Operationalizing Substantial Reduction in Functioning Among Young Adults with Chronic Fatigue Syndrome.
Operationalizing Substantial Reduction in Functioning Among Young Adults with Chronic Fatigue Syndrome.
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DOI：
10.1007/s12529-018-9732-1
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发表时间：
2018-08
影响因子：
2.7
通讯作者：
Jason LA
中科院分区：
文献类型：
--
作者：
Gleason KD;Stoothoff J;McClellan D;McManimen S;Thorpe T;Katz BZ;Jason LA
慢性疲劳综合征和肌痛性脑脊髓炎是疲劳性疾病，通常会导致长期的日常功能障碍。在审查病例定义时，Thrope等人（Fatigue 4（3）：175-188，2016）指出，用于描述这些疾病的绝大多数病例定义将活动的“大幅减少”列为诊断所需的特征。然而，对于如何最好地实施大幅度削减标准，尚未达成共识。本研究采用一系列受试者工作曲线（ROC）分析，探讨由Ware和Shelbourne设计的医学结局研究简表-36健康调查（SF-36）在年轻成人人群（18-29岁）中的应用。我们比较了SF-36分量表的各种临界评分的敏感性和特异性，并评估了它们在区分一组已知诊断为慢性疲劳综合征或肌痛性脑脊髓炎的年轻人（n = 98）与未诊断为慢性疲劳综合征或肌痛性脑脊髓炎的年轻人（n = 272）方面的有用性。确定了四个表现最好的子量表及其相关临界值：身体功能≤ 80，一般健康≤ 47，身体角色≤ 25，社会功能≤ 50。结合使用，这四个临界值被证明是可靠的区分患者和对照组在我们的样本中的年轻人。这些研究结果的影响，在临床和研究设置采用大幅减少标准进行了讨论。
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. 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). 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. The implications of these findings for employing the substantial reduction criterion in both clinical and research settings are discussed.
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