Also childhood atopy is something else most children grow out of it
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"Increased Risk of Chronic Fatigue Syndrome Following Atopy: A Population-Based Study."
- Thread starter Kyla
- Start date
Also childhood atopy is something else most children grow out of it
I find this difficult to interpret. I'd find it more helpful to know the rate of atopy in ME patients.
So a fifty percent increase in atopy rates compared to healthy controls
Bob
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I still can't interpret this. The figures refer to the rate of ME/CFS in atopy patients, and I don't find this illuminating. I'd rather know the rate of atopy in ME/CFS patients. Ignoring the methodological weaknesses that have been pointed out in this thread, the figures suggest that more atopy patients have ME/CFS than in the normal population, but they tell us little else. Even without the methodology weaknesses discussed, it doesn't seem to tell us anything particularly significant. Or am I missing something? Maybe I'm over complicating things for myself, but the figures are still meaningless for me to interpret; i.e. What does "1.37 per 1000 person-year" actually mean?The overall incidence rate of CFS was higher in the atopy cohort compared with the nonatopy cohort (1.37 versus 0.87 per 1000 person-year), with an adjusted hazard ratio of 1.48 (95% confidence interval 1.30-1.69).
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I still can't interpret this. ... What does "1.37 per 1000 person-year" actually mean?
“Person-years” is a statistic for expressing incidence rates—it is the summing of the results of events divided by time. In many studies, the length of exposure to the treatment is different for different subjects, and the patient-year statistic is one way of dealing with this issue.
The calculation of events per patient-year(s) is the number of incident cases divided by the amount of person-time at risk. The calculation can be accomplished by adding the number of patients in the group and multiplying that number times the years that patients are in a study in order to calculate the patient-years (denominator). Then divide the number of events (numerator) by the denominator.
* Example: 100 patients are followed for 2 years. In this case, there are 200 patient-years of follow-up.
* If there were 8 myocardial infarctions in the group, the rate would be 8 MIs per 200 patient years or 4 MIs per 100 patient-years.
The rate can be expressed in various ways, e.g., per 100, 1,000, 100,000, or 1 million patient-years. In some cases, authors report the average follow-up period as the mean and others use the median, which may result in some variation in results between studies.
Another example: Assume we have a study reporting one event at 1 year and one event at 4 years, but no events at year 2 and 3. This same information can be expressed as 2 events/10 (1+2+3+4=10) years or an event rate of 0.2 per person-year.
An important issue is that frequently the timeframe for observation in studies reporting patient-years does not match the timeframe stated in the study. Brian Alper of Dynamed explains it this way: “If I observed a million people for 5 minutes each and nobody died, any conclusion about mortality over 1 year would be meaningless. This problem occurs whether or not we translate our outcome into a patient-years measure. The key in critical appraisal is to catch the discrepancy between timeframe of observation and timeframe of conclusion and not let the use of ‘patient-years’ mistranslate between the two or represent an inappropriate extrapolation.”[1]
See bolded bitAs an interesting aside, after I was diagnosed as CFS, by another doctor years later, my allergist let it be known that he didn't "believe" in CFS. A few years later a close friend of his, a doctor, lost his practice to, you guessed it, CFS. My allergist changed his mind...able to believe his doctor friend, though he hadn't been able to believe me.
Fam Pract. 2005 Aug;22(4):389-93. Epub 2005 Apr 1.
Chronic Fatigue Syndrome: a survey of GPs' attitudes and knowledge.
Bowen J1, Pheby D, Charlett A, McNulty C.
Author information
Abstract
BACKGROUND:
GPs need evidence and guidance to help them diagnose and manage Chronic Fatigue Syndrome (CFS)/ME appropriately.
OBJECTIVES:
The aim of this survey was to obtain baseline data and identify the factors associated with GPs' attitudes to and knowledge of CFS/ME. The attitude of GPs to the condition is an important indicator of likely prognosis.
METHODS:
A postal questionnaire was sent to 1054 GPs served by Taunton, Bristol and Gloucester laboratories. GPs' attitudes to nine statements about CFS/ME were assessed and the factors associated with positive or negative responses were determined. Knowledge of the clinical features was also assessed.
RESULTS:
811 GPs (77%) returned the questionnaire. 48% of GPs did not feel confident with making a diagnosis of CFS/ME and 41% did not feel confident in treatment. 72% of GPs accepted CFS/ME as a recognisable clinical entity and those GPs had significantly more positive attitudes. Three other key factors that were significantly, positively associated with GPs' attitudes were knowing someone socially with CFS/ME, being male and seeing more patients with the condition in the last year.
CONCLUSION:
Despite the publication of guidance for GPs on CFS/ME, confidence with making a diagnosis and management was found to be low. Educational initiatives and guidance for GPs should stress the importance of accepting CFS/ME as a recognisable clinical entity, as this is linked to having a positive attitude and could lead to improved confidence to make a diagnosis and treat CFS/ME patients.
PMID:
15805128
[PubMed - indexed for MEDLINE]
Free full text http://fampra.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=15805128
People can improve attitudes by making sure professionals now they are ill (which won't happen if somebody hides their illness).
One issue with these types of studies is that cases of ME/CFS could have been missed and so one isn't seeing truly new cases of ME/CFS.
I'll give an example: if one looks at the charts of people with ME/CFS (say year 2000) a year before they were diagnosed (say year 1999), one might find higher than normal rates of depression during 1999. While it could certainly be true that depression is a risk factor for ME/CFS, an alternative view of the data would be that many of the supposedly new cases of ME/CFS in year 2000 actually already had ME/CFS in 1999 and either their symptoms were misinterpreted as depression and/or they got some sort of secondary depression from struggling with the illness. If it's the scenario that many people actually had ME/CFS in 1999, then one can't say anything about risk factors.
This is important if ME/CFS could lead to the supposed risk factor. Although there doesn't seem to be a massive increase in atopy* in ME/CFS, given that the risk found in this case isn't so huge, it is possible that ME/CFS might cause such an increase and so one isn't see a true risk factor. Alternatively it may be true.
Better definitive tests for ME/CFS will help us eventually be able to get more conclusive data from such studies.
*although intolerances do seem to increase a lot
I'll give an example: if one looks at the charts of people with ME/CFS (say year 2000) a year before they were diagnosed (say year 1999), one might find higher than normal rates of depression during 1999. While it could certainly be true that depression is a risk factor for ME/CFS, an alternative view of the data would be that many of the supposedly new cases of ME/CFS in year 2000 actually already had ME/CFS in 1999 and either their symptoms were misinterpreted as depression and/or they got some sort of secondary depression from struggling with the illness. If it's the scenario that many people actually had ME/CFS in 1999, then one can't say anything about risk factors.
This is important if ME/CFS could lead to the supposed risk factor. Although there doesn't seem to be a massive increase in atopy* in ME/CFS, given that the risk found in this case isn't so huge, it is possible that ME/CFS might cause such an increase and so one isn't see a true risk factor. Alternatively it may be true.
Better definitive tests for ME/CFS will help us eventually be able to get more conclusive data from such studies.
*although intolerances do seem to increase a lot
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The full text of this paper is now available for free at: http://journals.lww.com/md-journal/...ased_Risk_of_Chronic_Fatigue_Syndrome.36.aspx