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Issues in Estimating Rates of Pediatric CFS and ME in a Community-Based Sample
- Thread starter Dolphin
- Start date
I didn't find this very interesting.
The main thing I found interesting was the discussion of exclusions and the like:
The main thing I found interesting was the discussion of exclusions and the like:
Ultimately, both researchers and clinicians will need to decide which case definition to use for clinical and study purposes. There are now multiple case definitions, and there is need for a consensus definition for clinical as well as research purposes. Aside from the two detailed cases studies presented, we have also examined youth who present with a wide range of reasons for their impairment, and it is possible that different case definitions will select different youth. For example, some youth fulfilled the IOM (27) case definition, but also had exclusionary conditions so did not meet the Fukuda et al. (20) or Canadian (24) criteria. In addition, as we screen youth, a number met criteria for one or more case definitions, but some seemed too active to be given a diagnosis of CFS or ME (e.g., one child played soccer every day which causes joint/muscle pain, while another child’s symptoms were due to the fact that she plays water polo 3 hours daily). The child who played soccer came home exhausted and appeared to have major cognitive problems in the evening due to exhaustion, and also evidenced significant evening post-exertional malaise. He then had to stay up late to complete his homework and, as a result, did not get enough sleep and evidenced sleep difficulties. While this child might have met one of the case definitions, it was apparent that he was a healthy child who was over doing his level of sports involvement and did have CFS or ME.
Other children met the Fukuda et al. (20) less effective than the criteria but did not endorse post-exertional malaise (e.g., one child felt better after exercise). A variety of other reasons seemed to well describe other youth’s symptoms, including: health (e.g., medication for depression caused one child headaches and was related to his inactivity/unwillingness to be involved in activities), long day/busy schedule (some children were very busy or had long days, or were involved in a lot of activities during school and after), poor sleep hygiene (e.g., some children had difficulty regulating their sleep schedule, and this is leading to fatigue or other symptoms), mild symptomatology (e.g., some children’s symptoms were mostly mild and/or occur infrequently), lack of parental concern (e.g., some parents felt that their children’s fatigue was normal for the amount of activity they are doing), weight (e.g., the child's BMI is 31.9, the 96th percentile for age, indicating obesity), poor diet (e.g., one child had fatigue due to not eating properly), and inactivity (e.g., one child was inactive by choice, preferred to play video games, and was not interested in physical activity). According to the IOM (27) definition, such issues are classified as co-morbidities, whereas for the Fukuda et al. (20) and Carruthers et al. (24) criteria, they would be more likely to be considered exclusionary. More work needs to be conducted comparing the different case definitions. There are few studies in the pediatric literature that have made these types of comparisons. However, in one study, Jason et al. (6) compared two case definitions in a group of 33 children and adolescents thought to have pediatric CFS and 21 without. Findings suggested the Fukuda et al. (20) criteria are less effective than the Pediatric criteria in correctly diagnosing pediatric CFS.
The article seems to be from 2015 but I don't recall seeing it before now so I am glad you have posted it @Dolphin .
On reflection that sentence is perhaps of greater significance than at first assumed.
It looks wrong. The construction of the sentence appears to indicate an intention, at some stage of the process, to state that the child did not have ME or CFS. This has been altered, either intentionally inadvertently.
If the error be a typo it has escaped the attention of seven co authors, peer reviewers and journal editor. That would say something about the process.
If it be the intended view of the authors, then they are expressly stating that "a healthy child who was overdoing his level of sports involvement ... did have CFS or ME." This view might not be unexpected if stated within a radius of,say, one hundred miles of London, but from a team led by Jason it would be of concern.
It calls into question the whole concept of chronic illness, which, at least in general usage is expected to be both of lengthy duration and resistant to treatment. If one considers a condition to be caused by overdoing the level of sports activity, it is a strange world where the child is diagnosed with CFS rather than being advised to curtail the said activity. I must admit to being old fashioned about these ideas.
It looks wrong. The construction of the sentence appears to indicate an intention, at some stage of the process, to state that the child did not have ME or CFS. This has been altered, either intentionally inadvertently.
If the error be a typo it has escaped the attention of seven co authors, peer reviewers and journal editor. That would say something about the process.
If it be the intended view of the authors, then they are expressly stating that "a healthy child who was overdoing his level of sports involvement ... did have CFS or ME." This view might not be unexpected if stated within a radius of,say, one hundred miles of London, but from a team led by Jason it would be of concern.
It calls into question the whole concept of chronic illness, which, at least in general usage is expected to be both of lengthy duration and resistant to treatment. If one considers a condition to be caused by overdoing the level of sports activity, it is a strange world where the child is diagnosed with CFS rather than being advised to curtail the said activity. I must admit to being old fashioned about these ideas.
On reflection that sentence is perhaps of greater significance than at first assumed.
It looks wrong. The construction of the sentence appears to indicate an intention, at some stage of the process, to state that the child did not have ME or CFS. This has been altered, either intentionally inadvertently.
If the error be a typo it has escaped the attention of seven co authors, peer reviewers and journal editor. That would say something about the process.
If it be the intended view of the authors, then they are expressly stating that "a healthy child who was overdoing his level of sports involvement ... did have CFS or ME." This view might not be unexpected if stated within a radius of,say, one hundred miles of London, but from a team led by Jason it would be of concern.
I think it is a typo based on my reading of the paper and knowledge of Lenny Jason.