Re: Suggestions for diagnosis of patients presenting with fatigue
The primary problem arising from any discussion involving fatigue, is
how the term is defined. Both English and American dictionaries define
the term as a consequence of long continued exertion - which does not seem
appropriate.
The recent article by Greenberg could provide a background to a claim that
CFS is an example of citation bias. When the CDC introduced CFS in 1988,
there was no definition of "fatigue" nor any reference to the considerable
literature on the topic. Perhaps of greatest significance was the failure
to recognise the 1921 report by Muscio, who had completed a 2 year long
study of industrial fatigue. Because he was unable to define or to
measure fatigue, he recommended that, "..the term fatigue should be
absolutely banished from strict scientific discussion."
Greenberg pointed out that citation bias, which involved the
rejection of some published information, could lead to erroneous
conclusions. Thus the CDC, in utilising a term which was incapable of
being defined or measured, provided a basis for the confusion which has
arisen about patients who present with inexplicable tiredness.
ME people are the most affected by being included under the umbrella
term of CFS. It is a matter of concern that the remissions which were so
well described by Ramsay are no longer referred to. Furthermore it is
obvious that any pathophysiology for ME which cannot account for
remissions, is inappropriate. Because it is possible to account for
remissions in terms of changes in blood rheology, which have been
published, this is either an example of citation bias of of selective use
of the literature.
What is glaringly obvious is that the quality of life of those with
ME will not be improved until ME is extricated from CFS.
Rapid Response:
Re: Suggestions for diagnosis of patients presenting with fatigue
The primary problem arising from any discussion involving fatigue, is
how the term is defined. Both English and American dictionaries define
the term as a consequence of long continued exertion - which does not seem
appropriate.
The recent article by Greenberg could provide a background to a claim that
CFS is an example of citation bias. When the CDC introduced CFS in 1988,
there was no definition of "fatigue" nor any reference to the considerable
literature on the topic. Perhaps of greatest significance was the failure
to recognise the 1921 report by Muscio, who had completed a 2 year long
study of industrial fatigue. Because he was unable to define or to
measure fatigue, he recommended that, "..the term fatigue should be
absolutely banished from strict scientific discussion."
Greenberg pointed out that citation bias, which involved the
rejection of some published information, could lead to erroneous
conclusions. Thus the CDC, in utilising a term which was incapable of
being defined or measured, provided a basis for the confusion which has
arisen about patients who present with inexplicable tiredness.
ME people are the most affected by being included under the umbrella
term of CFS. It is a matter of concern that the remissions which were so
well described by Ramsay are no longer referred to. Furthermore it is
obvious that any pathophysiology for ME which cannot account for
remissions, is inappropriate. Because it is possible to account for
remissions in terms of changes in blood rheology, which have been
published, this is either an example of citation bias of of selective use
of the literature.
What is glaringly obvious is that the quality of life of those with
ME will not be improved until ME is extricated from CFS.
Competing interests:
None declared
Competing interests: No competing interests