• Khaled Al-shair, Hana Muellerova, Janelle Yorke, Stephen I Rennard, Emiel F M Wouters, Nicola A Hanania, Amir Sharafkhaneh, Jørgen Vestbo, and ECLIPSE investigators.
• University of Manchester, Medicines Evaluation Unit, NIHR Translational Research Facility, Manchester Academic Health Sciences Centre, University Hospital of South Manchester Foundation Trust, Wythenshawe, Manchester, UK. alshair02@yahoo.com
• Health Qual Life Out. 2012 Jan 1;10:100.

IntroductionFatigue is a disruptive symptom that inhibits normal functional performance of COPD patients in daily activities. The availability of a short, simple, reliable and valid scale would improve assessment of the characteristics and influence of fatigue in COPD.MethodsAt baseline, 2107 COPD patients from the ECLIPSE cohort completed the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scale. We used well-structured classic method, the principal components analysis (PCA) and Rasch analysis for structurally examining the 13-item FACIT-F.ResultsFour items were less able to capture fatigue characteristics in COPD and were deleted. PCA was applied to the remaining 9 items of the modified FACIT-F and resulted in three interpretable dimensions: i) general (5 items); ii) functional ability (2 items); and iii) psychosocial fatigue (2 items). The modified FACIT-F had high internal consistency (Cronbach's α = 0.91) and it did not fit a uni-dimensional Rasch model, confirming the prior output from the PCA. The correlations between total score and each dimension were ≥ 0.64 and within dimensions ≥0.43 (p < 0.001 for all).The original and modified FACIT-F had significant convergent validity; its scores were associated with SGRQ total score (0.69 and 0.7) and mMRC dyspnoea scores (0.48 and 0.47), (p = <0.001 for all). The scale had meaningful discriminating ability in identifying patients with poor exercise performance and more depressive symptoms.ConclusionThe original and modified FACIT-F are valid and reliable scales in COPD. The modified version is shorter and measures not only total fatigue but also its sub-components in COPD.

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