A Predictive Model for Fatigue and Its Etiologic Associations in Primary Biliary Cirrhosis  Julia L. Newton, Jessie Pairman, Kathryn Sutcliffe, Katharine Wilton, David E.J. Jones  Clinical Gastroenterology and Hepatology  Volume 6, Issue 2, Pages 228-233 (February 2008) DOI: 10.1016/j.cgh.2007.11.021 Copyright © 2008 AGA Institute Terms and Conditions

Figure 1 Predictive value of ESS (solid line) and OGS (dashed line) scores for the presence of moderate or severe fatigue in PBC patients in the derivation cohort 1 assessed by receiver operating characteristic analysis. ESS area under the curve, 0.82 (95% CI, 0.74–0.79); OGS area under the curve, 0.78 (95% CI, 0.70–0.87); both P < .0001. Clinical Gastroenterology and Hepatology 2008 6, 228-233DOI: (10.1016/j.cgh.2007.11.021) Copyright © 2008 AGA Institute Terms and Conditions

Figure 2 (A and B) Numbers of PBC patients within the derivation cohort with no fatigue (defined as scores within the range for no or mild fatigue using previously described criteria) and with fatigue (scores within the previously described range for moderate or severe fatigue) who achieve (pos) and do not achieve (neg) the diagnostic criteria for (A) significant symptoms suggestive of daytime somnolence (ESS ≥10) and (B) significant symptoms suggestive of vasomotor autonomic dysfunction (OGS ≥4). (C) Correlation between ESS and OGS scores in individual patients. Dashed lines denote ESS ≥10 and OGS ≥4. (D) Numbers of fatigued and nonfatigued PBC patients (defined as stated earlier) within the development cohort who achieve (pos) and do not achieve (neg) the composite predictive criterion. (A) χ2, 23.8; P < .0001; positive predictive value, 0.92 (0.78–0.98); negative predictive value, 0.55 (0.44–0.66); sensitivity, 0.47 (0.35–0.59); specificity, 0.94 (0.84–0.99). (B) χ2, 18.2; P < .0001; positive predictive value, 0.83 (0.69–0.92); negative predictive value, 0.55 (0.44–0.67); sensitivity, 0.53 (0.41–0.65); specificity, 0.84 (0.71–0.93). (D) χ2, 32.0; P < .0001; positive predictive value, 0.84 (0.72–0.92); negative predictive value, 0.66 (0.53–0.78); sensitivity, 0.71 (0.59–0.81); specificity, 0.80 (0.67–0.90). Clinical Gastroenterology and Hepatology 2008 6, 228-233DOI: (10.1016/j.cgh.2007.11.021) Copyright © 2008 AGA Institute Terms and Conditions

Figure 3 Percentage of PBC patients in the development cohort with PBC-40 Fatigue domain scores suggestive of no, low, moderate, and high fatigue who were identified using the fatigue etiology predictive criterion. χ2, 49.6; P < .0001. Clinical Gastroenterology and Hepatology 2008 6, 228-233DOI: (10.1016/j.cgh.2007.11.021) Copyright © 2008 AGA Institute Terms and Conditions

Figure 4 PBC-40 Fatigue domain scores in patients in the development cohort who were positive and negative for the fatigue etiology diagnostic criterion. Median values (solid lines) are denoted for both groups. The dashed line denotes the cut-off value between mild and moderate fatigue. P < .0001. Clinical Gastroenterology and Hepatology 2008 6, 228-233DOI: (10.1016/j.cgh.2007.11.021) Copyright © 2008 AGA Institute Terms and Conditions

Figure 5 PBC-40 Fatigue domain scores in PBC-40 patients meeting the diagnostic criterion for ESS abnormality alone (ESS, ≥10), OGS alone (OGS, ≥4), both ESS and OGS, and for neither. Median values are denoted for all groups. The solid horizontal line denotes the mild/moderate fatigue boundary and the dashed lines denote the none/mild and moderate/severe boundaries. ***P < .0001 versus neither. Clinical Gastroenterology and Hepatology 2008 6, 228-233DOI: (10.1016/j.cgh.2007.11.021) Copyright © 2008 AGA Institute Terms and Conditions

Figure 6 Distribution of fatigue severity and its causes/associated features in the whole study cohort. Clinical Gastroenterology and Hepatology 2008 6, 228-233DOI: (10.1016/j.cgh.2007.11.021) Copyright © 2008 AGA Institute Terms and Conditions