Examining the Institute of Medicine's Recommendations Regarding CFS: Clinical Vs Research Criteria

[Dolphin]

Free full text: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/27595126/

Examining the Institute of Medicine's Recommendations Regarding Chronic Fatigue Syndrome: Clinical Versus Research Criteria.

J Neurol Psychol. 2015;2015(Suppl 2). pii: http://www.avensonline.org/wp-content/uploads/JNP-2332-3469-S2-0002.pdf. Epub 2015 Nov 25.

Jason LA1, McManimen S1, Sunnquist M1, Brown A1, Newton JL2, Strand EB3.


Abstract
The Institute of Medicine (2015) has proposed a new clinical case definition for what had been known as chronic fatigue syndrome (CFS).

This new criteria involved the following domains: substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities; post-exertional malaise; unrefreshing sleep; and at least one of the two following symptoms: cognitive impairment or orthostatic intolerance.

In addition, in August of 2015, the CFS Advisory Committee, which makes recommendations to the Secretary of US Department of Health and Human Services, proposed that the Canadian 2003 criteria should serve as the research case for CFS.

Up to now, there have not been any published investigations comparing these clinical and research criteria. Using patient samples collected in the United States, Great Britain, and Norway, the current study compared and contrasted patients who met the clinical and research criteria.

Overall findings indicated that those meeting the research criteria in comparison to those meeting the clinical criteria were significantly more impaired on a wide variety of symptoms and functional areas.

The implications of these findings are discussed.

KEYWORDS:
Myalgic Encephalomyelitis; case definition; chronic fatigue syndrome

PMID: 27595126

PMCID: PMC5008852

 

[Dolphin]

I have read a lot of Leonard Jason's papers. There was not much new in the text that I saw.

At the present time, there will be considerable debate concerning the usefulness of the newly-proposed IOM criteria. But ultimately, the research community needs to explore with data the ways these new criteria compare with past ones, as well as how the clinical criteria might differ from a research criteria. This is a healthy discussion and there might be other ways of classifying patients with these types of complex illnesses. For example, rather than classifying patients into the clinical criteria based on the IOM criteria, we might classify patients into the following categories: patients with exclusionary psychiatric or medical illness; and patients who meet IOM criteria, but who do not have psychiatric or medical exclusions. It is still unclear whether a broad category of those who meet the IOM criteria without exclusionary illnesses is the best clinical case definition.

 

[Dolphin]

I have read a lot of Leonard Jason's papers. There was not much new in the text that I saw.

I think all of the data is in the tables.

It is a little interesting how the Canadian group (all but 0.6% must also satisfy IoM) have higher symptom scores in every single category, with all but three of these being statistically significant differences.

 

[Skippa]

Dolphin, thank you for continually posting all these papers re CFS.

It is clear that you don't just post them, but actually read them all too!

That means, imho, you are probably a candidate for the world's foremost expert on ME/CFS!