I'm sorry but the whole premise of this study is disingenuous and preposterous. The idea that doctors can't distinguish different types of fatigue because they all look the same is laughable. As a severe ME patient, my level of disability is extreme, unfathomable, impossible to grasp even for a person that is dying of cancer. And even I pale in comparison to patients who are so extreme they can't even leave their bed or use their phone at all. You're telling me you need to use AI to look at the granular details to tell that apart from healthy people?! Anyone my age that i know (aside from ME patients) can work 15 hours a day no problem.
The reason doctors can't tell different types of fatigue apart is because they don't think your fatigue is real. They have been trained to think you are complaining about nothing and fatigue is not a medical problem but a psychological one. By the way, that's what they mean by fatigue being caused by "modern lifestyle". Our society is competitive and the losers manifest their discontent as fatigue. That's why there is so much focus on "coping". Social programs are meant to condescendingly handle your "loserness" while the winners run the show. If Elon Musk started complaining about fatigue, no doctor would dare tell him it's because he works 18 hours a day (or however much he claims to work).
As far as medicine is concerned, fatigue is what happens when you are unable to cope with being a loser. That's why doctors show disdain and disgust. A study like this isn't going to change anything, it just adds insult to injury by going with this narrative that doctors can't tell what going on. They can, they just don't care because they think you're either a loser who can't cope or a lunatic.
The only useful behavior to study here is the ones doctors exhibit in front of these patients. If psychology had any scientific merit to it, maybe it could figure out a way to make prejudice within medicine less extreme. But it can't even see its own prejudice, so I'm not very confident it can see any.
The more I look at it, the more it seems like the main problem is differential diagnosis being the one and only model, with no plan B. Technically plan B is the BPS model, which even worse than having no plan B.
And something that bugged me but couldn't identify in the latest RECOVER paper made it all in focus: they made the definition worse, carrying less meaning and understanding, just so it could be a special differentiable snowflake. It's worse, simply because it has to meet the arbitrary criterion of being unique. So if a unique but irrelevant feature, like a skin mark, were to be a feature of ME, medicine would entirely obsess with this skin mark and neglect everything else, because it's the only differentiable feature.
Except most illness isn't unique, certainly doesn't have unique symptoms. But the obsession with this is everywhere. From the start it was "here are the symptoms of COVID", except they are also the symptoms of basically hundreds of illnesses and diseases, and they vary a lot. And most of the media framing over this latest paper is in some form of "here are the 12 symptoms to check out", when in fact those are simply the symptoms that differentiate it somewhat, but not really since so many of us have high scores despite never having had COVID. That it always plays out the same in practice, "X doesn't have this symptom" doesn't seem to bother anyone. It was especially absurd in the first few weeks and months, obsessing over travelling to China or having a very specific cough.
The main interface between patients and physicians is based on a lie, or at best a misunderstanding. That any illness or disease HAS to have unique features, so that it can be differentiated by physicians. But this is not actually a feature of the illnesses, it's a feature for physicians, by physicians. Which is the same problem that the latest "12 symptoms" paper did: it makes all definitions worse, so that it can meet the requirement of being that special snowflake that can be identified at a glimpse.
And that process works fine for most issues. It's the lack of a plan B that breaks everything. If weather science were that foolish, hurricanes wouldn't exist to them, or at least wouldn't be a concern, since there's nothing unique between one hurricane or another, all the damage is common to not only all hurricanes, but in fact many other types of natural disasters. This model is simply absurd in real life.
Far worse is officially using complete BS as if it acts like a plan B, when actually the BPS model is so much worse than no plan at all. This is dogma, arbitrary and capricious, mostly informed by historical needs that don't exist anymore. Most of the diseases medicine worked on before it became scientific were the most obvious, visible ones. They had scabs and pustules and bleeding from many orifices. They were easy to differentiate, and so this is what they focused on. But this legacy requirement, a huge technical debt, carries on even though it's clearly causing more problems than it's solving by now.
But this is fundamental medicine, basically untouchable, it's the cornerstone of all clinical practice. And it would be fine, if it respected the fact that uniqueness is not actually a feature of illness and disease, it's only a shortcut to identify some and is only useful to physicians in a differential diagnosis process, if it applies. And for a while it may have seemed like it covered most health issues, but more and more it looks like it's actually a minority.
Especially when you consider that the exact reverse principle is applied to the BPS model and everything mental health, where merely being unable to differentiate is used to assert one thing or another. "It could be anxiety" basically carries the same weight as 3 independent validated tests. The double standards especially break that process entirely, and is probably behind the obsession with blaming everything on "mental health", where nothing can be differentiated with current technology.
