E2 ModerateModerate confidencePEM not requiredMethods-PaperPeer-reviewedReviewed
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Paediatric short fatigue questionnaire, a 4-item fatigue questionnaire for children.
Nap-van der Vlist, Merel M, Vroegindeweij, Anouk, Hoefnagels, Johanna W et al. · Journal of psychosomatic research · 2023 · DOI
Quick Summary
Researchers created and tested a short 4-question fatigue questionnaire (pSFQ) designed specifically for teenagers ages 12-18 to quickly and accurately measure severe fatigue. They tested it on over 900 young people—both healthy teens and those with ME/CFS or other chronic illnesses—and found it works reliably and can identify severe fatigue with 94% accuracy while being 50% shorter than the original longer questionnaire.
Why It Matters
For ME/CFS patients and clinicians, a validated short fatigue screening tool reduces assessment burden while maintaining diagnostic accuracy—particularly important given that fatigue assessment is central to ME/CFS diagnosis and monitoring. This instrument could improve clinical efficiency and allow for repeated fatigue measurement in paediatric populations without excessive questionnaire burden, supporting better clinical management and research participation.
Observed Findings
The 4-item pSFQ showed excellent internal consistency (Cronbach's alpha 0.84–0.94) across all groups tested.
A cut-off score of ≥21 correctly identified severe fatigue with 93.9% sensitivity and 96.2% specificity.
The pSFQ demonstrated strong correlations with two other established fatigue measurements (r = −0.76 and −0.87), confirming it measures the same construct.
Normative data showed similar patterns between healthy children and children with chronic disease, comparable to other established fatigue questionnaires.
The pSFQ achieves 50% reduction in questionnaire length compared to the original CIS-8 while maintaining validity.
Inferred Conclusions
The pSFQ is a valid, practical screening instrument for severe fatigue in both healthy and chronically ill children aged 12–18 years.
The tool effectively balances brevity with psychometric strength, making it suitable for clinical and research settings where assessment efficiency is important.
Normative data support its use as a comparative measure across different paediatric populations.
Remaining Questions
Does the pSFQ respond sensitively to changes in fatigue over time or in response to treatment (responsiveness and minimal clinically important difference)?
What This Study Does Not Prove
This study establishes that the pSFQ reliably measures fatigue severity and discriminates between groups, but does not demonstrate whether the tool can track fatigue changes over time or in response to treatment (responsiveness). The study also does not establish whether this fatigue measure specifically captures ME/CFS-related fatigue distinct from other chronic disease fatigue, nor does it validate the tool in younger children below age 12.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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How does the pSFQ perform in children younger than 12 years of age?
Can the pSFQ distinguish ME/CFS-specific fatigue patterns from fatigue in other chronic paediatric conditions, or is it a general fatigue measure only?
What is the test-retest reliability of the pSFQ across different time intervals?