The diagnostic accuracy of single-item scales in detecting fatigue in patients with cancer: A systematic review and meta-analysis

Background: Early detection of fatigue is crucial for cancer patients. Although single-item scales are convenient, their diagnostic accuracy remain unclear, and the variability across studies may affect generalizability. This systematic review and meta-analysis evaluates the diagnostic value of single-item fatigue detection scales. Methods: We systematically searched CINAHL, Cochrane Library, Embase, and PubMed. Meta-analyses were conducted to calculate pooled sensitivity, specificity, likelihood ratios, predictive values, and diagnostic odds ratios (DOR). We also calculated the area under a hierarchical summary receiver operating characteristic curve. Subgroup analyses were performed to address heterogeneity. All analyses were done R (version 4.3.1). The study registered in PROSPERO (CRD42023457658). Results: Eleven studies involving 3509 participants were included. Pooled results revealed a sensitivity of 0.89 (95 % CI: 0.82–0.93), specificity of 0.72 (95 % CI: 0.63–0.80), DOR of 19.95 (95 % CI: 10.47–38.04), and an AUC of 0.90 (95 % CI: 0.89–0.91). Moderate to high heterogeneity was observed, influenced by variations in cancer types, study designs, and gold standard references. Conclusion: Single-item fatigue scales demonstrate commendable diagnostic accuracy, comparable to multidimensional scales. Despite study variability, they are effective for routine clinical use to detect and manage fatigue in cancer patients. Future research should focus on standardizing assessment criteria and optimizing the balance between simplicity and diagnostic precision. © 2024 Elsevier B.V.