The research questions
should guide the study protocol. Data can be collected retrospectively
from the medical record or other sources, or prospectively
from the patient. In the latter case, complementary data also
can be obtained from the medical record or other sources.
Retrospective studies of phenomena that are inherently subjective,
such as fatigue, usually are problematic because fatigue is
often inadequately assessed and the notes written by physicians
and nurses are unlikely to provide a valid and reliable record
of a patient's experience. For this reason, retrospective
studies of the phenomenon are not preferred.
of information about fatigue would yield credible data only
if the symptom was systematically evaluated as an integral
aspect of clinical practice. For example, the routine administration
of a symptom assessment scale to all patients admitted to
a hospital unit might yield some credible information about
fatigue that could be captured through a retrospective review.
collection from the patient is the "gold standard" for surveys
of subjective phenomena. The challenge in these surveys is
to design a questionnaire packet and an assessment protocol
that will yield high recruitment and completion rates, and
will also adequately address the specific aims of the study.
include a case definition for fatigue and other information
that defines the study population. Eligible patients complete
one or more questionnaires. In most cases, it is appropriate
to include a multidimensional fatigue scale, supplemented
by other questions about fatigue or related phenomena, as