Myalgic Encephalomyelitis Case Definitions

Jason, Leonard A.; Damrongvachiraphan, Dylan; Hunnell, Jessica; Bartgis, Lindsey; Brown, Abigail; Evans, Meredyth; Brown, M. E.

doi:10.4303/acpsf/k110601

Cited by 19 publications

(35 citation statements)

References 36 publications

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“…This implies that a sudden onset is not a distinctive feature of ME as suggested by others [19,20,21]. …”

Section: Resultsmentioning

confidence: 61%

“…Other authors have also proposed an operational definition of ME [19,20,21], but this definition has two important shortcomings. The definition [19,20,21] requires a sudden onset.…”

Section: Discussionmentioning

confidence: 99%

“…The definition [19,20,21] requires a sudden onset. Although ME is often initiated by an infection [2], a gradual onset is also possible [1,2,3,4].…”

Section: Discussionmentioning

confidence: 99%

“…Although ME is often initiated by an infection [2], a gradual onset is also possible [1,2,3,4]. The operational definition proposed [19,20,21] also interprets muscle fatigability/post-exertional muscle weakness as post-exertional “malaise”, but as argued, (post-exertional) muscle weakness and “malaise” are two different concepts.…”

Section: Discussionmentioning

confidence: 99%

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Myalgic Encephalomyelitis (ME) or What? An Operational Definition

Twisk¹

2018

Diagnostics

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Myalgic encephalomyelitis (ME), identified as a new clinical entity with distinctive features in 1956, was originally considered as a neuromuscular disease. In 1988 the Centers for Disease Control and Prevention introduced the ill-defined concept of chronic fatigue syndrome (CFS). As predicted, CFS, unjustly considered to be a synonym for ME, pushed ME to the background. To develop effective therapies for of ME and CFS, it is essential to investigate patients with ME specifically. For that reason, an operational definition of ME is indispensable. This article proposes an operational definition based on the most recent formal definitions and symptoms observed in ME. ME is a multi-systemic illness, which (1) often has a sudden onset, in most cases a respiratory and/or gastro-intestinal infection, but a gradual or more dramatic onset is also possible; (2) has an epidemic and an endemic form; (3) has an unique clinical pattern deviating from other post-viral states; (4) is distinguished by muscle fatigability/prolonged muscle weakness after trivial exertion; (5) is accompanied by symptoms relating to neurological disturbance, especially of cognitive, autonomic, and sensory functions; (6) can be accompanied by symptoms associated with cardiac and other systems; (7) is characterized by fluctuation of symptoms (within and between “episodes”); (8) has a prolonged relapsing course; and (9) has a tendency to become chronic. In conclusion, a discriminative definition for ME contains four mandatory elements: (1) muscle fatigability/post-exertional muscle weakness lasting for days; (2) operational criteria for “neurological disturbance, especially of cognitive, autonomic and sensory functions”; (3) fluctuation of symptoms; and (4) a prolonged relapsing course. This tentative definition of ME justifies the qualification “neuromuscular disease”.

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“…This implies that a sudden onset is not a distinctive feature of ME as suggested by others [19,20,21]. …”

Section: Resultsmentioning

confidence: 61%

“…Other authors have also proposed an operational definition of ME [19,20,21], but this definition has two important shortcomings. The definition [19,20,21] requires a sudden onset.…”

Section: Discussionmentioning

confidence: 99%

“…The definition [19,20,21] requires a sudden onset. Although ME is often initiated by an infection [2], a gradual onset is also possible [1,2,3,4].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Myalgic Encephalomyelitis (ME) or What? An Operational Definition

Twisk¹

2018

Diagnostics

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“…Several years later, Jason, Damrongvachiraphan, et al (2012) attempted to better operationalize the ME criteria, based on the work of a number of theorists and practitioners (Dowsett, Ramsay, McCartney, & Bell, 1990; Goudsmit, Shepherd, Dancey, & Howes, 2009; Hyde, Goldstein, & Levine, 1992; Ramsay, 1988). The major symptom categories of ME in this revised case definition included: post-exertional malaise, neurological manifestation, and autonomic dysfunction, and these investigators used more precise frequency and severity criteria for symptoms.…”

Section: Case Definitionsmentioning

confidence: 99%

Defining Essential Features of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome

Jason¹,

Sunnquist²,

Brown³

et al. 2015

Journal of Human Behavior in the Social Environment

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Considerable debate surrounds the search for the defining features of patients with Myalgic Encephalomyelitis (ME) and chronic fatigue syndrome (CFS). Current case definitions were created through clinical consensus. Failure to operationalize these case definitions has led to considerable variability in the identification of patients. In addition, some case definitions (e.g., Fukuda et al., 1994) do not require cardinal symptoms of this illness, where as other case definitions do require core symptoms of this illness (Carruthers et al., 2003, 2011), and these latter case criteria appear to identify a more impaired group of patients. Criterion variance is most likely to occur when operationally explicit criteria do not exist for diagnostic categories (Spitzer, Endicott, & Robins, 1978), or when there are varying criteria for contrasting case definitions, which is an impediment to the research in this field. To deal with this problem, it is possible to differentiate those that meet more loosely defined criteria from those that are more narrowly and defined, thus differentiating CFS from ME. In order to progress the search for biological markers and effective treatments, essential features need to be operationalized and broadly used in order to increase the probability that individuals included in samples have the same underlying illness.

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