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Determining the minimal clinically important difference criteria for the Multidimensional Fatigue Inventory in a radiotherapy population

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Abstract

Purpose

The Multidimensional Fatigue Inventory (MFI) is a commonly used cancer-related fatigue assessment tool. Unlike other fatigue assessments, there are no published minimal clinically important difference (MCID) criteria for the MFI in cancer populations. MCID criteria determine the smallest change in scores that can be regarded as important, allowing clinicians and researchers to interpret the meaning of changes in patient’s fatigue scores. This research aims to improve the clinical utility of the MFI by establishing MCID criteria for the MFI sub-scales in a radiotherapy population.

Materials and methods

Two hundred ten patients undergoing radiotherapy were recruited to a single-centre prospective cohort study. Patients were assessed at three time points, at the start of radiotherapy, the end of radiotherapy and 6 weeks after radiotherapy completion. Assessment consisted of four clinically relevant constructs: (1) treatment impact on fatigue, (2) health-related quality of life, (3) performance status and (4) occupational productivity. These constructs were used as external or anchor-based measures to determine MCIDs for each sub-scale of the MFI.

Results

Multiple MCIDs were identified, each from a different perspective based on the constructs cited. Researchers seeking to use a generic MCID may wish to use a two-point reference for each MFI sub-scale as it was consistent across the pre- and post-radiotherapy comparison and occupational productivity anchors.

Conclusions

MCIDs validated in this study allow better interpretation of changes in MFI sub-scale scores and allow effect size calculations for determining sample size in future studies.

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Abbreviations

MFI:

Multidimensional Fatigue Inventory

MCID:

minimal clinically important difference

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Acknowledgements

The authors wish to thank the generous funding provided by the Queensland Health Cancer Clinical Network and the Princess Alexandra Hospital Cancer Collaborative Group.

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Authors and Affiliations

  1. School of Health and Rehabilitation Sciences, The Univeristy of Queensland, St Lucia, Brisbane, 4067, Australia

    Amanda Purcell & Jennifer Fleming

  2. Occupational Therapy, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, Brisbane, 4102, Australia

    Amanda Purcell & Jennifer Fleming

  3. School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, 4067, Australia

    Sally Bennett

  4. Radiation Oncology, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, Brisbane, 4102, Australia

    Bryan Burmeister

  5. Clinical Research, Southern Physiotherapy School, Monash University, Clayton, Australia

    Terry Haines

  6. Allied Health Clinical Research, Continuing Care, Southern Health, Kingston Centre, Kingston Rd, Cheltenham, Victoria, 3192, Australia

    Terry Haines

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  1. Amanda Purcell
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  2. Jennifer Fleming
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  3. Sally Bennett
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  4. Bryan Burmeister
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Correspondence to Amanda Purcell.

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Purcell, A., Fleming, J., Bennett, S. et al. Determining the minimal clinically important difference criteria for the Multidimensional Fatigue Inventory in a radiotherapy population. Support Care Cancer 18, 307–315 (2010). https://doi.org/10.1007/s00520-009-0653-z

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  • DOI: https://doi.org/10.1007/s00520-009-0653-z

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