Cheshire
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Natural course of chronic fatigue syndrome/myalgic encephalomyelitis in adolescents
Tom Norris Simon M Collin Kate Tilling Roberto Nuevo Stephen A Stansfeld Jonathan AC Sterne Jon Heron Esther Crawley
http://adc.bmj.com/content/early/2017/01/19/archdischild-2016-311198.full.pdf html
The problem of diagnostic criteria is still a burning question for this study. Althought claiming that they can't say they're studying "CFS/ME" in the text because children haven't been diagnosed by a physician but an entity they call CDF, the title and the text still refer constantly to CFS/ME. More muddling of the water...
And she still uses weakened NICE criteria:
Tom Norris Simon M Collin Kate Tilling Roberto Nuevo Stephen A Stansfeld Jonathan AC Sterne Jon Heron Esther Crawley
Abstract
Objective Little is known about persistence of or recovery from chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in adolescents. Previous studies have small sample sizes, short follow-up or have focused on fatigue rather than CFS/ME or, equivalently, chronic fatigue, which is disabling. This work aimed to describe the epidemiology and natural course of CFS/ME in adolescents aged 13–18 years.
Design Longitudinal follow-up of adolescents enrolled in the Avon Longitudinal Study of Parents and Children.
Setting Avon, UK.
Participants We identified adolescents who had disabling fatigue of >6 months duration without a known cause at ages 13, 16 and 18 years. We use the term ‘chronic disabling fatigue’ (CDF) because CFS/ME was not verified by clinical diagnosis. We used multiple imputation to obtain unbiased estimates of prevalence and persistence.
Results The estimated prevalence of CDF was 1.47% (95% CI 1.05% to 1.89%) at age 13, 2.22% (1.67% to 2.78%) at age 16 and 2.99% (2.24% to 3.75%) at age 18. Among adolescents with CDF of 6 months duration at 13 years 75.3% (64.0% to 86.6%) were not classified as such at age 16. Similar change was observed between 16 and 18 years (75.0% (62.8% to 87.2%)). Of those with CDF at age 13, 8.02% (0.61% to 15.4%) presented with CDF throughout the duration of adolescence.
Conclusions The prevalence of CDF lasting 6 months or longer (a proxy for clinically diagnosed CFS/ME) increases from 13 to 18 years. However, persistent CDF is rare in adolescents, with approximately 75% recovering after 2–3 years.
http://adc.bmj.com/content/early/2017/01/19/archdischild-2016-311198.full.pdf html
The problem of diagnostic criteria is still a burning question for this study. Althought claiming that they can't say they're studying "CFS/ME" in the text because children haven't been diagnosed by a physician but an entity they call CDF, the title and the text still refer constantly to CFS/ME. More muddling of the water...
And she still uses weakened NICE criteria:
The aim of this study was to describe the prevalence of CFS/ME at 18 years and the persistence and recovery of CFS/ME during adolescence. By defining persistent fatigue using a 6 months criterion, we aimed to compare persistence and recovery consistent with the widely used CDC diagnostic criteria for CFS/ME.7 ,16 However, results based on a 3-month criterion of fatigue duration, in line with the NICE diagnostic criteria, will also be presented in the online supplementary material. As children in our study were not examined by a physician, we have used the term ‘chronic disabling fatigue’ (CDF) rather than CFS/ME to indicate chronic fatigue that is disabling.