Bob
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It seems that I've been making some false assumptions about NICE.
I had thought that NICE only recommended the CDC criteria, but it seems that NICE does not insist on any particular criteria being used, but gives details on a range of them, and NICE does not seem to give special prominence to one particular criteria.
They include a mention of the Oxford Criteria in the NICE Guidelines.
So it seems that the PACE Trial is relevant to CFS/ME, as recognised by NICE.
That's rather depressing.
(Diagnostic criteria have always confused the hell out of me.)
Here are some extracts from the NICE full guidelines about diagnostic criteria...
5.2.1 Evidence statements
Key clinical question 1
5.2.1.1 Evidence to substantiate existing case definitions of CFS or ME is
limited. No studies have established the superiority of one case
definition over another (Evidence level 2).
5.2.1.2 Community-based studies have indicated that patients meeting CDC
1994 criteria form a more heterogeneous group than patients
meeting CDC 1988 criteria (Evidence level 2).
5.2.1.3 There is currently limited evidence that patients meeting Dowsett ME
or the Canadian criteria are more likely to have more symptoms than
those meeting CDC 1994 criteria (Evidence level 2).
5.2.2 Clinical evidence summary
5.2.2.1 Summary of evidence presented in Appendix 1 Question 1 part 1
diagnostic criteria
The Oxford Criteria of CFS/ME, developed in 1991 by a panel of clinicians and
scientists, defined CFS/ME as a syndrome in which fatigue has been present for at
least six months, during which time it has been present more than 50 per cent of the
time. Other symptoms may also be present, such as myalgia, and mood and sleep
disturbance.27
In 1994, new criteria were drawn up by the US Centers for Disease Control (CDC),
the 1994 CDC/Fukuda CFS Criteria.28 The CDC definition included the requirement
of the presence of new-onset fatigue lasting at least 6 months and the presence of at
least four of eight other physical symptoms.
Australian 2002: Recommend (with provisos or alterations)
Canadian 2003: Would not recommend
UK 2002 (CMO Report): Recommend (with provisos or alterations)
http://guidance.nice.org.uk/nicemedia/live/11824/36191/36191.pdf
I had thought that NICE only recommended the CDC criteria, but it seems that NICE does not insist on any particular criteria being used, but gives details on a range of them, and NICE does not seem to give special prominence to one particular criteria.
They include a mention of the Oxford Criteria in the NICE Guidelines.
So it seems that the PACE Trial is relevant to CFS/ME, as recognised by NICE.
That's rather depressing.
(Diagnostic criteria have always confused the hell out of me.)
Here are some extracts from the NICE full guidelines about diagnostic criteria...
5.2.1 Evidence statements
Key clinical question 1
5.2.1.1 Evidence to substantiate existing case definitions of CFS or ME is
limited. No studies have established the superiority of one case
definition over another (Evidence level 2).
5.2.1.2 Community-based studies have indicated that patients meeting CDC
1994 criteria form a more heterogeneous group than patients
meeting CDC 1988 criteria (Evidence level 2).
5.2.1.3 There is currently limited evidence that patients meeting Dowsett ME
or the Canadian criteria are more likely to have more symptoms than
those meeting CDC 1994 criteria (Evidence level 2).
5.2.2 Clinical evidence summary
5.2.2.1 Summary of evidence presented in Appendix 1 Question 1 part 1
diagnostic criteria
The Oxford Criteria of CFS/ME, developed in 1991 by a panel of clinicians and
scientists, defined CFS/ME as a syndrome in which fatigue has been present for at
least six months, during which time it has been present more than 50 per cent of the
time. Other symptoms may also be present, such as myalgia, and mood and sleep
disturbance.27
In 1994, new criteria were drawn up by the US Centers for Disease Control (CDC),
the 1994 CDC/Fukuda CFS Criteria.28 The CDC definition included the requirement
of the presence of new-onset fatigue lasting at least 6 months and the presence of at
least four of eight other physical symptoms.
Australian 2002: Recommend (with provisos or alterations)
Canadian 2003: Would not recommend
UK 2002 (CMO Report): Recommend (with provisos or alterations)
http://guidance.nice.org.uk/nicemedia/live/11824/36191/36191.pdf