Als we de resultaten van een recent onderzoek van Pheby en kollega's mogen doortrekken
Dat is heel wat anders dan 1 op 40 (2,5%) van mensen met "CVS" volgens de Reeves-kriteria!
Prevalence of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in three regions of England: a repeated cross-sectional study in primary care.
BMC Medicine 2011, 9:91. doi:10.1186/1741-7015-9-91.
Nacul LC, Lacerda EM, Pheby D, Campion P, Molokhia M, Fayyaz S, Leite, JCDC, Poland F, Howe A, Drachler ML.
Published: 28 July 2011
ME/CFS or chronic fatigue syndrome (CFS)
has been used to name a range of chronic conditions
characterized by extreme fatigue and other disabling symptoms.
Attempts to estimate the burden of disease have been limited
by selection bias, and
by lack of diagnostic biomarkers and of agreed reproducible case definitions.
We estimated the prevalence and incidence of ME/CFS
in three regions in England, and
discussed the implications of frequency statistics and
the use of different case definitions for
health and social care planning and for research.
We compared the clinical presentation, prevalence and incidence of ME/CFS
based in a sample of 143,000 individuals aged 18 to 64 years,
covered by primary care services in 3 regions of England.
Case ascertainment involved:
- electronic search for chronic fatigue cases;
- direct questioning of general practitioners (GPs)
on cases not previously identified by the search;
- clinical review of identified cases
according to CDC-1994, Canadian and Epidemiological Case (ECD) Definitions.
This enabled the identification of cases with high validity.
The estimated minimum prevalence rate of ME/CFS was
0.2% for cases meeting any of the study case definitions,
0.19% for the CDC-1994 definition,
0.11% for the Canadian definition and
0.03% for the ECD.
The overall estimated minimal yearly incidence was 0.015%.
The highest rates were found in London and the lowest in East Yorkshire.
All cases conforming to the Canadian criteria also met the CDC-1994 criteria
but presented higher prevalence and severity of symptoms.
ME/CFS is not uncommon in England and
represents a significant burden to patients and society.
The number of people with chronic fatigue
who do not meet specific criteria for ME/CFS
is higher still.
have high levels of need for
service provision, including health and social care.
We suggest combining the use of
both the CDC-1994 and Canadian criteria
for ascertainment of ME/CFS cases,
alongside careful clinical phenotyping
of study participants.
This combination if used systematically will enable
minimisation of bias, and
the identification and investigation of
distinct sub-groups of patients
with possibly distinct aetiologies and pathophysiologies,
standing a better chance of
translation into effective specific treatments.