BACKGROUND Fatigue is a burdensome and prevailing symptom in patients with chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) improves fatigue however, interpreting when such improvement is clinically relevant is challenging. Minimal clinically important differences (MCIDs) for instruments assessing fatigue are warranted to better tailor PR and guide clinical decisions. We estimated MCIDs for the functional assessment of chronic illness therapy-fatigue subscale (FACIT-FS), the modified-FACIT-FS and the checklist of individual strength-fatigue subscale (CIS-FS), in patients with COPD after PR. METHODS Data from patients with COPD who completed a 12-weeks community-based PR programme were used to compute the MCIDs. The pooled MCID was estimated by calculating the arithmetic weighted mean, resulting from the combination of anchor (weight-2/3) and distribution-based (weight-1/3) methods. Anchors were patients' and physiotherapists' global rating of change scale, COPD assessment test, St. George's respiratory questionnaire (SGRQ) and exacerbations. To estimate MCIDs we used mean change, receiver operating characteristic curves and linear regression analysis for anchor-based approaches, and 0.5*standard deviation, standard error of measurement (SEM),1.96*SEM and minimal detectable change for distribution-based approaches. RESULTS Fifty-three patients with COPD (79%male, 68.4±7.6years, FEV148.7±17.4%predicted) were used in the analysis. Exacerbations, the SGRQ-impact and the SGRQ-total scores fulfilled the requirements to be used as anchors. Pooled MCIDs were 4.7 for FACIT-FS, 3.8 for the modified-FACIT-FS and 9.3 for the CIS-FS. CONCLUSION The MCIDs proposed in this study can be used by different stakeholders to interpret PR effectiveness.

中文翻译：

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肺康复后 COPD 患者报告的疲劳结果测量的最小临床重要差异。

背景疲劳是慢性阻塞性肺病（COPD）患者的负担和普遍症状。肺康复 (PR) 可改善疲劳，但要解释这种改善何时具有临床相关性是具有挑战性的。评估疲劳的仪器的最小临床重要差异 (MCID) 有必要更好地定制 PR 并指导临床决策。我们估计了 MCID，用于 PR 后 COPD 患者的慢性疾病治疗疲劳分量表 (FACIT-FS)、改良 FACIT-FS 和个体力量疲劳分量表 (CIS-FS) 的功能评估。方法 使用完成 12 周基于社区的 PR 计划的 COPD 患者的数据来计算 MCID。通过计算算术加权平均值来估计合并的 MCID，由锚（权重 2/3）和基于分布（权重 1/3）方法的组合产生。锚点是患者和物理治疗师对变化量表、COPD 评估测试、圣乔治呼吸问卷 (SGRQ) 和恶化的全球评级。为了估计 MCID，我们使用均值变化、接收器操作特征曲线和基于锚的方法的线性回归分析，以及 0.5*标准偏差、测量标准误差 (SEM)、1.96*SEM 和基于分布的方法的最小可检测变化。结果 53 名 COPD 患者（79% 男性，68.4±7.6 岁，FEV148.7±17.4% 预测）用于分析。恶化、SGRQ 影响和 SGRQ 总分满足用作锚点的要求。FACIT-FS 的汇总 MCID 为 4.7，修改后的 FACIT-FS 为 3.8，9。3 为 CIS-FS。结论 本研究中提出的 MCID 可以被不同的利益相关者用来解释公关有效性。