Unidentified (CFS/ME) is a major cause of school absence: surveillance outcomes from school-based clinics, 2011, Crawley et al

Andy

Andy

Retired committee member
Objective To investigate the feasibility of conducting clinics for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in schools.

Design School-based clinical project.

Participants Children aged 11–16 years were enrolled in three state secondary schools in England.

Main outcome measures Number of children newly diagnosed as having CFS/ME.

Methods Attendance officers identified children missing ≥20% of school in a 6-week term without a known cause, excluding those with a single episode off school, a known medical illness explaining the absence or known to be truanting. Children with fatigue were referred to a specialist CFS/ME service for further assessment. The authors compared children with CFS/ME identified through school-based clinics with those referred via health services. Outcomes of CFS/ME were evaluated at 6 weeks and 6 months.

Results 461 of the 2855 enrolled children had missed ≥20% school over a 6-week period. In 315, of whom three had CFS/ME, the reason for absence was known. 112 of the 146 children with unexplained absence attended clinical review at school; two had been previously diagnosed as having CFS/ME and 42 were referred on to a specialist clinic, where 23 were newly diagnosed as having CFS/ME. Therefore, 28 of the 2855 (1.0%) children had CFS/ME. Children with CFS/ME identified through surveillance had been ill for an amount of time comparable to those referred via health services but had less fatigue (mean difference 4.4, 95% CI 2.2 to 6.6), less disability (mean difference −5.7, 95% CI −7.9 to −3.5) and fewer symptoms (mean difference 1.86, 95% CI 0.8 to 2.93). Of 19 children followed up, six had fully recovered at 6 weeks and a further six at 6 months.

Conclusions Chronic fatigue is an important cause of unexplained absence from school. Children diagnosed through school-based clinics are less severely affected than those referred to specialist services and appear to make rapid progress when they access treatment.
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Open access, https://bmjopen.bmj.com/content/1/2/e000252

Reason for posting above
The “Ethics approval” statement in this article has been amended to read:

Ethics approval: The clinical service in this study was provided as an outreach from the Bath specialist CFS/ME service. The North Somerset & South Bristol Research Ethics Committee decided that the collection and analysis of data from children and young people seen by the specialist CFS/ME service as part of service evaluation did not require ethical review by an NHS research ethics committee or approval from the NHS R&D Office (REC reference number 07/Q2006/48).
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https://bmjopen.bmj.com/content/9/11/e000252corr1

@dave30th
 
The “Ethics approval” statement in this article has been amended to read:

Ethics approval: The clinical service in this study was provided as an outreach from the Bath specialist CFS/ME service. The North Somerset & South Bristol Research Ethics Committee decided that the collection and analysis of data from children and young people seen by the specialist CFS/ME service as part of service evaluation did not require ethical review by an NHS research ethics committee or approval from the NHS R&D Office (REC reference number 07/Q2006/48).
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Is that true?

I didn't think that the Ethics committee were asked about data from children and young people?
 
Is this the original reference number to the letter relating to anonymous service evaluation of existing adult service provision that Crawley inappropriately used for the eleven separate studies recently investigated by Bristol at the instigation of the HRA?

I am not on the ball today, but did that investigation go as far as saying that this original letter was appropriate justification for avoiding any ethical approval for this research evaluating a paediatric screening service?
 
David Tuller's blog: Today I can disclose that the scrutiny involves papers linked to a specific research ethics committee (REC) reference: 07/Q2006/48. That is the number of a 2007 REC opinion issued for a study titled “What happens to children with CFS/ME? The study of a longitudinal cohort of children who access a paediatric CFS/ME service. Version 2.” The investigators were seeking permission to add some more questionnaires to those already being filled out by (or about) pediatric patients at the specialized Bath clinic run by Professor Crawley.
 
Hold up isn't that the complete opposite? That the review panel has found that ethical approval should have been sought because it should have been classified as research? Which it clearly was. Do service evaluation even need to get REC approval? The original article is still classified under pediatrics research!

When you read the original article, the summary is literally "hypothesis" and "research question".

What is this double-whitewash nonsense? Those are not the droids we are looking for? That Jedi mind trick does not work in this universe, all it adds up to is literal hand-waving. Yet again those magical optional requirements that BPS research is exempted from.
 
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