10.103. Multidimensional Fatigue Inventory (MFI-20)


(§) Permissible for use in some situations but not all (e.g.: clinical, research, commercial, educational), enforced by CamCOPS based on the user’s replies.

20 questions rated on a 5-point scale (1 = “yes, that is true” to 5 = “no, that is not true”).

Items are scored 1–5, with 10 [fatigue-]positively phrased items reverse scored (items 2, 5, 9, 10, 13, 14, 16, 17, 18, 19). In the final score, high scores represent more fatigue.

Total score calculated for 5 subscales:

  • general fatigue (items 1, 5, 12, 16);

  • physical fatigue (items 2, 8, 14, 20);

  • reduced activity (items 3, 6, 10, 17);

  • reduced motivation (items 4, 9, 15, 18);

  • mental fatigue (items 7, 11, 13, 19).

10.103.1. Intellectual property rights

  • “The MFI-20 is copyrighted on the names of the authors. The MFI is free for academic use, charges apply for commercial use. For further information, the developers can be contacted.” [http://oml.eular.org/oml_search_results_details.cfm?id=119&action=All%20information, 2020-02-07]

    • Thus, copyright 1995 Ellen Smets and colleagues.

  • Permission given by the lead author, Prof. Smets, 3 Feb 2020 (personal communication, as below).

  • Restricted to research and educational use as per the copyright holder’s instructions (as below).

From: Smets, E.M.A. (Ellen) [...]
Sent: 03 February 2020 17:01
To: Joel Parkinson [...]
Subject: RE: MFI-20 permission

Dear Joel,

Thank you for your interest in incorporating the MFI in CamCops. You
herewith have my permission to do so. Although I realize it depends on the
trustworthiness of the end-user, I would prefer tasks including the MFI to
be restricted to researchers en educators.

I hope you helps.

Kind regards,

Ellen Smets

Prof. dr. Ellen Smets
Department of Medical Psychology
Location AMC | J3-220 | Meibergdreef 9, 1105 AZ Amsterdam
www.amsterdamumc.nl | www.vumc.nl / www.amc.nl

Van: Joel Parkinson <[...]cam.ac.uk>
Verzonden: woensdag 29 januari 2020 14:50
Aan: Smets, E.M.A. (Ellen) [...]
Onderwerp: MFI-20 permission

Dear Professor Smets,

We are very interested in incorporating the Multidimensional Fatigue
Inventory into CamCOPS (https://camcops.readthedocs.io/), and wonder
whether you might permit this.

Our understanding of the copyright status of the MFI-20 is:

· It is copyrighted on the names of the authors.
· It is free for academic use.

May we ask if that is correct?

CamCOPS is free and open-source software for capturing structured data
relevant to psychiatry directly from patients, clinicians, and researchers.
It was developed in the University of Cambridge, UK, and is in use for
clinical and research purposes. Data flow is entirely under the control of
the hosting institution. CamCOPS implements both open/free tasks and
closed/restricted tasks using one of the following methods:

· Open/free tasks are embedded into CamCOPS directly; this is our preferred

· Some tasks may be permitted to some institutions but not others. These
  can be implemented via a public “skeleton” in CamCOPS (with no task
  content) and a “plugin” containing the task content (e.g. text for a
  questionnaire) that licensed users can add to their CamCOPS installation,
  converting the skeleton into a fully working copy.

· Some closed tasks do not permit electronic reproduction. Sometimes, these
  still benefit from an electronic data capture “skeleton” that never
  includes task content, but is still preferable to paper capture and
  manual (laborious and error-prone) transcription. The electronic skeleton
  can then be used in conjunction with a licensed paper copy of the task.

In addition, all CamCOPS tasks can be restricted if necessary according to
flags that the end user can set: clinical use? Research use? Educational
use? Commercial use? For example, a task can be restricted to noncommercial
use only (though this relies on end-user honesty and end-user liability).

Would it be permissible for us to incorporate the MFI-20 into CamCOPS,
using one of the above methods? We’d be most grateful.

Thank you for your time in considering this. If you have any questions or
if there is anything I can clarify, please just let me know.

Yours sincerely,

Joel Parkinson

10.103.2. History

  • Smets E, Garssen B, Bonke Bd, De Haes J (1995). The Multidimensional Fatigue Inventory (MFI): psychometric qualities of an instrument to assess fatigue. Journal of Psychosomatic Research 39: 315-25. https://www.ncbi.nlm.nih.gov/pubmed/7636775

  • Smets EM, Garssen B, Cull A, de Haes JC (1996). Application of the multidimensional fatigue inventory (MFI-20) in cancer patients receiving radiotherapy. Br J Cancer 73: 241-5. https://www.ncbi.nlm.nih.gov/pubmed/8546913

10.103.3. Modifications

  • Original scoring (from 2019-07-19) was as follows:

    “Items are scored 1–5, with 10 positively phrased items reverse scored (items 2, 5, 9, 10, 13, 14, 16, 17, 18, 19). Total score calculated for 5 subscales: general fatigue (items 1, 5, 12, 16), physical fatigue (items 2, 8, 14, 20), reduced activity (items 7, 11, 13, 19), reduced motivation (items 3, 6, 10, 17), and mental fatigue (items 4, 9, 15, 18).”

    Per https://github.com/ucam-department-of-psychiatry/camcops/issues/199, from https://github.com/pjbulls, on 7 Sep 2021:

    The grouping of MFI-20 questions into categories (general, physical, motivation…) is not in line with literature, which almost invariably uses the following:

    • General [Fatigue] = items 1, 5, 12, 16 [same as our original]

    • Physical [Fatigue] = items 2, 8, 14, 20 [same as our original]

    • Reduced Activit[y] = items 3, 6, 10, 17 [this list was “reduced motivation” previously]

    • [Reduced] Motivation = items 4, 9, 15, 18 [this list was “mental fatigue” previously]

    • Mental [Fatigue] = items 7, 11, 13, 19 [this list was “reduced activity” previously]

    Example references include:

    The changes are clearly correct and our previous version clearly wrong. Changes implemented 2021-10-07. No changes are made to the underlying data; this merely alters its presentation in summary views.

    Also (simultaneously) fixed minor typo: “keep my thought on it” –> “keep my thoughts on it” in Q7.

10.103.4. Source