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The Newcastle NHS Chronic Fatigue Syndrome Service: Not all fatigue is the same – Source: Journal of the Royal College of Physicians of Edinburgh, Dec 2010

  [ 10 votes ]   [ 2 Comments ]
By Julia L Newton, et al. • • December 16, 2010

[Note: To read the full text pdf of this article, click here]

In England the Department of Health has funded specialist clinical services aimed at diagnosing and managing the symptoms of chronic fatigue syndrome (CFS). These services are not available to those who do not fulfill the diagnostic criteria for CFS.

This service evaluation examined the proportion of those referred to a specialist CFS service fulfilling:

• The Fukuda diagnostic criteria for CFS. [The Fukuda criteria were established by the CDC in 1994 and include chronic fatigue plus 4 or more of 8 other symptoms. The later Empirical Case Definition, which the CDC started using in 2005, has been criticized for lacking specificity and accordingly allowing cases of other disorders, such as major depressive disorder, to be misclassified as CFS.]

• And the alternative fatigue-associated diagnoses.

The CFS database was interrogated to include every patient referred to the Newcastle service from November 2008 to December 2009.

All medical notes were reviewed and the diagnosis, sex and age recorded. Data were compared to a previous service
evaluation (2005–2007).

In 2008–2009, 260 subjects were referred: 19 referrals per month (260/14), compared with 17 referrals per month in 2005–2007 (375/24).

The proportion of patients diagnosed with CFS increased significantly compared with 2007 (36% [20/56] vs 60% [157/260]; p<0.0001).

Of the 40% of patients subsequently found not to have CFS:

• The most common diagnosis was fatigue associated with a chronic disease (47% of all alternative diagnoses);

• 20% had primary sleep disorders,

• 15% psychological/psychiatric illnesses,

• And 4% a cardiovascular disorder.

• 13% remained unexplained (5.2% of the total referrals).

This study found a significant increase in the proportion of patients referred to National Health Service (NHS) CFS services diagnosed with CFS.

A large proportion of patients presenting with fatigue are not eligible for referral to the Department of Health specialist fatigue services, which represents an unmet need in terms of symptom management in current NHS services.

Source: Journal of the Royal College of Physicians of Edinburgh, Dec 2010;40:304-7. By Newton JL, Mabillard H, Scott a, Hoad A, Spickett G. NIHR Biomedical Research Centre in Ageing and Institute for Ageing & Health, Newcastle University; Northern Regional CFS/ME Clinical Service, Newcastle upon Tyne Hospitals NHS Trust, UK. [Email: Julia.newton@nuth.nhs.uku]

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Article Comments Post a Comment

Can someone put this "in other words" so I can understand it?
Posted by: DeborahLynn
Dec 18, 2010
What does it mean? How is it relevant? Is this another example of how England is ignoring CFS, or is it that they are beginning to look into it? I must be suffering from a bad case of fibro-fog, because I couldn't make sense of this article...
Reply Reply

In Other Words
Posted by: Minnesota
Dec 21, 2010
It looks as though primary care physicians have been referring people with fatigue caused by illnesses other than ME/CFS to the CFS service. Probably because they're not applying strict criteria for ME/CFS, which is much more than fatigue? Does this mean these people with fatigue caused by other illnesses are being included in "ME/CFS" blood sample testing?
Reply Reply
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