Systematic review of fatigue assessment instruments for systemic lupus erythematosus: psychometric validation with COSMIN 2.0 Guidelines

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ID: 325356
2026
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Abstract
Abstract Objective To identify and evaluate the methodological quality and psychometric properties of patient-reported outcome measures (PROMs) for fatigue assessment in systemic lupus erythematosus (SLE) patients. Methods A systematic search was performed across eight databases (PubMed, EMBASE, Web of Science, CINAHL, CNKI, WanFang, VIP, SinoMed) from inception to June 12, 2026. Eligible studies focused on developing/psychometrically validating SLE fatigue-specific PROMs with explicit reporting of at least one psychometric property. Study methodological quality and PROM psychometric performance were assessed in accordance with COSMIN 2.0 guidelines; measurement property evidence for each PROM was synthesized across eligible studies, and evidence certainty evaluated via a modified Grading of Recommendations Assessment, Development and Evaluation(GRADE)system. Results Fifteen studies involving six distinct PROMs were included. No instrument was conclusively recommendable for clinical practice/research due to insufficient high-certainty evidence, particularly for cross-cultural validity/measurement invariance and criterion validity. The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) was the most promising, with high-quality evidence for five core psychometric properties (content validity, structural validity, internal consistency, construct validity hypothesis testing, responsiveness), and it assesses physical/mental fatigue and their impacts on functional status and daily living. Conclusions A critical gap exists in fully validated, high-quality SLE-specific PROMs for fatigue assessment. FACIT-Fatigue is the most viable tool for this population but requires further rigorous psychometric validation. Future research should prioritize comprehensive validation of FACIT-Fatigue (e.g., supplementing cross-cultural and criterion validity evidence) and the development/validation of SLE-specific PROMs to quantify fatigue and its disease-specific manifestations. Systematic review registration PROSPERO (CRD420251272840).
Reference Key
openalex_W7203830662 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Suxiang Liu, Xiaocha Zhu, Qingqing Liu, Chaoqian Li
Journal Lara D. Veeken
Year 2026
DOI
10.1093/rheumatology/keag449
URL
https://doi.org/10.1093/rheumatology/keag449
Keywords Keywords not found

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