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Fatigue after stroke: the development and evaluation of a case definition
Authors:Lynch Joanna  Mead Gillian  Greig Carolyn  Young Archie  Lewis Susan  Sharpe Michael
Institution:Geriatric Medicine, School of Clinical Sciences and Community Health, University of Edinburgh, New Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom.
Abstract:OBJECTIVE: While fatigue after stroke is a common problem, it has no generally accepted definition. Our aim was to develop a case definition for post-stroke fatigue and to test its psychometric properties. METHODS: A case definition with face validity and an associated structured interview was constructed. After initial piloting, the feasibility, reliability (test-retest and inter-rater) and concurrent validity (in relation to four fatigue severity scales) were determined in 55 patients with stroke. RESULTS: All participating patients provided satisfactory answers to all the case definition probe questions demonstrating its feasibility For test-retest reliability, kappa was 0.78 (95% CI, 0.57-0.94, P<.01) and for inter-rater reliability kappa was 0.80 (95% CI, 0.62-0.99, P<.01). Patients fulfilling the case definition also had substantially higher fatigue scores on four fatigue severity scales (P<.001) indicating concurrent validity. CONCLUSION: The proposed case definition is feasible to administer and reliable in practice, and there is evidence of concurrent validity. It requires further evaluation in different settings.
Keywords:Fatigue  Stroke  Reliability  Interview  Case definition
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