Ann Schluederberg, James F. Jones, Andrew R. Lloyd, Simon Wessely, Nelson M. Gantz, Gary P. Holmes, Uedra Buchwald, Susan Abbey, Jonathan Rest, Jay A. Levy (FDA), Heidi Jolson (Incline Village, Nevada), Daniel L. Petereson, Jan H.M.M. Vercoulen, Umberto Tirelli, Birgitta Evengard, Benjamin H. Natelson, (CDC); Lea Steele (CDC), Michele Reyes (CDC), and William C. Reeves (CDC).
CDC Fukuda definition of CFS
Clinically evaluated, unexplained, persistent or relapsing chronic fatigue that is:
- of new or definite onset (has not been lifelong);
- is not the result of ongoing exertion;
- is not substantially alleviated by rest;
- and results in substantial reduction in previous levels of occupational, educational, social, or personal activities.
The concurrent occurrence of four or more of the following symptoms:
- substantial impairment in short-term memory or concentration;
- sore throat;
- tender lymph nodes;
- muscle pain;
- multi-joint pain without swelling or redness;
- headaches of a new type, pattern, or severity;
- unrefreshing sleep; and
- post-exertional malaise lasting more than 24 hours.
These symptoms must have persisted or reoccurred during 6 or more consecutive months of illness and must not have stated before the fatigue.
All other known causes of chronic fatigue must have been ruled out, specifically clinical depression, side effects of medication, eating disorders and substance abuse.
- Post-exertional malaise (PEM) is not mandatory. (Most US researchers use PEM option.)
- Doctors and researchers not using PEM option have misdiagnosed chronic fatigue (CF) patients with chronic fatigue syndrome (CFS)
- In research, if PEM option is not used the study is not considered by patients and many researchers to be a true CFS study; it is considered to be a (CF) study. Or both CFS and CF patients are in a CFS study as some patients have PEM and other patients do not making the study severely flawed and useless to either CFS or CF research.
- It is not easy to use on a clinical level as it was created for research. It can take several specialists and years to diagnose a patient.
- Dual diagnosis is not always possible and this is not useful in a clinical setting. (i.e., AIDS + CFS or MS + CFS.)
- Leads to confusion over chronic fatigue (a symptom of many illness, depression, diseases, medications) and chronic fatigue syndrome (a grossly misnamed disease.)
- Fukuda criteria summary
- CDC criteria
- 2001, A Comparison of the 1988 and 1994 Diagnostic Criteria for Chronic Fatigue Syndrome. Leonard Jason et al.
- 2003, Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution, by Reeves, et al.
- 2004, Comparing the Fukuda et al. Criteria and the Canadian Case Definition for Chronic Fatigue Syndrome. Leonard Jason et al.
- Case Definition Comparison - Graph 1
- Definitions of ME and CFS
- Centers for Disease Control and Prevention
- International Consensus Criteria
- Canadian Consensus Criteria
- Fukuda, K.; Straus, S. E.; Hickie, I.; Sharpe, M. C.; Dobbins, J. G.; Komaroff, A. (Dec 15, 1994). "The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group" (PDF). Annals of Internal Medicine. American College of Physicians. 121 (12): 953–959. doi:10.7326/0003-4819-121-12-199412150-00009. ISSN 0003-4819. PMID 7978722.
- Chronic Fatigue Versus Chronic Fatigue Syndrome - About.com Health - By: Carol Eustice
Fukuda criteria - The most commonly used diagnostic criteria for chronic fatigue syndrome, created by the United States Centers for Disease Control (CDC).
Adverse reaction - Any unintended or unwanted response to the treatment under investigation in a clinical trial.
Post-exertional malaise (PEM) - A notable exacerbation of symptoms brought on by small physical or cognitive exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others.