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>>>>> Help ME Circle <<<<
>>>> 29 July 2011 <<<<
Editorship : j.van.roijen@chello.nl
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http://www.ncbi.nlm.nih.gov/pubmed/21794183
BMC Med. 2011 Jul 28;9(1):91.
[Epub ahead of print]
Prevalence of myalgic
encephalomyelitis/chronic
fatigue syndrome
(ME/CFS) in three
regions of England: a
repeated cross-sectional
study in primary care.
Nacul LC, Lacerda EM, Pheby
D, Campion P, Molokhia M,
Fayyaz S, Leite JC, Poland F,
Howe A, Drachler ML.
ABSTRACT:
BACKGROUND:
ME/CFS or chronic fatigue
syndrome (CFS) has been used
to name a range of chronic
conditions characterized by
extreme fatigue and other
disabling symptoms.
Attempts to estimate the
burden of disease have been
limited by selection bias, and
by lack of diagnostic
biomarkers and of agreed
reproducible case definitions.
We estimated the prevalence
and incidence of ME/CFS in
three regions in England, and
discussed the implications of
frequency statistics and the
use of different case
definitions for health and
social care planning and for
research.
METHODS:
We compared the clinical
presentation, prevalence and
incidence of ME/CFS based in a
sample of 143,000 individuals
aged 18 to 64 years, covered
by primary care services in 3
regions of England.
Case ascertainment involved:
i) electronic search for chronic
fatigue cases;
ii) direct questioning of
general practitioners (GPs) on
cases not previously identified
by the search;
iii) clinical review of identified
cases according to CDC-1994,
Canadian and Epidemiological
Case (ECD) Definitions. This
enabled the identification of
cases with high validity.
RESULTS:
The estimated minimum
prevalence rate of ME/CFS was
0.2% for cases meeting any of
the study case definitions,
0.19% for the CDC-1994
definition, 0.11% for the
Canadian definition and 0.03%
for the ECD.
The overall estimated minimal
yearly incidence was 0.015%.
The highest rates were found
in London and the lowest in
East Yorkshire.
All cases conforming to the
Canadian criteria also met the
CDC-1994 criteria but
presented higher prevalence
and severity of symptoms.
CONCLUSIONS:
ME/CFS is not uncommon in
England and represents a
significant burden to patients
and society.
The number of people with
chronic fatigue who do not
meet specific criteria for
ME/CFS is higher still.
Both groups have high levels
of need for service provision,
including health and social
care.
We suggest combining the use
of both the CDC-1994 and
Canadian criteria for
ascertainment of ME/CFS
cases, alongside careful
clinical phenotyping of study
participants.
This combination if used
systematically will enable
international comparisons,
minimisation of bias, and the
identification and
investigation of distinct
sub-groups of patients with
possibly distinct aetiologies
and pathophysiologies,
standing a better chance of
translation into effective
specific treatments.
PMID: 2179418
[PubMed - as supplied by
publisher]
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