The Brief Fatigue Inventory (BFI) is a brief instrument for measuring fatigue in patients with cancer. It provides a rapid assessment that can identify patients with severe fatigue. The authors are from the M.D. Anderson Cancer Center in Houston.


NOTE: The form for the BFI (Figure 1) page 1189 is copyrighted by the University of Texas M.D. Anderson Cancer Center.


Number of items: 9, plus an introductory question


The first 3 items dealing with feelings of fatigue (right now, usual level, worst level) over the past 24 hours. These 3 items are graded from 0 (no fatigue) to 10 (as bad as you can imagine)


The next 6 items dealing with various activities of daily living, relationships or quality of life experienced over the previous 24 hours. These 6 items are graded from 0 (does not interfere) to 10 (completely interferes)


brief inventory index =

= SUM(points for all 9 items) / 9



• minimum index:: 0

• maximum index: 10

• The higher the index, the greater the fatigue.

• Scoring the index when not all of the questions are answered needs to be clarified. Since the completion rate was very high (98%) this may be a minor issue.

• Identification of severe fatigue using a score >= 7 appears reliable (see pages 1194-1195) but separation of mild and moderate fatigue was less clearcut.



Level of Fatigue



1 to 3 (or 4)


4 (or 5) to 6


7 to 10



The use of an average score has certain advantages but also can mask a small number of extreme scores. An alternative scoring method used for other scores would be to convert the total score to a percent of maximal.


percent of maximal fatigue =

= SUM(points for all 9 items) / 90 * 100%



• Almost all patients are able to complete the questionnaire.

• The index is internally stable (reliable) measure for severe fatigue. The Cronbach alpha was 0.95 to 0.96.

• It correlates highly with other measures of fatigue (page 1193).


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