Medscape: "New Clinical Practice Guidelines, August 2018 Edition"

I saw this on the Medscape website today. I think it's just a summary of recent changes posted on CDC website but I'm not sure.

Full article (may require Medscape registration/login) - https://reference.medscape.com/viewarticle/900291_5

 

You'd think with 7 authors, someone would have noticed.

Agreed it's a very nice summary. Hopefully they will fix the cut-off ending. I'd like to share this with some doctors when it's corrected.

I sent quick notes to WebMD (ETA: and Medscape) editors. If they don't respond, I will send notes to the authors.

Edit: Still no response from editorial, so I will start contacting the 7 authors one by one until I get a response.

 

Just spoke on the phone with one of the listed article authors (turns out he's an editor), Brian Feinberg. Brian said he would take care of getting it fixed and send me an email when it's done.

 

Looks like the article has been fixed. The final sentence now reads: "Each patient’s program typically includes a combination of therapies to address symptoms, techniques to help patients cope, and strategies to manage daily activities."

 

I understand you may prefer not to but Medscape logins can be had by anyone, it's a free sign-up.

 

This one is the same as discussed here, https://s4me.info/threads/medscape-cfs-linked-to-low-t3-syndrome-by-miriam-tucker.3261/

 

Selected excerpts from the CFS series of pages

Under Epidemiology

Quoting this bit in full as it's less good

References are
14 - Longitudinal follow-up of employment status in patients with chronic fatigue syndrome after mononucleosis, 2014, Nyland et al, https://bmjopen.bmj.com/content/4/11/e005798
15 & 16 - The prognosis of chronic fatigue and chronic fatigue syndrome: a systematic review., 1997, Joyce J; Hotopf M; Wessely S, https://reference.medscape.com/medline/abstract/9093600

All pages say they were updated Aug 9th 2018. Apart from the couple of uses of CSF when CFS is meant, and the prognosis bit, my scan through tells me that otherwise it's pretty much as we would want it at the moment.

 

Sure a load of stakeholders said GET should go, but NICE themselves haven’t yet changed their recommendation for GET. Sadly.

 

A Revised Approach for Chronic Fatigue Syndrome | The Morning Report

Medscape

Published on Dec 12, 2018
Currently, chronic fatigue syndrome, which is now called myalgic encephalomyelitis syndrome or ME/CFS, has no cure. But a recent summit concluded that there is much we can do to improve patients' symptoms and quality of life. The multispecialty group endorsed the 2015 Institute of Medicine diagnostic criteria of unexplained fatigue with substantial functional impairment, postexertional malaise, unrefreshing sleep, and either cognitive dysfunction or orthostatic intolerance.

https://www.youtube.com/watch?v=nv2X74TgaV4

 

But the 2015 IOM (NAM) proposed diagnostic criteria actually say:

So, is it substantial functional impairment with fatigue (IOM), or fatigue with substantial functional impairment (Medscape)? These are not equivalent and the distinction is important.

Medscape is not alone in this. UpToDate, Healthwise, even Cort's recent blog characterize ME/CFS as primarily a fatigue disorder. But that is not what the IOM report says.

Here's how the CDC breaks down the first IOM ME/CFS diagnostic criterion:

Note that the CDC bolds functional impairment and places it first, but does not bold fatigue which is also under a subcategory.