Conformity of prevalence estimates in studies where patients diagnosed with CFS/ME with one set of diagnostic criteria are diagnosed sequentially with other case definitions (model B)
| Study recruitment | Case definitions | Conformity* (95% CI) | Symptom and burden profile |
|---|---|---|---|
| Brimacombe et al,69 USA Fukuda-positive from register | Fukuda† (n=200) Holmes (n=171) | 1 0.85 (0.80 to 0.90) | (F+/H–) patients do not endorse infectious-type symptoms as often or to the same degree of severity as (F+/H+) patients |
| Jason et al,70 USA Fukuda-positive from register | Fukuda† (n=32) Holmes (n=14) | 1 0.44 (0.26 to 0.62) | (F+/H+) patients with more symptoms and functional impairment than (F+/H–). No difference in psychological comorbidity |
| Jason et al,52 USA Fukuda-positive from register | Fukuda† (n=32) Canada (n=23)‡ | 1 0.63 (0.44 to 0.79) | C+ patients have less psychiatric comorbidity, more physical function impairment, are more fatigued with more neurological symptoms than (F+/C–) patients |
| Jason et al,33 USA Fukuda-positive recruited from many sources | Fukuda† (n=113) Canada (n=57) ME-2011 (n=27) | 1 0.50 (0.41 to 0.60) 0.24 (0.16 to 0.33) | (F+/C+) patients had more functional impairments, and physical, mental and cognitive problems than (F+/C–) patients. (F+/ME+) patients had more functional impairments, and more severe physical and cognitive symptoms than (F+/ME–) patients |
| Fluge et al,9 Norway Fukuda-positive patients recruited to trial | Fukuda† (n=30) Canada (n=28) | 1 0.93 (0.78 to 0.99) | Not reported |
| Jason et al,71 USA Register | Fukuda† (n=24) Reeves empirical Canada | Of 24 F+ and 84 F-patients empirical criteria and Canada identified 79 and 87% correctly | Canadia-2003 case definition appears to select more cardinal and central features of the illness than Empirical CDC-2005/Reeves case definition |
| Jason et al,65 USA Register | Fukuda† (n=27) Reeves emp. (n=41)§ | 1 1.00 (0.87 to 1.00) | Empirical CDC-2005/Reeves case definition led to misclassification of major depressive disorder as CFS |
| Brown et al,53 USA Fukuda-positive recruited from many sources | Fukuda† (n=113) ICC (n=39) | 1 0.35 (0.26 to 0.44) | ICC+ patients with more functional impairments and physical, mental and cognitive problems than (F+/ICC–) patients. The ICC+ patients also had greater rates of psychiatric comorbidity |
| Jason et al,72 USA Fukuda-positive from register | Fukuda† (n=32) Dowsett (n=17)¶ | 1 0.44 (0.26 to 0.62) | D+ patients appear to be more symptomatic than (F+/D–) patients, especially in the neurological and neuropsychiatric areas |
| White et al,60 UK Oxford-positive patients recruited to trial | Oxford† (n=641) Fukuda (n=427) London ME (n=329) | 1 0.67 (0.63 to 0.70) 0.51 (0.47 to 0.55) | Effect of CBT and GET similar regardless of diagnostic group affiliation |
| Wearden et al,73 UK Oxford-positive patients recruited to trial | Oxford† (n=296) London ME (n=92) | 1 0.31 (0.26 to 0.37) | Not reported |
| Stubhaug et al,74 Norway Neurasthenia-positive patients recruited to trial | Neurasthenia† (n=72) Oxford (n=65) Fukuda (n=29) | 1 0.90 (0.81 to 0.96), 0.40 (0.29 to 0.53) | Not reported |
*The proportion of cases relative to the evaluation standard.
†Evaluation standard.
‡Three of the 23 participants who tested positive according to the Canada criteria were negative according to Fukuda.
§14 of the 37 patients who tested positive according to Reeves were negative according to Fukuda (these 14 patients had a depression diagnosis).
¶Three of the 17 participants who tested positive according to Dowsett were negative according to Fukuda.
CBT, cognitive behavorial therapy; CFS, chronic fatigue syndrome; GET, graded exercise therapy; ICC, International Consensus Criteria; ME, myalgic encephalomyelitis.