Unable to edit on my device
Assuming this is still going please add
25% of patients severely or very severely affected
Citation: IOM report
https://www.nap.edu/read/19012/chapter/4?term=25+percent#32
25% of patients housebound, bedbound or reliant on wheelchairs
Citation: IOM report
https://www.nap.edu/read/19012/chapter/4?term=25+percent#32
Some patients too ill to even attempt to stand or to complete a simple questionnaire
Citation:
"Defining the prevalence and symptom burden of those with self-reported severe chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a two-phase community pilot study in the North East of England"
https://doi.org/10.1136/bmjopen-2017-020775
Bias:
Some measures of illness used in CFS cannot represent further deterioration
eg Chalder Fatigue Syndrome
Use of Oxford criteria
"For every 15 patients selected under Oxford criteria, 14 will be false positives when compared to Canadian Consensus Criteria. The Pace trial and FINE trial used Oxford criteria."
"When studies using the broad Oxford criteria (Sharpe et al., 1991) were excluded, a virtual disappearance of effect for graded exercise therapy (GET), cognitive behaviour therapy (CBT) and other psychological therapies recommended by the NICE guidelines (National Institute for Health and Care Excellence (NICE), 2007) was revealed. "
both from
How have selection bias and disease misclassification undermined the validity of myalgic encephalomyelitis/chronic fatigue syndrome studies? 2017 Journal of Health Psychology: 1359105317695803. doi:10.1177/1359105317695803
Furthermore, the multiple case definitions for ME/CFS have hindered progress. In particular, continuing to use the Oxford definition may impair progress and cause harm. Therefore, for progress to occur, we recommend that this definition be retired; the ME/CFS community concur on a single case definition (even if it is not perfect); and patients, clinicians, and researchers agree on a definition for meaningful recovery.
Citation:
Green, C. R., Cowan, P., Elk, R., O'Neil, K. M., & Rasmussen, A. L. (2015). National institutes of health pathways to prevention workshop: advancing the research on myalgic encephalomyelitis/chronic fatigue syndrome.
Annals of Internal Medicine,
162(12), 860-865.
https://annals.org/aim/fullarticle/...-advancing-research-myalgic-encephalomyelitis
Wessely et al.’s 1990s’ RCT reported a 50-per cent recovery rate at trial end, yet only a 26-per cent recovery rate at 5-year follow-up and most of the patients classed as ‘recovered’ continued to report considerable problems with fatigue (Deale et al., 2001). A sister trial of the PACE trial, the FINE trial, found no substantive benefits over standard care using home-based nurse-provided CBT-GET in CFS patients at 70 weeks (Wearden et al., 2010). Across RCTs, recovery rates are inconsistent, do not mirror objective scoring of improvement and fall away over the long term.
Citation:
The ‘cognitive behavioural model’ of chronic fatigue syndrome: Critique of a flawed model
https://journals.sagepub.com/doi/10.1177/2055102919838907
Thus the Oxford criteria designated about 10-fold more females and males as CFS compared to the Fukuda criteria. This stark difference suggests that studies using the Oxford criteria have investigated largely mild fatigue and recruited fewer than 10% of “true” CFS subjects. Over 90% of Oxford CFS subjects were false positives when subsequently assessed using the more rigorous quadrant and Fukuda criteria.
Using Oxford criteria, CFS was designated in 19.9% of women (n = 297) (Table 2). These women were then divided into 5 groups by quadrant analysis and the HealthStyles exclusionary conditions. Astonishingly, one quarter (25.6%) of the Oxford CFS women fell into the healthy control quadrant.
Both from Baraniuk
Chronic Fatigue Syndrome prevalence is grossly overestimated using Oxford criteria compared to Centers for Disease Control (Fukuda) criteria in a U.S. population study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407870/
Bias & Media bias
"By having a role on the [PACE trial] Steering Committee and Management Group, there was a de facto endorsement of the use of £5m of research funding to focus on behavioural treatments. Neither I nor the current Board of Trustees would agree to do this now, as reflected by our current research strategy, the focus of which is collaborative biomedical research.
I am sorry that the charity did not advocate for this considerable level of funding to be invested in biomedical research instead. It was never our intention to contribute to any stigma or misunderstanding about the illness and I sincerely apologise to those who feel that, in not speaking out sooner and more strongly, we have caused harm."[54]
Sonya Chowdhury, Chief Executive, Action for ME, Aug 2017
https://www.actionforme.org.uk/news/pace-trial-and-behavioural-treatments-for-me/
A literature search identified all papers published on chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME) in the Lancet between 1995 and 2000. Analysis of the findings revealed a bias towards the views of one school of thought and a lack of papers on the immunological or virological aspects of CFS. The lack of balance contrasts with the mainstream American journals, which generally covered a much wider range of subjects and views. We examine the arguments against covert editorial policies, and illustrate how the present situation in the UK is undermining the medical profession’s understanding of both CFS and ME.
Citation:
Chronic Fatigue Syndrome: Editorial Bias in The Lancet (2005)
http://www.axfordsabode.org.uk/me/lanbias1.htm