Article type
Year
Abstract
Introduction: The following classification criteria (CC) for chronic fatigue syndrome (CFS) were based upon a prospective randomized multi-centre longitudinal study of 198 patients with severe fatigue over 6 months. For the first time the statistical value was determined of 26 CFS symptoms by comparing them with a control group consisting of patients with fibromyalgia (FMA) and systemic lupus erythematosus (SLE). These diseases are also associated with severe fatigue and they are well defined.
Objective: To determine the statistical value of CFS symptoms and to develop classification criteria.
Methods: The CC were determined according to the recommendations of the American College of Rheumatology (ACR) using a collective of 158 randomized patients (CFS: n=79, male:female (m:f) 38:41, mean age 41.8 years; FMA: n=54, m:f 8:46, mean age 50.7 years; SLE: n=25, m:f 3:22, mean age 49.6 years). These include CC in the traditional format (TFC), regression coefficients criteria (RCC) and regression tree criteria (RTC). A validation of CC-CFS was undertaken with a collective of a further 40 patients (CFS: n=20, m:f 9:11, mean age 41.7 years; FMA: n=4, m:f 1:3, mean age 52.0 years; SLE: n=16, m:f 4:12, mean age 48.1 years), which had not been used for the generation of the criteria. A comparison to the CDC criteria was undertaken.
Results: The CC were shown to be easy to apply and to have high accuracies (A) and high validities (V) as TFC: A 94.3%, V 77.5%, RCC: A 97.5%, V 82.5% and RTC: A 98.7%, V 82.5%. The CDC criteria from Holmes yielded A 78.3% and V 62.5%. Sudden onset of fatigue and sore throat were demonstrated to be the most discriminative symptoms in CFS.
Discussion: Using only clinical data the CC allow a reliable and valid classification with a well characterized symptomatology, which suggests an infectious aetiology in CFS.
Objective: To determine the statistical value of CFS symptoms and to develop classification criteria.
Methods: The CC were determined according to the recommendations of the American College of Rheumatology (ACR) using a collective of 158 randomized patients (CFS: n=79, male:female (m:f) 38:41, mean age 41.8 years; FMA: n=54, m:f 8:46, mean age 50.7 years; SLE: n=25, m:f 3:22, mean age 49.6 years). These include CC in the traditional format (TFC), regression coefficients criteria (RCC) and regression tree criteria (RTC). A validation of CC-CFS was undertaken with a collective of a further 40 patients (CFS: n=20, m:f 9:11, mean age 41.7 years; FMA: n=4, m:f 1:3, mean age 52.0 years; SLE: n=16, m:f 4:12, mean age 48.1 years), which had not been used for the generation of the criteria. A comparison to the CDC criteria was undertaken.
Results: The CC were shown to be easy to apply and to have high accuracies (A) and high validities (V) as TFC: A 94.3%, V 77.5%, RCC: A 97.5%, V 82.5% and RTC: A 98.7%, V 82.5%. The CDC criteria from Holmes yielded A 78.3% and V 62.5%. Sudden onset of fatigue and sore throat were demonstrated to be the most discriminative symptoms in CFS.
Discussion: Using only clinical data the CC allow a reliable and valid classification with a well characterized symptomatology, which suggests an infectious aetiology in CFS.