Diagnosis and Treatment of Chronic Fatigue Syndrome/Myalgic Encephalopathy (CFS/ME)
Notice bibliographique
Résumé
Aim: To assess and synthesize the evidence base for diagnosing and treating chronic fatigue syndrome/myalgic encephalopathy (CFS/ME).Methods: The overview of the scientific knowledge is based on systematic reviews and a search of recent primary and qualitative studies. The assessment was done stepwise, starting with 1168 abstracts and ending with 6 systematic reviews, 5569 abstracts of RCTs/CCTs and ending with 4 RCTs on adults and 3 RCTs on children/adolescents. We identified 807 qualitative studies and included 18. Level of documentation was based on GRADE.A review team performed the assessment, with input from 2 patient organizations. The literature was searched via the Cochrane Database of Systematic Reviews, DARE, MEDLINE, EMBASE, PsycINFO, and AMED. Patients with CFS, ME, postviral fatigue syndrome, and chronic fatigue and immunodysfunctional syndrome were included. Interventions included any kind of treatment for CFS/ME. All outcomes were considered, and fatigue, physical and mental health, and quality of life are reported.Results: Diagnosis: The recommendations for diagnosis are based on guidelines for clinical diagnosis of CFS/ME published by British, Australian, Canadian, and other groups.Patient history includes extreme fatigue lasting at least 6 months triggered by disproportional demands, and is unpredictable, does not improve by rest, or is worsened by physical or mental effort. Other symptoms are, e.g., sore throat, swollen lymph nodes, painful joints and muscles, headache, and sleeping problems. Comorbidities may include fibromyalgia or irritable bowel syndrome. The course varies.Differential diagnoses, e.g., metabolic diseases, diabetes, coeliac disease, cancer, bipolar or depressive conditions, neurological disease, and Addison's disease must be ruled out. No diagnostic test can verify the diagnosis, nor point to the best treatment.Treatment: Cognitive behavioral therapy, graded exercise therapy, pharmacological treatment, immunological treatment, supplements and alternative/complementary treatment. Documentation is low or very low for most outcomes: Cognitive behavioral therapy suggests improved physical function and quality of life, but it is uncertain if the treatment influences mental health. Graded exercise therapy suggests reduced fatigue, but effects on depression or quality of life are not documented. Dropout was high, especially with high-intensity exercise. No evidence recommends pharmacological treatment unless there is relevant comorbidity. Immune modulating treatment has uncertain effects, but could have serious adverse effects. Effects of supplements and alternative/complementary medicine are uncertain. Few studies investigated the effects of treatment in children and adolescents. No studies investigated the effects of treatment in the severely ill or disabled. Further research/reviews required: Studies on better treatment for severely ill or disabled sufferers are insufficient. Evidence on children and adolescents is scarce, and for adults the level of documentation is low or very low. Diagnostic criteria vary by study, making comparisons difficult. Empirical studies on treatment experiences are missing. CFS/ME symptoms are subjective. Qualitative studies show that patients feel stigmatized and mistrusted, and doctors find it challenging to diagnose and treat CFS/ME. The prevalence, prognosis, and cause of CFS/ME remain unclear. More research is needed.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».