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Measuring fatigue in clinical and community settings.

Discussion in 'Latest ME/CFS Research' started by Dolphin, Dec 25, 2010.

  1. Dolphin

    Dolphin Senior Member

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    Probably not the most exciting research for most people. But the Chalder fatigue scale is used in a lot of CFS research including as one of the two primary outcome measures in the PACE Trial.

  2. Dolphin

    Dolphin Senior Member

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    The main reason I'm posting this is that I noticed something about this paper which I appeared to be a dubious claim. In the end, I was too busy to letter to the editor. Here's what I wrote to somebody at the time when I was wondering whether to write a letter or not. I used the 2.5% prevalence figure because of the following:


  3. Enid

    Enid Senior Member

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    It is unbelievable that measuring fatigue by psychiatrists sheds light on the pathology of ME or indeed aids.
  4. oceanblue

    oceanblue Senior Member

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    I'm not sure that discriminating between healthy people and those with ME is a particularly impressive acheivement. How could a fatigue scale not discriminate between those with Chronic Fatigue Syndrome and healthy individuals?? Surely a better test would be the ability to distinguish between CFS and people with an illness that is only moderately fatiguing, such as arthritis. Lenny Jason's work here is interesting looking at the specifc nature of fatigue eg post-exertional fatigue, and the ability of such measures to discriminate between ME and other types of ill health.
  5. Dolphin

    Dolphin Senior Member

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    This study was used to define normal fatigue for the PACE Trial paper in the Lancet (main one) and the recovery paper.
    They used a sample of people who had attended their GP in the last year:

    I happened to see the following on Twitter today:

    This would suggest the sample is likely not representative at all.
    Valentijn, WillowJ and Purple like this.
  6. Simon

    Simon

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    I wonder what their source is? This huge study [p16] looking at GP practices with 1 million patients in 95/6, close to the time the Cella data was collected, gives an average of 2 consultations a year for men aged 18-40 (its much higher for older men). Unless those 15% of men are visiting their GP more than once a month the figures don't tally.

    A 2009 poll of 3,000 men for a prostate cancer charity reported:
    Those average number of visits are well short of those found by the much larger study - I'm guessing that most people's recall of the number of times they visited their surgery in the last year might not be that accurate.

    I suspect a bigger bias is that, statistically, those who go to see their doctor many times a year (and so are likely to be sicker) were much more likely to be included the fatigue sample than those who only visit their doctor once a year.
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  7. Dolphin

    Dolphin Senior Member

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    Thanks for the extra info, Simon. It certainly makes me suspect the 15% figure.

    Do we have reason to think this? I thought it was simply sent by post to people who had attended in the previous twelve months.
  8. Esther12

    Esther12 Senior Member

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    The 15% figure seems low to me too... but it could be that the consensus figures (around 50%+?) are unduly high because healthy young men who move around and don't see their doctors are also the sort of people likely to be harder to poll.

    Getting reliable figures for population norms seems really difficult.
    Valentijn likes this.
  9. Simon

    Simon

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    Yes:
    -In stage 1 the survey was mailed to many thousands of registered patients
    -In stage 2 they took 1,000 patients attending with a suspected viral illness, together with the next non-viral patient after each viral patient (another 1,000). Obviously, the more often you went to the doctor, the more likely you were to be in either cohort.
    - the CFQ scores used in the study were the stage 1 survey scores of those who were included in stage 2

    More here
  10. Dolphin

    Dolphin Senior Member

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    Thanks. I recalled the thread but not the details. I should probably have looked back at that before replying to the latest PACE Trial paper to help with the criticism of the use of <=18 as a threshold for recovery.

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