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Chalder fatigue scale
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=== Content validity === Some authors have questioned whether the CFQ adequately assesses fatigue. [[Gerwyn Morris|Morris]] et al.<ref name=":5" /> noted that the item “[[Somnolence|feeling sleepy]] or drowsy” seems more related to sleepiness and problems with [[Insomnia|maintaining sleep at night]], than fatigue. [[Tom Kindlon]] has argued that the item “do you have problems starting things” seems more related to motivation instead of fatigue.<ref name=":14">{{Cite web | url = https://www.s4me.info/threads/my-feedback-on-content-of-cdes-fatigue-myalgic-encephalomyelitis-chronic-fatigue-syndrome-me-cfs-cde-public-review.2017/ | last = Kindlon | first = Tom | authorlink = Tom Kindlon | title = My feedback on content of CDEs (Fatigue) - Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) CDE Public Review | website = Science for ME|language=en-US|access-date=2019-02-16}}</ref> Both these questioned received low scores in a study of [[Myalgic encephalomyelitis|ME]] patients.<ref name=":11">{{Cite journal |url = https://www.researchgate.net/publication/260987489_Fatigue_in_Myalgic_Encephalomyelitis | last = Goudsmit | first = Ellen M. | authorlink = Ellen Goudsmit | last2 = Stouten | first2 =Bart | last3 = Howes | first3 = S | author-link3 = Sandra Howes|journal = Bulletin of the IACFS/ME | date = 2008| title = Fatigue in Myalgic Encephalomyelitis.}}</ref> [[Carolyn Wilshire|Wilshere]] et al.<ref name=":2" /> pointed out that four items of the CFQ measure cognitive difficulties ([[Cognitive dysfunction|difficulties concentrating]], [[Speech difficulties|slips of the tongue]], difficulty finding the [[Word-finding problems|right word]] and [[memory problems]]) instead of [[fatigue]]. Since a bimodal score of four or more on the CFQ has been defined as caseness of fatigue, it’s possible for a patient to be a fatigue case if their only symptoms are these [[Nervous system|neurological]] symptoms. A detailed critique of the CFQ, written by members of the online forum Science for ME, concluded: <blockquote>“The scale assumes that memory problems, speech errors, [[Somnolence|sleepiness]]/drowsiness, [[Paresis|muscle weakness]] and so on are indicators of fatigue, and that the more such symptoms a patient reports, the greater their overall fatigue. These assumptions are untested and their basis is unclear.”<ref name=":2" /> </blockquote>
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