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Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review

OBJECTIVE: To identify case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and explore how the validity of case definitions can be evaluated in the absence of a reference standard. DESIGN: Systematic review. SETTING: International. PARTICIPANTS: A literature search, upd...

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Autores principales: Brurberg, Kjetil Gundro, Fønhus, Marita Sporstøl, Larun, Lillebeth, Flottorp, Signe, Malterud, Kirsti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918975/
https://www.ncbi.nlm.nih.gov/pubmed/24508851
http://dx.doi.org/10.1136/bmjopen-2013-003973
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author Brurberg, Kjetil Gundro
Fønhus, Marita Sporstøl
Larun, Lillebeth
Flottorp, Signe
Malterud, Kirsti
author_facet Brurberg, Kjetil Gundro
Fønhus, Marita Sporstøl
Larun, Lillebeth
Flottorp, Signe
Malterud, Kirsti
author_sort Brurberg, Kjetil Gundro
collection PubMed
description OBJECTIVE: To identify case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and explore how the validity of case definitions can be evaluated in the absence of a reference standard. DESIGN: Systematic review. SETTING: International. PARTICIPANTS: A literature search, updated as of November 2013, led to the identification of 20 case definitions and inclusion of 38 validation studies. PRIMARY AND SECONDARY OUTCOME MEASURE: Validation studies were assessed for risk of bias and categorised according to three validation models: (1) independent application of several case definitions on the same population, (2) sequential application of different case definitions on patients diagnosed with CFS/ME with one set of diagnostic criteria or (3) comparison of prevalence estimates from different case definitions applied on different populations. RESULTS: A total of 38 studies contributed data of sufficient quality and consistency for evaluation of validity, with CDC-1994/Fukuda as the most frequently applied case definition. No study rigorously assessed the reproducibility or feasibility of case definitions. Validation studies were small with methodological weaknesses and inconsistent results. No empirical data indicated that any case definition specifically identified patients with a neuroimmunological condition. CONCLUSIONS: Classification of patients according to severity and symptom patterns, aiming to predict prognosis or effectiveness of therapy, seems useful. Development of further case definitions of CFS/ME should be given a low priority. Consistency in research can be achieved by applying diagnostic criteria that have been subjected to systematic evaluation.
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spelling pubmed-39189752014-02-11 Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review Brurberg, Kjetil Gundro Fønhus, Marita Sporstøl Larun, Lillebeth Flottorp, Signe Malterud, Kirsti BMJ Open Diagnostics OBJECTIVE: To identify case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and explore how the validity of case definitions can be evaluated in the absence of a reference standard. DESIGN: Systematic review. SETTING: International. PARTICIPANTS: A literature search, updated as of November 2013, led to the identification of 20 case definitions and inclusion of 38 validation studies. PRIMARY AND SECONDARY OUTCOME MEASURE: Validation studies were assessed for risk of bias and categorised according to three validation models: (1) independent application of several case definitions on the same population, (2) sequential application of different case definitions on patients diagnosed with CFS/ME with one set of diagnostic criteria or (3) comparison of prevalence estimates from different case definitions applied on different populations. RESULTS: A total of 38 studies contributed data of sufficient quality and consistency for evaluation of validity, with CDC-1994/Fukuda as the most frequently applied case definition. No study rigorously assessed the reproducibility or feasibility of case definitions. Validation studies were small with methodological weaknesses and inconsistent results. No empirical data indicated that any case definition specifically identified patients with a neuroimmunological condition. CONCLUSIONS: Classification of patients according to severity and symptom patterns, aiming to predict prognosis or effectiveness of therapy, seems useful. Development of further case definitions of CFS/ME should be given a low priority. Consistency in research can be achieved by applying diagnostic criteria that have been subjected to systematic evaluation. BMJ Publishing Group 2014-02-07 /pmc/articles/PMC3918975/ /pubmed/24508851 http://dx.doi.org/10.1136/bmjopen-2013-003973 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Diagnostics
Brurberg, Kjetil Gundro
Fønhus, Marita Sporstøl
Larun, Lillebeth
Flottorp, Signe
Malterud, Kirsti
Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review
title Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review
title_full Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review
title_fullStr Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review
title_full_unstemmed Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review
title_short Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review
title_sort case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (cfs/me): a systematic review
topic Diagnostics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918975/
https://www.ncbi.nlm.nih.gov/pubmed/24508851
http://dx.doi.org/10.1136/bmjopen-2013-003973
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