;25(4):448-455. doi: 10.1007/s12529-018-9732-1.

Operationalizing Substantial Reduction in Functioning Among Young Adults with Chronic Fatigue Syndrome.

Author information

1
University of Southern Maine, 512 Science Building, 96 Falmouth Street, Portland, ME, 04103, USA.
2
Center for Community Research, DePaul University, 990 W Fullerton Avenue, Suite 3100, Chicago, IL, 60614, USA.
3
Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Avenue, Chicago, IL, 60611, USA.
4
Center for Community Research, DePaul University, 990 W Fullerton Avenue, Suite 3100, Chicago, IL, 60614, USA. ljason@depaul.edu.

Abstract

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.

KEYWORDS:

CFS case definitions; Chronic fatigue syndrome; Myalgic encephalomyelitis; Substantial reduction; Young adults

PMID:
29872989
DOI:
10.1007/s12529-018-9732-1
[Indexed for MEDLINE]

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