Leonard Jason, Julia Newton en anderen
hebben op basis van de DePaul vragenlijst en op basis
van eigen criteria patienten ingedeeld in vier (zelf gedefinieerde) categorieen (zie afbeelding onder):
- onverklaarde chronische vermoeidheid,
- chronische vermoeidheid die verklaard wordt door een medische of psychische aandoening,
- Neuroendocrineimmune Dysfunction Syndrome (NDS) =
"CVS" volgens de definitie van Jason, en
- "ME", volgens de definitie van Jason, die wel strenger is, maar niet lijkt op ME/Ramsay.
Case definitions integrating empiric and consensus perspectives.
Fatigue: Biomedicine, Health & Behavior. 2016 Jan 19. doi: 10.1080/21641846.2015.1124520.
Jason LA, McManimen S, Sunnquist M, Brown A, Furst J, Newton JL, Strand EB.
There has been considerable controversy regarding how to name and define
the illnesses known as myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS).
The Institute of Medicine (IOM) report has proposed
new clinical criteria and a new name for this illness,
but aspects of these recommendations have been scrutinized by patients and scientists.
It is possible that both empiric and consensus approaches could be used
to help settle some of these diagnostic challenges.
Using patient samples collected in the USA, Great Britain, and Norway (N=556),
the current study attempted to categorize patients
using more general as well as more restricted case definitions.
Overall, the outcomes suggest that there might be four groupings of patients,
with the broadest category involving those with chronic fatigue (N=62),
defined by six or more months of fatigue
which cannot be explained by medical or psychiatric conditions.
A second category involves those patients
who have chronic fatigue that can be explained by a medical or psychiatric condition (N=47).
A third category involves
more specific criteria
that have been posited both by
the IOM report, Canadian
Clinical Case criteria, ME-ICC criteria and a more empiric approach.
These efforts have specified domains of substantial reductions of
activity, post-exertional malaise, neurocognitive impairment, and sleep dysfunction
Patients with these characteristics were more functionally impaired
than those meeting just chronic fatigue criteria, p < .05.
Finally, those meeting even more restrictive ME criteria proposed by Ramsay,
identified a smaller and even more impaired group, p < .05.
It is important that scientists world-wide develop consensus on
how to identify and classify patients using clinical and research criteria, and
ultimately develop subtypes within such categories.
Myalgic encephalomyelitis; chronic fatigue syndrome; case definition