Journal of IiME Volume 6 Issue 1 (June 2012) multidisciplinary team-based clinical project has been started at Dept. of Rehabilitation Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden. The aim of the ME/CFSproject is to improve the diagnosis of ME/CFS patients, to transfer clinical knowledge to the primary care structures, and to establish rehabilitation methods for ME/CFS-patients. The research on ME/CFS from a broad perspective, including assessment, biomarkers, rehabilitation and treatment is also included The multidisciplinary team consists of clinician (1.5 position), medical nurse, physiotherapist, psychologist (1.5 position), social worker and occupational therapist. Three weeks team-based evaluation includes: one visit to the doctor, nurse and social worker; 2 visits to psychologist and occupational therapist and 3 visits to physiotherapist. The ME/CFS diagnosis is based on patient history, subjective and objective findings according to CDC (Fukuda 1994) and Canadian (Carruthers et al 2003) criteria. To exclude other somatic disorders, extended blood and urine analysis as well as polysomnography and 3T brain MRI (including assessment of cerebral blood flow for research purpose) are performed. Moreover, important previous investigations, previous treatment and rehabilitation experiences are also considered. Since April 2011, the ME/CFS-project had 101 new visits to physician. In 55% of cases (55 patients: 11 male and 44 female) there was a clear indication for further team evaluation because of suspected ME/CFS. After team evaluation 33 patients fulfilled the criteria for ME/CFS: 28 according to Canadian and CDC and 5 only according to CDC-criteria. In cases which did not fulfil the criteria for ME/CFS, other diagnoses were found: 10 cases of chronic psychiatric or neuropsychiatric disorders, and 7 of them together with chronic pain syndrome/fibromyalgia. In 2 cases idiopathic fatigue was explained by chronic sleep disturbances. In 17 cases the previous ME/CFS diagnosis concluded by other clinicians was confirmed by the team, whereas in 11 patients it was given for the first time. It is of interest to note that in 14 cases the existing ME/CFS diagnosis was explained by other disorders either during the first visit to the doctor or after team evaluation. Altogether, the results of one year multidisciplinary team evaluation show that it is a Invest in ME (Charity Nr. 1114035) great advantage to use a multidisciplinary approach in ME/CFS in combination with a thorough medical investigation since the symptoms are very complex and overlap with other disorders that sometimes are very difficult to exclude only by a physician interview/examination and standard laboratory tests. From the clinical point of view a correct diagnosis is of course vital as specific medical treatments or effective rehabilitation techniques exists for many of the other disorders that seemed to mimic ME/CFS, e.g. sleep apnoea, chronic stress-related psychiatric disorders with accompanying pain syndrome, neuropsychiatric disorders, etc. We also believe that a thorough multidisciplinary assessment is beneficial for research purposes, e.g. as a clinical basis for studies of the immunological and CNS patophysiology of ME/CFS, both for diagnostic biomarker- and treatment-studies. Dr Daniel Peterson Clinical Research Update 2012 Daniel L. Peterson, M.D., is an internist in Incline Village, Nevada and recognized medical expert on CFS/ME. Dr. Peterson is founder of Simmaron Research, and serves on its Scientific Advisory Board. Dr. Peterson has devoted 25 years of his clinical career to diagnosing and caring for patients with CFS/ME and related neuroimmune disorders, and collaborating with researchers to better understand the illness. Dr. Peterson’s repository of more than 1,000 patient biological samples and records is a rich resource for research studies. His experience as both a clinician and a research collaborator provides a unique perspective on CFS/ME for developing translational science. In 2011, Dr. Peterson was appointed Adjunct Professor on the faculty of Health Sciences and Medicine at Bond University in Queensland, Australia. ABSTRACT: In spite of many years of intensive research in both the basic sciences and clinical realms, CFS/ME continues to present challenges to scientists and www.investinme.org Page 104 of 108
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