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

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International Journal of Behavioral Medicine Aims and scope Submit manuscript

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.

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Funding

Funding was provided by the National Institute of Allergy and Infectious Diseases (grant number AI105781).

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Authors and Affiliations

  1. University of Southern Maine, 512 Science Building, 96 Falmouth Street, Portland, ME, 04103, USA

    Kristen D. Gleason

  2. Center for Community Research, DePaul University, 990 W Fullerton Avenue, Suite 3100, Chicago, IL, 60614, USA

    Jamie Stoothoff, Damani McClellan, Stephanie McManimen, Taylor Thorpe & Leonard A. Jason

  3. Ann and Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Avenue, Chicago, IL, 60611, USA

    Ben Z. Katz

Authors
  1. Kristen D. Gleason
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  2. Jamie Stoothoff
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  3. Damani McClellan
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  4. Stephanie McManimen
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  5. Taylor Thorpe
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  6. Ben Z. Katz
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  7. Leonard A. Jason
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Corresponding author

Correspondence to Leonard A. Jason.

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Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Gleason, K.D., Stoothoff, J., McClellan, D. et al. Operationalizing Substantial Reduction in Functioning Among Young Adults with Chronic Fatigue Syndrome. Int.J. Behav. Med. 25, 448–455 (2018). https://doi.org/10.1007/s12529-018-9732-1

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  • DOI: https://doi.org/10.1007/s12529-018-9732-1

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