highlight it.
This definition has already been used for dozens of studies already on CDC
cohorts (all the Georgia cohort studies and all bar one of the Wichita 2-day
studies incl. the CAMDA and Pharmacogenomics papers as well as two childhood
abuse studies and a study on psychopathology (which found a rate of lifetime
psychopathology of 89%*) and we need to keep raising awareness of the issue
of the unusual definition the CDC is using. Apart from two papers by
Leonard Jason and co, I don't think it is alluded to in published papers.
Tom Kindlon
* i.e. At least one psychiatric diagnosis in their lifetime
===============================================================
Don't support the Reeves/empirical definition/criteria for CFS?
Sign the petition at: http://CFSdefinitionpetition.notlong.com
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http://tinyurl.com/yj9ymua
i.e.
http://consults.blogs.nytimes.com/2009/11/24/expert-answers-on-chronic-fatig
ue-syndrome/
Q.Dr. Klimas:
I find the new research hard to believe, especially the follow-up research
that shows 98 percent of patients who receive a clinical diagnosis of C.F.S.
tested positive for the retrovirus, compared with only 3 percent of
controls. Why hard to believe? It is almost impossible to be 98 percent
accurate with most clinical diagnoses, especially those without specific
tests, like C.F.S. Please comment.
jack
A. Dr. Klimas responds:
Well, it is hard to comment on unpublished data - the number of patients who
were shown to be positive for C.F.S. by antibody testing has not been
established.
There are likely to be wide differences when these prevalence studies come
out - as you point out, where the investigator gets the blood will matter.
Investigators will need to be very clear how they defined the illness, where
they got the samples, the demographics of the population, and any defining
subgroup information.
In my clinical immunology clinic, for instance, there may be more patients
with a post-viral or acute onset type of C.F.S. than other medical
practices. A rheumatology clinic, for example, may have a stronger
fibromyalgia overlay to the population.
In the population-based Georgia study conducted by the Centers for Disease
Control and Prevention, investigators used a broader case definition and
identified a population with C.F.S. that was fivefold larger than previous
prevalence studies. That study may have included people with other disorders
that cause fatigue, and I would expect to see up to a fivefold difference
when compared with a more tightly defined group.
There may also be regional differences in the prevalence of the XMRV virus
that was recently linked to C.F.S. A European study that failed to find the
virus in prostate cancer samples suggested that there might be differences
in the background population prevalence rate of the virus.
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