Socioeconomic determinants of ME/CFS in Norway: a registry study, Hilland and Anthun, 2023

Social economic status can change from having ME/CFS, much more often going lower than higher due to decreased economic productivity from the patient working less or not at all and other household members often having to do unpaid labour. This effect could be larger than other conditions on average.

So measuring it at illness onset and many years into the illness could give different results.

 

And G93.3 is "Postviral and related fatigue syndromes", so no guarantee of PEM.

 

Now published:

Free full text:
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-18757-7

• Research
• Open access
• Published: 13 May 2024

Socioeconomic determinants of myalgic encephalomyelitis/chronic fatigue syndrome in Norway: a registry study

• Geir Haakon Hilland &
• Kjartan Sarheim Anthun

BMC Public Health volume 24, Article number: 1296 (2024)

Abstract
Background
Previous research has shown that socioeconomic status (SES) is a strong predictor of chronic disease. However, to the best of our knowledge, there has been no studies of how SES affects the risk of Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) that has not been based upon self-reporting or retrospectively screening of symptoms. As far as we know, this is therefore the first study that isolate and describe socioeconomic determinants of ME/CFS and calculate how these factors relate to the risk of ME/CFS diagnosis by utilizing individual level registry data. This allows for objective operationalization of the ME/CFS population, and makes it possible to model SES affect the risk of ME/CFS diagnosis, relative to control groups.

Data and methods
We conduct a pooled cross-sectional analysis of registry data from all adult patients diagnosed with ME/CFS from 2016 to 2018 in Norway, coupled with socioeconomic data from statistics Norway from 2011 to 2018. We operationalize SES as household income and educational attainment fixed at the beginning of the study period. We compare the effects of SES on the risk of ME/CFS diagnosis to a population of chronically ill patients with hospital diagnoses that share clinical characteristics of ME/CFS and a healthy random sample of the Norwegian population. Our models are estimated by logistic regression analyses.

Results
When comparing the risk of ME/CFS diagnosis with a population consisting of people with four specific chronic diseases, we find that high educational attainment is associated with a 19% increase (OR: 1.19) in the risk of ME/CFS and that high household income is associated with a 17% decrease (OR:0.83) in risk of ME/CFS. In our second model we compare with a healthy population sample, and found that low educational attainment is associated with 69% decrease (OR:0.31) in the risk of ME/CFS and that low household income is associated with a 53% increase (OR: 1.53).

Conclusion
We find statistically significant associations between SES and the risk of ME/CFS. However, our more detailed analyses shows that our findings vary according to which population we compare the ME/CFS patients with, and that the effect of SES is larger when comparing with a healthy population sample, as opposed to controls with selected hospital diagnoses.

 

This seems expected given the difficulties in getting a diagnosis, which is more likely for people who can fight the system and confront GPs who want to run the usual abandonment script. It takes a certain level of privilege to be able to do this, let alone succeed at it.

But it tells us nothing about the socioeconomic determinants of ME/CFS, even less as predictors. This is more a study in the biases inherent in the health care systems than anything having to do with the patients or what is happening to them.

Just like the terrible so-called evidence-based medicine used to justify this disaster, consisting of nothing but highly biased pragmatic trials, is a garbage in garbage out process, so is this. Health care systems refuse to accurately record the data, therefore the data are not reliable. This is all by choice. We can't know anything for sure as long as there is this stubborn refusal to do it right.

 

Is ‘socioeconomic determinants’ what the authors intend to say, as this prejudges the issue and switches ‘associated with’ to ‘causes’?

 

I think they skipped the first semester bachelor presentation of the difference between causation or correlation.

 

Good on them then! My bad to judge before digging deep.

 

They've written a summary on Facebook:

Autotranslated:

Today, Geir and Kjartan from Sintef have published the first register data analysis from Tjenestenog MEg.
In the article, they find a strong statistical association between higher education and being given a G93.3 diagnosis by the specialist health service.
They write that it is unlikely that this is an epidemiological effect of high education on ME risk, although there is still much we do not know about this disease.
The findings can at present be interpreted as those with lower education being less able to ask for, or less likely to receive, a G93.3 diagnosis in an encounter with the specialist health service.
They write that if it should be the case that people with low education have a lower chance of getting an ME diagnosis due to factors associated with poorer "health literacy" and clinical perceptions of patients with low socioeconomic status, then this should be addressed.
More research is needed in this area.

 

Of course more educated people are more likely to be diagnosed with ME/CFS. Because they can do the research and self-advocacy necessary to get diagnosed.

 

The treatment is consideration to prevent deterioration.

What code is there for PEM-ME, or ICC-ME?

 

Doctors hate this one trick