From the rest of wine-o-saur's response:
"Given that CFS simply sounds like a formalised statement of 'you're tired all the time', whereas SEID is more specific ('you're disproportionately tired anytime you do something stressful'), I'd say it's an improvement there too.
The diagnostic criteria have also been trimmed down (and no longer include things like myalgia, headaches, or frequent sore throats) and place stronger emphasis than before on post-exertion malaise and unrefreshing sleep.
I think CFS is far more susceptible to the charge of being a catch-all 'bad patient' category, while SEID appears at least to be the result of a concerted effort to refine that category. Whether this impacts diagnosis patterns or clinician attitudes remains to be seen.
So here's where we end up, as far as I can see:
- Diagnostic/Hippocratic - These people need some kind of medical help, so it is right that there is some diagnosis available to them.
- Nosological/Research - The classification has at least the potential to refine the existing classified population, and thus provide a novel population against which to compare controls or populations of individuals with different but similar diagnoses.
- Prognostic/treatment - No novel implications. However, a more focused set of symptoms does have the potential to refine the diagnosed population into one with a more homogenous treatment response in future research.
So not a huge win, but it seems to me that this is pretty much the only way that medical knowledge progresses from initial discovery to differentiation to (hopefully) effective treatment/management of symptoms and/or discovery of underlying pathology.
Of course any situation in which we have to admit ignorance is less than ideal, but thinking through the issue over the course of this discussion, I feel as though the reclassification does represent some progress, however small or unrealised it may be.
If you've made it this far, I'd be interested to hear what you think. "