Not sure people are getting it. If Fukuda (let alone e.g. NICE Guidelines) are capturing 80% + people with PEM why is there a need to change criteria? That is what must be argued and proved for CDC et al. to move on.
I've just re-watched the video and, as you say, Unger says that over 80% of patients who meet the Fukuda CFS definition either 'have' or 'endorse' post-exertional malaise.
...why is there a need to change criteria?
But I think the reasons to separate patients with PEM from patients without PEM has been discussed in this thread.
Many people believe that ME patients, with PEM, have a distinct illness (or at least a group of very similar illnesses) that warrant being segregated for clinical treatment and research purposes. PEM is also one way to attempt to distinguish ME patients from idiopathic fatigue, so people advocate for separation for political and treatment reasons, attempting to separate ME from idiopathic fatigue or fatigue with a psychological basis.
I acknowledge that this is a very complex subject, and our community has clearly failed to successfully advocate that ME should be treated as an illness with a distinct set of symptoms, rather than as part of wide spectrum of fatiguing illnesses. Not because of a lack of effort though.
I remain unconvinced that PEM - physical - is unique to and defining of ME. And I am rather sick to death of hearing debate surrounding 'Pure ME' or even 'Genuine ME'.
(Jane Colby believes that ME is caused by an enterovirus in the gut, and anything else isn't ME. Some people only subscribe to the Ramsay definition of ME, which most patients haven't even heard of, and some subscribe only to the ICC which is a brand new criteria.)
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