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Lewis et al (2013) critiqued the Chalder Fatigue scale resoundingly in their paper “Clinical characteristics of a novel subgroup of chronic fatigue syndrome patients with postural orthostatic tachycardia syndrome” http://onlinelibrary.wiley.com/doi/...ionid=70907FE210C961680D4EFDB88398E516.f02t02The Chalder scale is one of the most idiotic, unscientific questionnaires I have ever had the misfortune to investigate. It's nonsense on so many levels. Maybe someone like Carolyn Wiltshire could do a demolition job on it.
Here are some quotes:
“Secondly, due to its ‘low ceiling effect’, the Chalder fatigue scale is not a good indicator of change in fatigue levels in patients with CFS.” (p.507)
“Whereas there was a wide range of FIS scores, there appeared to be a ‘low ceiling effect’ with the Chalder fatigue scale (Fig. 2a), in which due to the low range of scores on the Chalder fatigue scale, a high proportion of subjects demonstrated maximum fatigue scores, yet demonstrating highly varied FIS scores. There was a correlation between the two fatigue measuring tools (r = 0.1; r2 = 0.03; P = 0.01); however, 62.5% (n = 105) of subjects scored the maximum score of 7 on the Chalder fatigue scale (physical), whereas the same subjects reported fatigue on the FIS in the range from 44 to 156 (Fig. 2b). Similar results were found for both total and the mental domain of the Chalder fatigue scale.” (p.505)
“The observed ‘low ceiling effect’ with the Chalder fatigue scale in this study was consistent with previous findings [55–57]. Goudsmit et al. noted that 50% of CFS patients scored the highest possible score on this scale, whereas 77% scored the two highest possible scores. The authors noted a marked overlap between patients who rated themselves as moderately or severely ill, yet scored the highest possible score on the Chalder fatigue scale.
We demonstrated here that although there is some correlation between the Chalder fatigue scale and the FIS, there remains a marked discrepancy between what individuals report using the two scales in terms of fatigue. Subjects who reported the maximum possible Chalder fatigue score of 7 also scored a range of FIS scores from 44 to 156. Further research is needed to examine this effect of the Chalder fatigue scale. However in the meantime problems may arise in the clinical setting as those with a maximum score at baseline will not be able to record a change in fatigue during or following treatment and will therefore appear to be unresponsive to therapy.” (p.508)