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Canada leads the world with a medical milestone
Clinical definition for ME/CFS
Clinical Working Case Definition, Diagnostic and Treatment Protocols have been developed by an expert medical consensus panel of treating physicians, teaching faculty and world leaders in the research of ME/CFS. Haworth Press, Inc. has just published the expert consensus document in a special issue of the Journal of Chronic Fatigue Syndrome 11 (1), 2003 on February 1, 2003. The definition provides a flexible conceptual framework that more adequately reflects the complexity of symptoms of a given patient’s pathogenesis and should establish ME/CFS as a distinct medical entity and help distinguish it from overlapping medical conditions in the absence of a definitive laboratory test.
Most countries have been using the American CDC (Centers for Disease Control and Prevention) definition, which was designed to standardize research. However, there has been a growing demand for diagnostic criteria designed for a clinical setting. In response to a survey by the National ME/FM Action Network, doctors across Canada overwhelmingly concurred that a clinical definition, along with diagnostic and treatment guidelines, would be the most helpful items in diagnosing and treating ME/CFS patients. This led to Health Canada selecting an expert consensus panel and establishing their Terms of Reference.
The panel’s clinical case definition determines that more of the prominent symptoms are compulsory and symptoms that share a common region of pathogenesis are grouped together for clarity. In addition to severe prolonged fatigue, the definition includes the hallmark symptoms of post-exertional malaise and/or fatigue, sleep dysfunction, pain, two or more of the given neurological/cognitive manifestations, and at least one of the given symptoms from two of the categories of autonomic, neuroendocrine, and immune manifestations. The consensus document also includes a discussion of prominent symptoms, clinical practice diagnostic and treatment guidelines based on the best available research evidence, and an overview of available research on ME/CFS.
“The clinical definition will enable clinicians to make an early diagnosis which may assist in lessening the impact of ME/CFS in some patients,” said Dr. Bruce M. Carruthers, lead author of the definition. “It will reduce the expensive problem of patients being sent to many specialists before being diagnosed and will allow patients to receive appropriate treatments in a timely fashion.”
ME/CFS is a severe illness that can be debilitating. There is no known cure. It often begins with a viral type infection such as an acute respiratory or flu-like illness. But instead of recovering, the person’s health deteriorates and many other symptoms appear. A number of viruses have been studied but so far there is no conclusive support for any one pathogen causing the illness. Numerous studies have confirmed that there is a biochemical breakdown of one of the body’s defense pathways used to fight viruses, which supports the theory that ME/CFS is triggered by an infection. According to a large American study by Dr. Leonard Jason, approximately 422 per 100,000 people (approximately 150,000 Canadians) suffer from ME/CFS compared to 26 per 100,000 women who have breast cancer.
To view the clinical definition and for information on how to order the consensus document, please go to the website of the National ME/FM Action Network.