CFS Redefined. Again.

Researchers at the Centers for Disease Control and Prevention (CDC) and Emory University have published research supporting a new definition for chronic fatigue syndrome (CFS). Authors led by Dr. William Reeves of CDC propose a more objective approach to the classification of patients than any of the previous definition papers (Holmes, 1988; Fukuda, 1994; with “enhancements” published by Schluderberg, 1991 and Reeves, 2003). Using assessment tools that quantify functional impairment and symptom occurrence, duration and severity, the research team was able to identify CFS patients with precision. The Medical Outcomes Survey Short Form-36 (SF-36), the Checklist Individual Strength (CIS), the Multidimensional Fatigue Inventory (MFI) and the CDC Symptom Inventory were used to document clinical status. Those subjects who met CFS case criteria (Fukuda) had significantly worse impairment, more severe fatigue and more frequent and severe symptoms than other subjects in the study who were ill but did not meet the CFS definition. The authors report that the CFS patients exhibited scores similar to patients with congestive heart failure.

The definitions and criteria for CFS have been scrutinized, critiqued and revised. Most definitions, including those published by groups in England, Australia and Canada, have been written by consensus panels of experts, most of whom see patients in tertiary or referral-based clinics. This latest definition will require validation by other groups and, ultimately, adoption by other investigators in the field before it can be considered to replace the 1994 definition. The study authors propose that this tool-based approach will be easier for clinicians to use in patient care settings and will aid in the comparability of research through the selection of more homogeneous patient cohorts. They also suggest that these tools can be used to monitor the cyclic pattern of the illness and to assess response to specific interventions. The article was published on December 15, 2005 in the open access on-line journal BioMed Central Medicine.

Chronic fatigue syndrome – a clinical empirical approach to its definition and study. BMC Medicine 2005, 3:19; doi:10.1186/1741-7015-3-19. WC Reeves, D Wagner, R Nisenbaum, JF Jones, B Gurbaxani, L Solomon, D Papanicolaou, ER Unger, SD Vernon, C Heim. Article URL:  http://www.biomedcentral.com/content/pdf/1741-7015-3-19.pdf