A Self-administered Version of the Functioning Assessment Short Test for Use in Population-based Studies: A Pilot Study
Christoph Riegler1, 2, *, Silke Wiedmann1, 3, Viktoria Rücker1, Henning Teismann4, Klaus Berger4, Stefan Störk5, 6, Eduard Vieta7, Hermann Faller8, Bernhard T Baune9, 10, #, Peter U Heuschmann1, 5, 11, #
1 Institute for Clinical Epidemiology und Biometry, University of Würzburg, Würzburg, Germany
2 Department of Neurology, Charité - Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin), Berlin, Germany
3 Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Berlin, Germany
4 Institute for Epidemiology and Social Medicine, University of Münster, Münster, Germany
5 Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany
6 Department of Medicine I, University Hospital Würzburg, Würzburg, Germany
7 Bipolar and Depressive Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
8 Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
9 Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
10 Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
11 Clinical Trial Center Würzburg, University of Würzburg, Würzburg, Germany
The Functioning Assessment Short Test (FAST) is an interviewer-administered scale assessing functional impairment originally developed for psychiatric patients.
To adapt the FAST for the general population, we developed a self-administered version of the scale and assessed its properties in a pilot study.
The original FAST scale was translated into German via forward and backward translation. Afterwards, we adjusted the scale for self-administered application and inquired participants from two ongoing studies in Germany, ‘STAAB’ (Würzburg) and ‘BiDirect’ (Münster), both recruiting subjects from the general population across a wide age range (STAAB: 30-79 years, BiDirect: 35-65 years). To assess reliability, agreement of self-assessment with proxy-assessment by partners was measured via intraclass correlation coefficient (ICC) over the FAST score. Construct validity was estimated by conducting correlations with validated scales of depression (PHQ-9), anxiety (GAD-7), and health-related quality of life (SF-12) and regression analyses using these scales besides potentially disabling comorbidities (e.g. Chronic Back Pain (CBP)).
Participants (n=54) had a median age of 57.0 years (quartiles: 49.8, 65.3), 46.3% were female. Reliability was moderate: ICC 0.50 (95% CI 0.46-0.54). The FAST score significantly correlated with PHQ-9, GAD-7, and the mental sub-scale of SF-12. In univariable linear regression, all three scales and chronic back pain explained variance of the FAST score. In multivariable analysis, only CBP and the SF-12 remained significant predictors.
The German self-administered version of the FAST yielded moderate psychometric properties in this pilot study, indicating its applicability to assess functional impairment in the general population.
Keywords: Functional Assessment Short Test, FAST, Population-based, Self-administered, German.
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
* Address correspondence to this author at Institute for Clinical Epidemiology und Biometry, University of Würzburg, Josef-Schneider-Strasse 2, 97080 Würzburg, Germany; Tel: +49 931 / 201 47308, Fax: +49 931 / 201 647310 E-mail: firstname.lastname@example.org#Bernhard T Baune and Peter U Heuschmann contributed equally to the study.