A critical analysis of the proposal of the Institute of Medicine
to replace Myalgic Encephalomyelitis and Chronic Fatigue Syndrome
by a new diagnostic entity called Systemic Exertion Intolerance Disease.
Curr Med Res Opin. 2015 Apr 27. doi: 10.1185/03007995.2015.1045472.
Twisk FNM.
Abstract
The Institute of Medicine (IOM) recently published their report
in response to an assignment
'to define diagnostic criteria for
Myalgic Encephalomyelitis (ME)/chronic fatigue syndrome (CFS),
to propose a process for reevaluation of these criteria in the future, and
to consider whether a new name for this disease is warranted'.
The basic preassumption of the IOM committee
for the development of evidence-based diagnostic criteria for ME/CFS
was that ME and CFS denote conditions with similar symptoms,
hence ME/CFS.
The IOM committee recommends
1 that ME/CFS will be
renamed "systemic exertion intolerance disease" (SEID); and
that a new code should be assigned to SEID
in the International Classification of Diseases (ICD),
replacing the existing codes for ME (a neurological disease: G93.3)
and CFS ("signs, symptoms, and abnormal clinical and
laboratory findings, not elsewhere classified": R53.82).
2 that a diagnosis SEID should be made
if the new diagnostic criteria are met;
3 that the Department of Health and Human Services develops a toolkit
appropriate for screening and diagnosing patients; and
4 that a multidisciplinary group re-examines the new diagnostic criteria
when necessary.
This editorial reviews
the working procedure of the IOM and
two of the outcomes:
the recommendation to introduce
a new clinical entity (SEID) and new diagnostic criteria.
Based upon
the contents of the report, and
the arguments of the IOM,
a search of PubMed and
the archive of the Journal of Chronic Fatigue Syndrome
using the search terms ME (and old synonyms) and CFS, and
a search of PubMed related to the five core symptoms of SEID
was conducted.
Reviewing the working method and
the recommendations,
it is concluded
that the new diagnostic criteria for SEID
are based upon important methodological shortcomings and
that the introduction of SEID to replace both ME and CFS
has several profound negative consequences
outweighing the advantages.
Keywords:
Myalgic Encephalomyelitis, chronic fatigue syndrome, systemic exertion
intolerance disease, diagnosis, assessment, methodology.
Summary:
http://informahealthcare.com/…/10.1185/03007995.2015.1045472
Full-text (proof):
http://informahealthcare.com/…/10.1185/03007995.2015.1045472
