Psychometric evaluation of the fatigue severity scale for use in chronic hepatitis C

L. Kleinman, M. W. Zodet, Z. Hakim, J. Aledort, C. Barker, K. Chan, L. Krupp, D. Revicki

Research output: Contribution to journalArticlepeer-review

139 Scopus citations


Evidence exists demonstrating that infection with hepatitis C virus impairs health-related quality of life, but less is known about the effect of fatigue, a common symptom, on everyday life. The psychometric properties of the fatigue severity scale (FSS) were explored to determine suitability as an outcome measure in clinical trials. The FSS includes nine items developed to measure disabling fatigue and a visual analog scale (VAS) to measure overall fatigue. Using baseline data from three clinical trials (n = 1225) involving chronic hepatitis C patients, scaling and psychometric characteristics of the FSS were assessed. The SF-36 was also used in the trials. Item response theory analysis demonstrated that the FSS items can be placed along a single homogenous domain, fatigue. Internal consistency reliability was 0.94. Test-retest reliability was 0.82 for the total score and 0.80 for the VAS. The total score and the VAS were significantly correlated with the SF-36 vitality subscale (r = -0.76 and r = -0.76 respectively). Correlations with other SF-36 subscales were moderate (r = -0.46 to r = -0.67, all p < 0.0001). In summary, the FSS possesses good psychometric properties.

Original languageEnglish (US)
Pages (from-to)499-508
Number of pages10
JournalQuality of Life Research
Issue number5
StatePublished - 2000


  • Chronic hepatitis C
  • Clinical trials
  • Fatigue severity scale
  • Item response theory
  • Reliability
  • Validity

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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