G
Gerwyn
Guest
This scenario could apply to a creator of certain english CFS guidelines I portray it as a psychiatrist talking to his imaginary friend and i have added translations to simplyfy the ramblings
Ok guy we need a new definition here that suits us .We dont like the rules of this game so lets change thrm. I know Lets have a meeting and get a deug company to sponsor it
We will start by just concentrating on fatigue of unknown cause but pretend we are nicey nicey
Patients who present with a principal complaint of disabling fatigue of uncertain cause have received much attention in recent years
The meeting (attended by all those listed at the beginning of the paper) was held at Green College, Oxford, on 23 March 1990, and chaired by Professor
Anthony Clare. It was restricted to invited research workers, all of whom had studied patients with CFS
Translation lets make sure the meeting is packed with our mates
Before the meeting all participants (and several others who were unable to attend) were circulated with a questionnaire, and their responses used to
draw up an initial discussion document which formed the basis of discussion during the meeting.
Translation a meeting just with our mates may not be credible so we better use a qustionaire to get some other folks to voice their views
Points on which agreement was reached were
recorded and a draft of this paper circulated to participants
Translation we ignore any dissenting voices.
Signs
There are no clinical signs characteristic of the condition, but patients should be fully examined, and presence or absence of signs reported.
Lets make sure no objective measurements are used we cant fiddle those
Chronic fatigue syndrome (CFS)
a) A syndrome characterized by fatigue as the principal symptom.
b) A syndrome of definite onset that is not life long.
c) The fatigue is severe, disabling, and affects physical and mental functioning.
d) The symptom of fatigue should have been present for a minimum of 6 months during which it was present for more than 50% of the time.
e) Other symptoms may be present, particularly myalgia, mood and sleep disturbance.
f) Certain patients should be excluded from the definition. They include:
~ Patients with established medical conditions known to produce chronic fatigue (eg severe anaemia). Such patients should be excluded whether the medical condition is diagnosed at presentation or only subsequently.
Translation we can exclude any patients that look dodgy later
All patients should have a history and physical examination performed by a competent physician.
Translation Lets not bother with blood tests after all we are competent physicians arent we.
(i)Patients with a current diagnosis of schizophrenia, manic depressive illness, substance abuse, eating disorder or proven organic brain disease. Other psychiatric disorders (including depressive illness, anxiety disorders, and hyperventilation syndrome) are not necessarily reasons for exclusion.
Translation lets include as many depressed patients as we can
Post-infectious fatigue syndrome (PIFS)
Reliable measures of subjective fatigue and of disability are lacking and require development. When reporting studies the reliability of all measures should be assessed and specified whenever possible.
Translation we will define fatigue to suit ourselves
Fatigue
(i) When used to describe a symptom this is a subjective sensation and has a number of synonyms including, tiredness and weariness
Translation lets trivialize this as much as possible
Two aspects of fatigue are commonly reported: mental and physical. Mental fatigue is a subjective sensation characterized by lack of motivation and of alertness. Physical fatigue is felt as lack of energy or strength and is often felt in the muscles.
translationWe will define fatigue as caused by low motivation or something the patient feel in the legs or muscles implying it is psychological of course clever eh
The symptom of fatigue should not be confused with impairment of
performance as measured by physiological or psychological testing. The physiological definition of fatigue is of a failure to sustain muscle force or power output.
Translation this is real fatigue we are not going any where near that
Disability (eg inability to walk) should be distinguished from impairment of function (eg weak legs), and from handicap (eg unable to work).
Translation this should keep the government and the insurance companies happy
Ok guy we need a new definition here that suits us .We dont like the rules of this game so lets change thrm. I know Lets have a meeting and get a deug company to sponsor it
We will start by just concentrating on fatigue of unknown cause but pretend we are nicey nicey
Patients who present with a principal complaint of disabling fatigue of uncertain cause have received much attention in recent years
The meeting (attended by all those listed at the beginning of the paper) was held at Green College, Oxford, on 23 March 1990, and chaired by Professor
Anthony Clare. It was restricted to invited research workers, all of whom had studied patients with CFS
Translation lets make sure the meeting is packed with our mates
Before the meeting all participants (and several others who were unable to attend) were circulated with a questionnaire, and their responses used to
draw up an initial discussion document which formed the basis of discussion during the meeting.
Translation a meeting just with our mates may not be credible so we better use a qustionaire to get some other folks to voice their views
Points on which agreement was reached were
recorded and a draft of this paper circulated to participants
Translation we ignore any dissenting voices.
Signs
There are no clinical signs characteristic of the condition, but patients should be fully examined, and presence or absence of signs reported.
Lets make sure no objective measurements are used we cant fiddle those
Chronic fatigue syndrome (CFS)
a) A syndrome characterized by fatigue as the principal symptom.
b) A syndrome of definite onset that is not life long.
c) The fatigue is severe, disabling, and affects physical and mental functioning.
d) The symptom of fatigue should have been present for a minimum of 6 months during which it was present for more than 50% of the time.
e) Other symptoms may be present, particularly myalgia, mood and sleep disturbance.
f) Certain patients should be excluded from the definition. They include:
~ Patients with established medical conditions known to produce chronic fatigue (eg severe anaemia). Such patients should be excluded whether the medical condition is diagnosed at presentation or only subsequently.
Translation we can exclude any patients that look dodgy later
All patients should have a history and physical examination performed by a competent physician.
Translation Lets not bother with blood tests after all we are competent physicians arent we.
(i)Patients with a current diagnosis of schizophrenia, manic depressive illness, substance abuse, eating disorder or proven organic brain disease. Other psychiatric disorders (including depressive illness, anxiety disorders, and hyperventilation syndrome) are not necessarily reasons for exclusion.
Translation lets include as many depressed patients as we can
Post-infectious fatigue syndrome (PIFS)
Reliable measures of subjective fatigue and of disability are lacking and require development. When reporting studies the reliability of all measures should be assessed and specified whenever possible.
Translation we will define fatigue to suit ourselves
Fatigue
(i) When used to describe a symptom this is a subjective sensation and has a number of synonyms including, tiredness and weariness
Translation lets trivialize this as much as possible
Two aspects of fatigue are commonly reported: mental and physical. Mental fatigue is a subjective sensation characterized by lack of motivation and of alertness. Physical fatigue is felt as lack of energy or strength and is often felt in the muscles.
translationWe will define fatigue as caused by low motivation or something the patient feel in the legs or muscles implying it is psychological of course clever eh
The symptom of fatigue should not be confused with impairment of
performance as measured by physiological or psychological testing. The physiological definition of fatigue is of a failure to sustain muscle force or power output.
Translation this is real fatigue we are not going any where near that
Disability (eg inability to walk) should be distinguished from impairment of function (eg weak legs), and from handicap (eg unable to work).
Translation this should keep the government and the insurance companies happy