Arthur J. Hartz, MD, PhD, practices Epidemiology and Observation Medicine. He is an Professor Emeritus and former research director for the Department of Family Medicine at the Carver College of Medicine, University of Iowa, Iowa City, Iowa. One of his research interests is fatigue.
- 2002, Quality in Family Medicine Professorship, at the College of Medicine, University of Iowa.
Iowa Fatigue Scale
The Iowa Fatigue Scale (IFS) is a eleven question patient survey used to measure fatigue severity in primary care settings. It was developed by in 2003 by Arthur Hartz, Suzanne E. Bentler, and David Watson at the University of Iowa.
- 2005, Prospective observational study of treatments for unexplained chronic fatigue
Abtract-"BACKGROUND: Unexplained chronic fatigue is a frequent complaint in primary care. A prospective observational study design was used to evaluate whether certain commonly used therapies for unexplained chronic fatigue may be effective. METHOD: Subjects with unexplained chronic fatigue of unknown etiology for at least 6 months were recruited from the Wisconsin Chronic Fatigue Syndrome Association, primary care clinics, and community chronic fatigue syndrome presentations. The primary outcome measure was change in a 5-question fatigue score from 6 months to 2 years. Self-reported interventions tested included prescribed medications, non-prescribed supplements and herbs, lifestyle changes, alternative therapies, and psychological support. Linear regression analysis was used to test the association of each therapy with the outcome measure after adjusting for statistically significant prognostic factors. RESULTS: 155 subjects provided information on fatigue and treatments at baseline and follow-up. Of these subjects, 87% were female and 79% were middle-aged. The median duration of fatigue was 6.7 years. The percentage of users who found a treatment helpful was greatest for coenzyme Q10 (69% of 13 subjects), dehydroepiandrosterone (DHEA) (65% of 17 subjects), and ginseng (56% of 18 subjects). Treatments at 6 months that predicted subsequent fatigue improvement were vitamins (p = .08), vigorous exercise (p = .09), and yoga (p = .002). Magnesium (p = .002) and support groups (p = .06) were strongly associated with fatigue worsening from 6 months to 2 years. Yoga appeared to be most effective for subjects who did not have unclear thinking associated with the fatigue. CONCLUSION: Certain alternative therapies for unexplained chronic fatigue, especially yoga, deserve testing in randomized controlled trials."
- 2003, Measuring fatigue severity in primary care patients
Abtract-"Objective: We developed a new instrument to measure fatigue that synthesized information from existing instruments. Methods: 35 candidate items and 4 formats for a new fatigue scale were obtained from 15 previously developed instruments. A new scale was developed using factor analysis on a data set of 409 primary care patients and validated on a sample of 816 additional subjects. Results: Different formats for obtaining information about a given fatigue item gave similar results. The new 11 item scale contained four subscales: cognitive, fatigue, energy and productivity. Correlations between the four subscales ranged from .49 to .66. Patients with a higher fatigue score were much more likely to have lower health status, greater depression and more somatic symptoms. Conclusion: This new instrument may be useful in primary care and epidemiological studies to screen and monitor patients for fatigue severity and type.
- 1999, Prognostic Factors for Persons With Idiopathic Chronic Fatigue
- 1998, Characteristics of Fatigued Persons Associated with Features of Chronic Fatigue Syndrome
Abstract - "Background: Characteristics of persons with chronic fatigue syndrome (CFS) have previously been studied by comparing subjects with CFS to subjects with other conditions or no symptoms of fatigue- In the present study of subjects with idiopalhic chronic fatigue we examined the association between the number and severity of the features of CFS with other characteristics of the subjects. Methods: Data were obtained from a registry of persons over the age of 17 with fatigue for at least six months. All subjects in the registry completed an extensive questionnaire that provided information about fatigue, demographic characteristics, medical conditions, life style, sleeping habits, and psychological characteristics. The characteristics of the subjects were tested for an association with the number of CFS symptoms and the severity of individual CFS symptoms that are considered to be of fundamental importance and may identify more homogeneous subjects with chronic fatigue. Results: The number of CFS symptoms had a bell shaped distribution. This number was strongly associated with the severity of fatigue, the response of fatigue to mental and physical activity, and the following subject characteristics: a greater frequency of sinus and respiratory infections, a higher frequency of migraine headaches, a greater number of somatoform symptoms that were not included as criteria for CFS, and not drinking alcohol. These same subject characteristics were generally associated with at least one of the individual CFS symptoms but more weakly. Psychological complaints only had a statistically significant positive association with one feature of CFS, neurocognitive complaints. Conclusions: Persons with fatigue can be usefully characterized by the extent to which they meet the CFS criteria."
Talks & interviews
- Hartz, AJ; Bentler, SE; Watson, D (2003), "Measuring fatigue severity in primary care patients", Journal of Psychosomatic Research, 54 (6): 515-521, doi:10.1016/S0022-3999(02)00600-1
- HHS.gov (2009), May 27 & 28, 2009 CFSAC Meeting (PDF) (Roster)
- HHS.gov (2010), October 12 & 13, 2010 CFSAC Meeting (PDF) (Roster)
- Bentler, SE; Hartz, AJ; Kuhn, EM (2005), "Prospective observational study of treatments for unexplained chronic fatigue", J Clin Psychiatry, 66 (5): 625-32, PMID 15889950
- Hartz, Arthur J.; Kuhn, Evelyn M.; Bentler, Suzanne E.; Levine, Paul H.; London, Richard (1999), "Prognostic Factors for Persons With Idiopathic Chronic Fatigue", Archives of Family Medicine, 8: 495-501
- Arthur J. Hartz, Evelyn M. Kuhn & Paul H. Levine. (1998). Characteristics of Fatigued Persons Associated with Features of Chronic Fatigue Syndrome. Journal of Chronic Fatigue Syndrome, Vol. 4, Iss. 3, pp. 71-97. http://dx.doi.org/10.1300/J092v04n03_07