From Acta Paediatrica, 31 January 2015.
Study findings challenge the content validity of the Canadian Consensus Criteria for adolescent chronic fatigue syndrome
Tarjei Tørre Asprusten(1), Even Fagermoen(2,3), Dag Sulheim(4,5), Eva Skovlund(6), Øystein Sørensen(7), Tom Eirik Mollnes(8,9) and Vegard Bruun Wyller(10,*).
1) Division of Medicine and Laboratory Sciences, Medical Faculty, University of Oslo, Norway
2) Institute of Clinical Medicine, Medical Faculty, University of Oslo, Norway
3) Dept. of Anesthesiology and Critical Care, Oslo University Hospital, Norway
4) Dept. of Paediatrics, Oslo University Hospital, Norway
5) Dept. of Paediatrics, Innlandet Hospital Trust, Lillehammer, Norway
6) School of Pharmacy, University of Oslo, Norway
7) Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Norway
8) Department of Immunology, Oslo University Hospital, K.G. Jebsen IRC, University of Oslo, Research Laboratory, Nordland Hospital, Bodø, Faculty of Health Sciences, K.G. Jebsen TREC, University of Tromsø
9) Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
10) Dept. of Paediatrics, Akershus University Hospital, Nordbyhagen, Norway
* Correspondence
Vegard Bruun Wyller, Dept. of Paediatrics, Akershus University Hospital, N-1478 Lørenskog, Norway. E-mail: brwylle@online.no. Cell phone: +47 91 16 66 81
Abstract
AIM
The 2003 Canadian Consensus Criteria for chronic fatigue syndrome (CFS) are often assumed to suggest low-grade systemic inflammation, but have never been formally validated. This study explored the content validity of the Criteria in a sample of adolescents with CFS selected according to a wide case definition.
METHODS
A total of 120 CFS patients with a mean age of 15.4 years (range 12–18 years) included in the NorCAPITAL project were post hoc subgrouped according to the Canadian Consensus Criteria. Those who satisfied the criteria (Criteria positive) and those who did not (Criteria negative) were compared across a wide range of disease markers and markers of prognosis.
RESULTS
A total of 46 patients were classified as Criteria positive, 69 were classified as Criteria negative and five could not be classified. All disease markers were equal across the two groups, except the digit span backward test of cognitive function, which showed poorer performance in the Criteria positive group. Also, the prognosis over a 30 week period was equal between the groups.
CONCLUSION
This study questions the content validity of the Canadian Consensus Criteria, as few differences were found between adolescent CFS patients who did and did not satisfy the Criteria.
From Menopause, journal of the North American Menopause Society, published online 4 February 2015.
Here's how we covered the EurekAlert press agency report on this yesterday.
Early menopause and other gynecologic risk indicators for chronic fatigue syndrome in women.
Boneva, Roumiana S. MD, PhD; Lin, Jin-Mann S. PhD; Unger, Elizabeth R. PhD, MD
Abstract
OBJECTIVE
This study aims to examine whether gynecologic conditions are associated with chronic fatigue syndrome (CFS).
METHODS
This study includes a subset of 157 women from a population-based case-control study in Georgia, United States, conducted in 2004-2009. Gynecologic history was collected using a self-administered questionnaire. Crude odds ratios (ORs) with 95% CIs and ORs adjusted for body mass index and other covariates, where relevant, were estimated for gynecologic conditions between 84 CFS cases and 73 healthy controls.
RESULTS
Cases and controls were of similar age. Women with CFS reported significantly more gynecologic conditions and surgical operations than controls: menopause status (61.9% vs 37.0%; OR, 2.37; 95% CI, 1.21-4.66), earlier mean age at menopause onset (37.6 vs 48.6 y; adjusted OR, 1.22; 95% CI, 1.09-1.36), excessive menstrual bleeding (73.8% vs 42.5%; adjusted OR, 3.33; 95% CI, 1.66-6.70), bleeding between periods (48.8% vs 23.3%; adjusted OR, 3.31; 95% CI, 1.60-6.86), endometriosis (29.8% vs 12.3%; adjusted OR, 3.67; 95% CI, 1.53-8.84), use of noncontraceptive hormonal preparations (57.1% vs 26.0%; adjusted OR, 2.95; 95% CI, 1.36-6.38), nonmenstrual pelvic pain (26.2% vs 2.7%; adjusted OR, 11.98; 95% CI, 2.57-55.81), and gynecologic surgical operation (65.5% vs 31.5%; adjusted OR, 3.33; 95% CI, 1.66-6.67), especially hysterectomy (54.8% vs 19.2%; adjusted OR, 3.23; 95% CI, 1.46-7.17). Hysterectomy and oophorectomy occurred at a significantly younger mean age in the CFS group than in controls and occurred before CFS onset in 71% of women with records of date of surgical operation and date of CFS onset.
CONCLUSIONS
Menstrual abnormalities, endometriosis, pelvic pain, hysterectomy, and early/surgical menopause are all associated with CFS. Clinicians should be aware of the association between common gynecologic problems and CFS in women. Further work is warranted to determine whether these conditions contribute to the development and/or perpetuation of CFS in some women.