Prevalence, Incidence, and Classification of Chronic Fatigue Syndrome in Olmsted County, Minnesota, as Estimated Using the Rochester Epidemiology Project

Vincent, Ann; Brimmer, Dana; Whipple, Mary O.; Jones, James F.; Boneva, Roumiana S.; Lahr, Brian D.; Maloney, Elizabeth M.; Sauver, Jennifer L. St.; Reeves, William C.

doi:10.1016/j.mayocp.2012.08.015

Cited by 39 publications

(42 citation statements)

References 22 publications

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“…A relatively high proportion (47%) of the registry patients had exclusionary conditions identified after clinical evaluation. This finding replicates other CFS studies in which 50 - 70% of patients who met symptom criteria were found to have medical or psychiatric exclusions [3,16,17]. Future research needs to examine the potential for detecting treatable medical exclusionary conditions among people suffering from fatiguing illnesses because treatment may improve fatigue and associated symptoms for many of these patients.…”

Section: Discussionsupporting

confidence: 80%

“…Sixty-five percent of referred patients had CFS, which replicates similar findings from the CFS Rochester Epidemiology Project in which 66% of patients were accurately coded into the CFS category [17]. For an illness that has no known etiology or biomarkers, a fairly high level of knowledge and awareness was shown for providers who referred two-thirds of patients diagnosed with CFS at clinical evaluation.…”

Section: Discussionsupporting

confidence: 66%

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A pilot registry of unexplained fatiguing illnesses and chronic fatigue syndrome

et al. 2013

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BackgroundChronic fatigue syndrome (CFS) has no diagnostic clinical signs or biomarkers, so diagnosis requires ruling out conditions with similar signs and symptoms. We conducted a pilot registry of unexplained fatiguing illnesses and CFS to determine the feasibility of establishing and operating a registry and implementing an education outreach initiative. The pilot registry was conducted in Bibb County, Georgia. Patient referrals were obtained from healthcare providers who were identified by using various education outreach initiatives. These referrals were later supplemented with self-referrals by members of a local CFS support group. All patients meeting referral criteria were invited to participate in a screening interview to determine eligibility. If patients met registry criteria, they were invited to a one-day clinic for physical and laboratory evaluations. We classified patients based on the 1994 case definition.ResultsWe registered 827 healthcare providers. Forty-two providers referred 88 patients, and 58 patients (66%) completed clinical evaluation. Of the 188 CFS support group members, 53 were self-referred and 46 (87%) completed the clinical evaluation. Of the 104 participants completing evaluation, 36% (n = 37) met the criteria for CFS, 17% (n = 18) had insufficient fatigue or symptoms (ISF), and 47% (n = 49) were found to have exclusionary medical or psychiatric illnesses. Classification varied significantly by type of referral but not by previous history of CFS diagnosis. Healthcare providers referred more patients who were classified as CFS as compared to support group referrals in which more exclusionary conditions were identified. Family practice and internal medicine specialties made the most referrals and had the highest number of CFS cases. We conducted three CME events, held three “Meet and Greet” sessions, visited four large clinical health practices and health departments, mailed five registry newsletters, and conducted in-person office visits as part of education outreach, which contributed to patient referrals.ConclusionsReferrals from healthcare providers and self-referrals from the patient support group were important to registry enrollment. The number of potentially treatable conditions that were identified highlights the need for continued medical management in this population, as well as the limitations of registries formed without clinical examination. Education initiatives were successful in part because of partnerships with local organizations.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 66%

A pilot registry of unexplained fatiguing illnesses and chronic fatigue syndrome

et al. 2013

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“…In other words, structured interview schedules remove the unreliability introduced by differences in the way clinicians elicit clinical information. As an example, Vincent et al (2012) reported that just 36% of Fukuda patients had PEM, whereas Maes et al (2012) reported that 50% of Fukuda CFS patients had PEM. As one example of an instrument, Jason, Evans, et al (2010) published the DePaul Symptom Questionnaire (DSQ), comprised of questions regarding health, social and occupational history, as well as a 54-item symptom chart, designed to tap all of the symptoms of the Fukuda et al (1994) CFS case definition, the empiric criteria of Reeves et al (2005), the ME/CFS Canadian criteria (Carruthers et al, 2003), and the ME (Carruthers et al, 2011; Jason, Damrongvachiraphan, et al, 2012).…”

