Contrasting CFS versus ME/CFS

[Ember]

Fatigue: Biomedicine, Health & Behavior

Contrasting chronic fatigue syndrome versus myalgic encephalomyelitis/chronic fatigue syndrome

DOI: 10.1080/21641846.2013.774556

Leonard A. Jason, Abigail Brown, Meredyth Evans, Madison Sunnquist & Julia L. Newton

Received: 23 Nov 2012
Accepted: 05 Feb 2013
Version of record first published: 20 Mar 2013

http://www.tandfonline.com/doi/abs/10.1080/21641846.2013.774556

Abstract

Background: Much debate is transpiring regarding whether chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME) are different illnesses. Several prior studies that compared the Fukuda et al. CFS criteria to the Canadian ME/CFS criteria found that the Canadian criteria identified patients with more functional impairments and greater physical, mental, and cognitive problems than those who met Fukuda et al. criteria. These samples were located in the Chicago metropolitan area, so the results could not be generalized to other locations. In addition, past studies used a symptom questionnaire that was not specifically developed to tap the Canadian criteria.

Purpose: The present comparative study of CFS and ME/CFS criteria was intended to correct the limitations of prior studies.

Methods: This article used data from three distinct samples to compare patients who met criteria for the ME/CFS Canadian clinical case definition to those who met the Fukuda et al. CFS case definition.

Results: Findings indicated that fewer individuals met the Canadian criteria than the Fukuda et al. criteria. Those who met the Canadian criteria evidenced more severe symptoms and physical functioning impairment.

Conclusions: Future research should continue to compare existing case definitions and determine which criteria best select for this illness.

 

[Sasha]

Good to see a UK researcher (Prof Newton, who gets MERUK funding) involved in this.

 

[heapsreal]

There will always be a debate and no definitive answers until biomarkers at least are found. Otherwise i just find these types of threads put us against one another and also some type of competition over someone saying they are sicker then another. But I do think these types of threads show how important it is to do more research to find good biomarkers and diagnosis. Questionares and criteria's are never very accurate in my opinion unfortunately.

 

[Ember]

Given the importance of validating case definitions, studying the ICC would have been useful as well. The CCC is a decade old now, and Fukuda is almost twice its age. The ICC further develops the CCC strategy:

Other earlier and revised case definitions based on the disease concepts of Ramsay had made postexertional malaise and impairment of memory and concentration central to the diagnosis of ME (Lloyd AR et al Med J Aus., 153: 522-528, Goutsmit, E et al Health Psycholog. Update 18:27-31), but none before the Canadian Definition of 2003 had made this specific dynamic and projectable pattern of pathological fatigue criterial for the diagnosis of ME/CFS, and the ICC case definition of ME is carrying on and developing this strategy further (http://investinme.org/Documents/Journals/Journal of IiME Vol 6 Issue 1 Screen.pdf).

Case definitions drive all the research, including the search for biomarkers.

 

[caledonia]

Rich would have said, have them take the HDRI methylation panel and see how well their methylation cycle is functioning (that would be the biomarker). Everything else is just sort of....political.

 

[xchocoholic]

I'm at the point where I think they need to abolish the terms CFS and ME/CFS completely and start looking for root causes of each of our symptoms. Then use these diagnosises or test results to determine what we have in common. Knowing this might help us determine how to remedy our "CFS".

Getting Lymies on the right treatment would be the first priority.

I have a long list of diagnosises now that I didn't have when I was just under the CFS umbrella term used by traditional doctors. Things like celiac, Hashimoto's, hyperinsulinemia, digestive enzyme deficiency, POTS, etc etc .. These are just the tests my integrative doctor ran that I understand. I don't know everything she's learned about my body. I'd love to understand what these doctors know about their CFS patients.

tc ... x

 

[Dolphin]

Given the importance of validating case definitions, studying the ICC would have been useful as well. The CCC is a decade old now, and Fukuda is almost twice its age. The ICC further develops the CCC strategy:
Case definitions drive all the research, including the search for biomarkers.

The ICC was looked at in this paper: http://forums.phoenixrising.me/inde...teria-vs-the-fukuda-et-al-cfs-criteria.24865/

 

[Ember]

The ICC was looked at in this paper: http://forums.phoenixrising.me/inde...teria-vs-the-fukuda-et-al-cfs-criteria.24865/

This paper has already been discussed here.

 

[Dolphin]

I've read this. I found it a pity that as well as looking at CFS vs ME/CFS within each of the three samples, they didn't also combine the three samples to get averages and then compare. Somebody could probably do it to an extent, although might be hard/impossible to work out SDs.

 

[Dolphin]

Of the 392 with ME/CFS (Carruthers et al., 2003) in the study, only one didn't satisfy the Fukuda et al. criteria.

 

[Dolphin]

SF-36 and symptom results summary:

In summary, all samples showed significantly worse Physical Functioning and Bodily Pain scores for the ME/CFS group. In addition, both the BioBank and Newcastle samples showed significantly worse General Health and Social Functioning scores for the ME/CFS group. Only the BioBank sample showed significantly worse scores for the ME/CFS group for the Mental Health and Vitality subscales. No significant differences were found in any of the samples for the Role Physical or Role Emotional subscales.

Table 3 lists the Fukuda et al. and Canadian criteria symptoms. The symptoms are categorized into the following groups: Fatigue, Post-Exertional Malaise, Sleep, Pain, Neurological, Autonomic, Neuroendocrine, and Immune, based on the symptom categories described in the Canadian criteria. All MANOVAs for the DePaul and BioBank samples were significant, and univariate tests revealed that the ME/CFS group had significantly worse scores for 51 of the 54 symptoms analyzed in the DePaul sample and for all 54 items in the BioBank sample. The Newcastle ME/ CFS group had significantly worse scores for 28 of the 54 items compared to the CFS group. Across all three samples, most of the significant items were significant at the p < 0.001 level. For those items that were not significantly different, the ME/CFS group had directionally worse scores than the CFS group, with the exception of two items in the Newcastle sample (problems falling asleep and alcohol intolerance).