Introduction: Cancer-related fatigue (CRF) is a common consequence of cancer and/or its treatment, impacting over half of people with cancer. CRF places a significant burden on patients and survivors, highlighting the need for effective supportive care interventions. A recent systematic review of interventions targeting CRF identified large variability in the patient-reported outcome measures (PROMs) used to assess CRF across interventions, limiting comparability of findings and robust conclusions about relative effectiveness. This review aims to evaluate the content and psychometric properties of PROMS used to assess CRF in interventions designed to alleviate fatigue, to inform the selection of robust measures in future studies.
Method: All included PROMs were identified from a previous systematic review of CRF intervention trials. General characteristics of each measure were extracted and content was assessed against domains specified by the National Comprehensive Cancer Network definition of CRF. Psychometric properties were evaluated using adapted criteria from the COsensus-based Standards for the selection of heath Measurement INstruments (COSMIN) checklist. Recommendations for appropriate use were generated by the investigator team.
Results: We identified 28 measures: 20 were fatigue-specific and 8 were a fatigue subscale or single item within a broader measure (e.g. QLQ-C30 or Edmonton Symptom Assessment System). Sixteen measures were unidimensional and 12 multidimensional. There was large variability between measures in content, length, number and type of domains covered.
Conclusion: A wide range of measures have been used to assess CRF in intervention studies, each varying in content and domains covered, making it difficult to interpret effects across studies. This may be, at least partly, due to lack of consensus on an appropriate conceptual framework and gold standard definition of CRF. The final evaluation of the content and psychometric properties of included measures will be presented, along with recommendations for the selection of CRF measures in future studies.