Healthcare resources used by CFS Patients

[Dolphin]

Productivity losses due to CFS/ME in the UK have been estimated to be more than £100 M per annum [2].

2. Collin SM, Crawley E, May MT, Sterne JA, Hollingworth W. The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database. BMC Health Serv Res. 2011;11(1):217.

There are 100 million pound figures are ridiculously low. It is based on assuming there are 4424 adults with CFS in the UK, which this study itself found is a ridiculous claim.

 

[Dolphin]

We did not have a prior hypothesis about post-diagnosis health care resource use, although this might be expected to fall if diagnosis led to referral and effective treatment.

There isn't effective treatment at the moment at the services.

 

[Dolphin]

Symptoms
Adults
Relative rates of all (any) recorded symptoms were 55-69% higher in cases compared with controls from 6–15 years pre-diagnosis and 1–10 years post-diagnosis, peaking at a >2-fold higher rate in the year of diagnosis (RR 2.34 (2.28, 2.39)) (Table 3, Fig. 3, Additional file 1: Table S4). Relative rates of fatigue symptoms were much higher in cases compared with controls, rising from an 8-fold higher rate 11–15 years pre-diagnosis (RR 8.12 (4.83, 13.7)) to a 22- fold higher rate in the year of diagnosis (RR 21.9 (18.8, 25.5)), then falling to a 4-fold higher rate 6–10 years postdiagnosis (RR 3.75 (3.26, 4.32)).

One way to interpret this is that the patients could have been ill with CFS/ME for many years pre-diagnosis. Another possible alternative interpretation is that they did not have CFS/ME but were not healthy. The particular preponderance of fatigue might suggest that many could have been suffering from undiagnosed CFS/ME

 

[Dolphin]

One can read the peer reviewers' comments here:
https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-017-0635-z/open-peer-review

The 2 peer reviewers were Keith Geraghty and Anna Cheshire. Anna Cheshire worked on the GETSET trial with Peter White but she doesn't mention this.

https://www.westminster.ac.uk/about-us/our-people/directory/cheshire-anna#field_staff_research

Research Projects

[..]

Graded Exercise Therapy guided SElf-help Treatment (GETSET) for patients with chronic fatigue syndrome/myalgic encephalomyelitis: an interview study

 

[Alvin2]

Whats the point of this paper?
I suspect people with many diseases need more medical care, thats what modern medicine is for, to deal with diagnosing and treating medical issues. Anyone who wants to waste money proving this should consider changing careers to something useful like Phrenologist or bowling alley pinsetter

The money spent on writing it would have been better spent donated to OMF.

 

[Londinium]

As others correctly note, looking at the immediate years just prior to diagnosis is fairly pointless as it assumes commencement of the illness and diagnosis occur simultaneously and so is likely to capture GP visits running up to the diagnosis. Looking at the data further back, showing increased healthcare usage up to 15 years prior to diagnosis raises another, related, confounding factor: it can be bloody difficult to get a diagnosis (e.g. the two GPs who refused to diagnose me with ME because "you can't have ME, you're not depressed"). It can take tenacity to keep pushing for an ME diagnosis, with repeated GP visits and patient-instigated consultations. Therefore it's entirely plausible that people who are more comfortable in taking medical issues to the GP and setting up appointments are the ones more likely to push past the "please go away" attitude of some GPs and end up with a diagnosis/referral.

(I sometimes wonder if that also explains the somewhat dubious claims of a "Type A personality" preponderance as well - though prefer to default to the easier explanation that the whole Type A/B thing is just woo to begin with)

 

[Snowdrop]

In socialised medicine one of the problems that leads to so much waste in terms of time effort and money spent on healthcare use is the 7 minute appointment with your GP.
Having the health system pony up for a 45 minute appointment could if fact provide savings in the above mentioned.