Journal of IiME Volume 2 Issue 2 www.investinme.org R Reeaassoonnss wwhhyy MMEE DDooeess NNoott BBeelloonngg ttoo tthhee MMUUSS CCaatteeggoorryy (continued) the infectious disease department at Ullevål, Dr Brubakk, is very familiar with ME/Post Viral Fatigue Syndrome (PVFS) since as long as the 1980s. The occurrence of ME can be compared to Multiple Sclerosis. This is also a diagnosis which demands special investigation. In Bømlo, Hordaland, there are 10 people registered with MS in the MS register. This is a municipality with 12.000 inhabitants. In the same area there are also 10 documented people with ME. In two of the families there is either ME or MS in first degree relatives. This points to clear genetic and immunological components. At the Haukeland University Hospital, department of neurology, where there has been a ”fatigue clinic” for 15 years, they say that disability has to be documented using validated scales such as Fatigue Severity Scale (Krupp et al, 1989), Fatigue Scale (Chalder et al, 1993) and SF-36 (Ware & Sherbourne, 1992). It is considered very important not only to measure physical fatigue, but also cognitive fatigue, because it is often the cognitive dysfunction that patients themselves find most disabling. SF-36 is a well known tool which includes different functional dimensions. Data from a ten year period show that people with ME have fatigue scores at the highest level, from about 23-30 (extreme values) when compared to fatigue in the population (Loge, Ekeberg, Kaasa, 1998). The ME group differs therefore clearly in having far higher scores for total fatigue than one finds in the Norwegian population. More about this can be found in the summary of the biomedical conference in Oslo in 2007 (Stormorken 2007): ): http://www.meforening.no/index.php?option=com_content &task=view&id=103&Itemid=2 Reeves and colleagues at the Centres for Disease Control and Prevention (CDC, Atlanta, Georgia, USA) have explained in a scientific article a clinical, empirical approach to diagnosing and defining CFS (Reeves et al, Invest in ME (Charity Nr. 1114035) 2005). The study showed that patients who had been classified empirically as having ME/CFS, were significantly more disabled (measured using SF-36), more severely fatigued (measured by Multidimensional Fatigue Inventory) and had more frequent and more serious accompanying symptoms than patients with medically unexplained tiredness (MUS/MUPS). The study shows that the empirical definition (by including different fatigue scales) includes all aspects of ME/CFS This is a municipality with 12.000 inhabitants. In the same area there are also 10 documented people with ME. In two of the families there is either ME or MS in first degree relatives. This points to clear genetic and immunological components. which have been specified in the 1994 case definition, and identifies people with ME/CFS in a precise manner which can easily be reproduced both by researchers and clinicians. The empirical definition makes it possible to separate ME from depression and idiopathic fatigue. That said, Jason and Richman (2007) have criticised the empirical definition. The way Reeves and colleagues present it, it will lead to a clear broadening of the criteria in that the prevalence of ME/CFS will increase drastically, from about 800.000-1 million people to 4 million Americans. The critique against Reeves’ empirical definition can be found at the following web address: http://www.iacfsme.org/IssueswithCDCEmpiric alCaseDefinitionandPrev/tabid/105/Default.as px There is a reference to Reeves et al 2007 at: (continued on page 72) Page 71/74
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