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February/March 2015 (vol. 11/5)

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Research Plus

Chronic fatigue syndrome review

A systematic review (36 observational studies of diagnostic methods and 35 treatment trials) finds a lack of clear aetiology for chronic fatigue syndrome (CFS, sometimes known as myalgic encephalomyelitis), with considerable overlap with other conditions hampering diagnosis. There is no single reliable diagnostic tool or reference standard and a risk of incorrectly labelling patients with CFS. The review includes 36 observational studies of diagnostic methods and 35 treatment trials. It finds low-quality evidence that the immune modulator drug rintatolimod improves exercise performance in some patients; low- to moderate-strength evidence that counselling and behavioural therapies and graded exercise therapy can be beneficial, but these ‘have not been adequately tested in more disabled populations’; and insufficient evidence on the efficacy of a range of other drugs and alternative treatments. There is some evidence that receiving a CFS diagnosis can be associated with perceived stigma in terms of financial instability, reduced work opportunities, social isolation, and interaction with the healthcare system. 

Agency for Healthcare Research and Quality. Evidence. Report/Technology Assessment no. 219. Rockville, MD: AHRQ 2014.

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Occupational Health at Work February/March 2015 (vol. 11/5) pp40