Chronic fatigue syndrome and myalgic encephalomyelitis: towards an empirical case definition (Jason)

Dolphin

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Free full text: http://www.tandfonline.com/doi/full/10.1080/21642850.2015.1014489#abstract

Chronic fatigue syndrome and myalgic encephalomyelitis: towards an empirical case definition

Health Psychology and Behavioral Medicine: An Open Access Journal

Volume 3, Issue 1, 2015

Leonard A. Jasona*, Bobby Kota, Madison Sunnquista, Abigail Browna, Meredyth Evansa, Rachel Jantkea, Yolonda Williamsa, Jacob Fursta & Suzanne D. Vernonb

Received: 19 Nov 2014
Accepted: 19 Jan 2015
Published online: 20 Feb 2015

Abstract

Current case definitions of myalgic encephalomyelitis and chronic fatigue syndrome (CFS) have been based on consensus methods, but empirical methods could be used to identify core symptoms and thereby improve the reliability.

In the present study, several methods (i.e. continuous scores of symptoms, theoretically and empirically derived cut off scores of symptoms) were used to identify core symptoms best differentiating patients from controls.

In addition, data mining with decision trees was conducted.

Our study found a small number of core symptoms that have good sensitivity and specificity, and these included fatigue, post-exertional malaise, a neurocognitive symptom, and unrefreshing sleep.

Outcomes from these analyses suggest that using empirically selected symptoms can help guide the creation of a more reliable case definition.

Keywords

myalgic encephalomyelitits,
chronic fatigue syndrome,
biomarkers,
case definitions
 

Dolphin

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Our study found a small number of core symptoms that have good sensitivity and specificity, and these included fatigue, post-exertional malaise, a neurocognitive symptom, and unrefreshing sleep.
These criteria are similar to IoM criteria.
 

Dolphin

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They are using a different name and OI is notably absent.
They are an independent group and the paper was submitted before the IoM report was published.

Orthostatic intolerance is absent like you say. But if one has neurocognitive symptoms, one would automatically satisfy the IoM's criteria of neurocognitive symptoms or orthostatic intolerance.
 

melamine

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They are an independent group
What I'm wondering is, will there now be two different diseases with similarities in criteria but different names, one of which has ICC and CCC case definition and much research associated with its name, and one of which has none as of yet? Will future research continue dividing along these lines and using whatever name whoever is doing the research chooses? Will research reflect IOM rather than ICC/CCC? Is SEID in fact the chosen name and is the systemic laziness it implies to some of us considered a better option than chronic fatigue? The article here even features fatigue as one of 4 diagnostic characteristics.

I realize from reading many responses to the choice of the name SEID that systemic laziness is not what comes to mind for everyone, but I'm afraid it sounds even more ridiculous to enough others that if not for the legitimizing recognition of a certain collection of symptoms, this "new" illness is going to confront the same prejudice with respect to its new name. I'm not even sure how accurately SEID reflects the symptom it is trying to represent because of the way it was chosen to satisfy a consensus of experiences (of that class of symptom) in a heterogeneous population. How many healthy people think of the act of standing up or socializing for an hour as "exertion"?
 

Dolphin

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What I'm wondering is, will there now be two different diseases with similarities in criteria but different names, one of which has ICC and CCC case definition and much research associated with its name, and one of which has none as of yet? Will future research continue dividing along these lines and using whatever name whoever is doing the research chooses? Will research reflect IOM rather than ICC/CCC? Is SEID in fact the chosen name and is the systemic laziness it implies to some of us considered a better option than chronic fatigue? The article here even features fatigue as one of 4 diagnostic characteristics.
I'm not going to try to answer this except to say that this latest paper by Lenny Jason probably doesn't have the status to be used for lots of research by itself.
 

Ember

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These criteria are similar to IoM criteria.
As Dr. Bateman indicates, "The clinical diagnostic criteria in the report are core symptoms drawn directly from the published ME/CFS literature—much of which came from Dr. L. Jason’s works and the CDC multi-site study...."
 

melamine

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As Dr. Bateman indicates, "The clinical diagnostic criteria in the report are core symptoms drawn directly from the published ME/CFS literature—much of which came from Dr. L. Jason’s works and the CDC multi-site study...."
Dr Bateman:
"I hope we leave name change deliberations in the dust and focus on the people who are ill."

Before or after a name change? If before (for now) I would certainly agree.
 
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Dolphin

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From the chart, Fukuda is the most sensitive? It's more sensitive than the four question one which is similar to the IOM criteria.
The SEID criteria are broader (and hence more sensitive) than the empirical criteria as the empirical criteria involve only single questions from the neurocognitive. sleep, etc domains.