Section: Resultsmentioning

confidence: 99%

Defining Essential Features of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome

Jason¹,

Sunnquist²,

Brown³

et al. 2015

Journal of Human Behavior in the Social Environment

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Considerable debate surrounds the search for the defining features of patients with Myalgic Encephalomyelitis (ME) and chronic fatigue syndrome (CFS). Current case definitions were created through clinical consensus. Failure to operationalize these case definitions has led to considerable variability in the identification of patients. In addition, some case definitions (e.g., Fukuda et al., 1994) do not require cardinal symptoms of this illness, where as other case definitions do require core symptoms of this illness (Carruthers et al., 2003, 2011), and these latter case criteria appear to identify a more impaired group of patients. Criterion variance is most likely to occur when operationally explicit criteria do not exist for diagnostic categories (Spitzer, Endicott, & Robins, 1978), or when there are varying criteria for contrasting case definitions, which is an impediment to the research in this field. To deal with this problem, it is possible to differentiate those that meet more loosely defined criteria from those that are more narrowly and defined, thus differentiating CFS from ME. In order to progress the search for biological markers and effective treatments, essential features need to be operationalized and broadly used in order to increase the probability that individuals included in samples have the same underlying illness.

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“…In an American population study, the Centers for Disease Control (CDC) found that for every patient with CDC defined CFS, there were at least twice as many with fatigue that did not meet CFS criteria and many more with fatigue secondary to another condition . A number of studies have found that a substantial minority of people diagnosed as having CFS have alternative explanations for their symptoms when carefully worked up …”

Section: Chronic Fatigue Syndrome or Myalgic Encephalomyelitis?mentioning

confidence: 99%

“…Some 10% of people complain of chronic fatigue, whereas the prevalence of CFS is estimated at less than 1% . Inevitably, it is difficult to differentiate CFS from other causes of chronic fatigue, and it is notable that there is no point of rarity between severe CFS and fatigue, with fatigue being a continually distributed symptom …”

Section: Introductionmentioning

confidence: 99%

A perspective on causation of the chronic fatigue syndrome by considering its nosology

White

2019

Evaluation Clinical Practice

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The causes of chronic fatigue syndrome (CFS) remain unknown, with many failures to replicate new findings. This may be because the condition is hard to diagnose, difficult to classify, or because of its heterogeneous nature. Authors have problems in differentiating CFS from myalgic encephalomyelitis (ME), which leads many to label it as a hybrid CFS/ME or ME/CFS. Attempts to validate the many published criterion‐based definitions have ended in failure. The International Classification of Diseases provide several different descriptions to choose from, although the latest 11th edition has narrowed this down. This paper describes conventional attempts to define and classify the illness, suggesting that this may be what leads to a failure to replicate putative causes. The approach to CFS/ME may require a shift in the assumption that the illness is homogeneous. An alternative approach is provided by studies suggesting that the condition is heterogeneous. Conclusion The way forward may be to be over‐inclusive regarding the diagnosis as a first step, while subdividing the condition into likely subgroups as a means of finding valid and reliable associations with potential causes. Studies of aetiology must involve prospective designs since cross‐sectional studies cannot inform either aetiology or pathophysiology.

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Prevalence, Incidence, and Classification of Chronic Fatigue Syndrome in Olmsted County, Minnesota, as Estimated Using the Rochester Epidemiology Project

Cited by 39 publications

References 22 publications

A pilot registry of unexplained fatiguing illnesses and chronic fatigue syndrome

A pilot registry of unexplained fatiguing illnesses and chronic fatigue syndrome

Defining Essential Features of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome

A perspective on causation of the chronic fatigue syndrome by considering its nosology

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