The NIH Final Report: "Pathways to Prevention Workshop: Advancing the Research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Executive Summary:
https://prevention.nih.gov/sites/de.../programs/mecfs/ODP-P2P-MECFS-FinalReport.pdf
Some interesting points from this report; workshop date December 9-10, 2014:
Page 16 - "Conclusions...
" Furthermore, the multiple case definitions for ME/CFS have hindered progress.
Specifically, continuing to use the Oxford definition may impair progress and cause harm. Thus, for needed progress to occur we recommend (1) that the Oxford definition be retired, (2) that the ME/CFS community agree on a single case definition (even if it is not perfect), and (3) that patients, clinicians, and researchers agree on a definition for meaningful recovery..."
Page 2: "Unfortunately, ME/CFS is an area where the research and health care community has frustrated its constituents, by failing to appropriately assess and treat the disease and by allowing patients to be stigmatized....ME/CFS clearly exists though there is an absence of a universally accepted definition."
Page 3: "Strong evidence indicates immunologic and inflammatory pathologies, neurotransmitter signaling disruption, micorobiome perturbation, and metabolic or mitochondrial abnormalities in ME/CFS that are potentially important for defining and treating ME/CFS.... There are few disease-specific clinical trials; a disconnect on ways patients, clinicians, and researchers define meaningful outcomes..."
Page 4: "The scientific community also has a responsibility to address issues that are meaningful to ME/CFS patients."
Page 5: "Although psychological repercussions (e.g., depression) may accompany ME/CFS,
it is not a primary psychological disease in etiology..... Although
focusing on fatigue alone may identify many ME/CFS cases, it
does not capture the essence of this complex condition. Prior studies may have inadequately excluded individuals with these distinct diseases, leading to delayed or conflicting diagnoses, contradictory treatments, suboptimal care, and inappropriate health care utilization. Future studies that aim to better define cellular and molecular mechanisms for targeted treatments should distinguish between ME/CFS alone, ME/CFS with comorbidities, and other diseases."
Page 7: "The failure to give adequate attention to the severity of the physical, social, and emotional impact of ME/CFS has caused harm and diminished hope....End points need to be clarified: what is statistically significant, what is clinically significant, and what is significant to the patient."
Page 8 and 9: "The symptoms patients consider clinically meaningful are not in the scientific literature; this discordance must be rectified...Overall, there has been a failure to implement what we already know for ME/CFS patients while the disease steals their health and well-being. Scientifically rigorous research is needed to improve this situation. The subjective nature of ME/CFS, associated stigma, and lack of a 9 standard case definition has stifled progress. Patients must be at the center of the research efforts, and their engagement is critical, as is outreach to underserved and vulnerable populations."
Page 9: "Innovative biomedical research is urgently needed to identify risk and therapeutic targets. The scientific community and funding agencies responsible for conducting trials in an ethical way that is meaningful for patients. The influence of health literacy and cognitive impairment on informed consent must be considered. Investigators have a responsibility to hear the patient’s perspective, engage the community, and be accountable for translating and reporting research results to the ME/CFS community while responding to their feedback."
Page 15: "
Patients should be active participants in care and decision-making."
(my bolding)