EVALUATING FATIGUE IN SYSTEMIC LUPUS ERYTHEMATOSUS: INSIGHTS FROM THE ISLA COHORT USING THE FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY-FATIGUE SCALE
Bibliographic record
Abstract
PV192 / #414 Poster Topic: AS22 - SLE Heterogeneity Background/Purpose The prevalence of fatigue among patients with systemic lupus erythematosus (SLE) varies between 67% and 90%, representing a multifaceted phenomenon that significantly impacts overall functionality. Despite its prevalence, fatigue is often an overlooked characteristic in clinical assessments. This condition is inherently complex, and numerous measurement tools exist. Notably, the Functional Assessment of Chronic Disease Therapy (FACIT) Fatigue Scale, a crucial tool in this study, has been validated for use in this patient population. Consequently, the objective of this study is to evaluate fatigue within a cohort of Guatemalan lupus patients utilizing the FACIT scale. Methods A cross-sectional study was conducted on 268 patients diagnosed with SLE at a single rheumatology center in Guatemala, specifically within the Lupus cohort of the Guatemalan Social Security Institute in the Autonomous Unit (ISLA). Participants completed the FACIT-fatigue questionnaire during the last follow-up evaluation in 2024, with prior authorization for using the scale by FACIT.org . Fatigue was defined as a score of less than 30 points. The study characterized participants based on the presence or absence of fatigue. Subsequently, we examined the correlation between disease activity by the SLEDAI-2K and the scores obtained from the FACIT-fatigue scale. Additionally, the frequency of responses to the statements within the FACIT scale was described according to its measurement scale. Results The study revealed that 40.67% of the patients experienced moderate to severe fatigue, with 93.6% being women (Table 1). In patients with fatigue, the mean FACIT score was recorded at 20.72, while 52.3% presented active disease, indicated by a mean SLEDAI-2K value of 4.17. The Pearson correlation analysis between disease activity, measured by the SLEDAI-2K, and fatigue, as assessed by the FACIT, revealed a coefficient of -0.16, suggesting a low negative correlation, as illustrated in Figure 1. Table 1. Figure 1. Furthermore, an examination of the statements included in the FACIT scale indicated that the statements with the worst ratings were “I feel tired, weak, listless (‘washed out’), I am tired,” and “I can do my usual activities” (Table 2). Table 2. Conclusions Fatigue is a prevalent symptom among individuals with lupus within our population and exhibits a low negative correlation with disease activity. This relationship indicates that the FACIT score decreases as the disease activity score increases, demonstrating greater fatigue levels in patients experiencing high disease activity. A critical implication of this fatigue is the difficulty in performing daily activities. Given these findings, it is imperative to recognize that fatigue should not be underestimated as a clinical symptom, and the ongoing monitoring of patients is essential to address this issue effectively.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".