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Assessment of fatigue in postpartum women using patient-reported outcome measures: a systematic review utilising Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines
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  • Sarah Ciechanowicz,
  • Perman Pandal,
  • Brendan Carvalho,
  • Lindsay Blake,
  • Stefaan Van Damme,
  • Jan Taylor,
  • Pervez Sultan
Sarah Ciechanowicz
University College London Hospitals NHS Foundation Trust

Corresponding Author:[email protected]

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Perman Pandal
Stanford University School of Medicine
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Brendan Carvalho
Stanford University
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Lindsay Blake
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Stefaan Van Damme
Ghent University
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Jan Taylor
University of Canberra
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Pervez Sultan
Stanford University School of Medicine
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Background Fatigue is a burden for a substantial proportion of women in the postpartum period. A wide array of patient-reported outcome measures (PROMs) are used for assessment, which makes comparison of data difficult. Objective To identify the best PROM for postpartum fatigue using Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. Search strategy We searched Web of Science, Embase, PubMed and CINAHL, with no date limiters, in July 2020 for validated PROMs used to assess fatigue in the postpartum period. Selection criteria Studies evaluating at least one author-defined domain of postpartum fatigue and one psychometric measurement property of a PROM. Data collection and analysis An overall rating was assigned based upon COSMIN criteria and the quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Main results We identified 49 validation studies using 18 PROMs in 21 209 women that evaluated postpartum fatigue. All three fatigue domains (Physical, Mental, Interference) were assessed by four PROMs: Fatigue Assessment Scale (FAS), Brief Fatigue Inventory (BFI), Checklist Individual Strength (CIS) and Fatigue Severity Scale (FSS). The FAS, which is freely available online, was the only PROM to demonstrate adequate content validity and at least a low level evidence of sufficient internal consistency, resulting in a Class A recommendation. Conclusion The FAS is the best available PROM to assess postpartum fatigue. However, it fails to assess important areas of postpartum recovery. Future studies should aim to develop a more specific PROM for postpartum fatigue.
22 Mar 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
27 Mar 2022Assigned to Editor
27 Mar 2022Submission Checks Completed
01 Apr 2022Reviewer(s) Assigned
10 Sep 2022Review(s) Completed, Editorial Evaluation Pending
02 Oct 2022Published in Fatigue: Biomedicine, Health & Behavior volume 10 issue 4 on pages 173-189. 10.1080/21641846.2022.2142030