Tuesday, June 18, 2024

Comprehensive Analysis of Fatigue Severity in ME/CFS Patients

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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) presents significant challenges in the medical field due to its unexplained nature and the subjective assessment of fatigue severity. Affecting around 1% of the global population, this study seeks to enhance the understanding of fatigue in ME/CFS patients by evaluating data from various randomized controlled trials (RCTs) and providing a comprehensive analysis of fatigue severity across different demographics and intervention types.

Methodology and Data Collection

Researchers systematically gathered data on fatigue levels from RCTs focusing on ME/CFS, sourcing information from PubMed, Cochrane Library, Web of Science, and CINAHL up to January 31, 2024. Fatigue measurements were standardized to a 100-point scale. A meta-analysis was conducted to assess fatigue severity across subgroups defined by age, domain of fatigue, intervention type, case definition, and assessment tools.

Study Findings

Out of 497 relevant studies, 60 RCTs met the inclusion criteria, comprising 7,088 ME/CFS patients (1,815 males, 4,532 females, and 741 with unspecified gender). The overall fatigue severity was found to be 77.9 on a 100-point scale. Adults showed a severity of 77.7, while adolescents exhibited a slightly higher score of 79.6. Cognitive and physical fatigue levels were similar, both around 74, while mental fatigue was marginally lower at 70.1.

Non-pharmacological interventions resulted in a higher fatigue level (79.1) compared to pharmacological interventions (75.5). The severity varied significantly based on diagnostic criteria and assessment tools, with scores ranging from 54.2 using ICC to 83.6 using Canadian criteria, and from 54.2 using MFS to 88.6 using CIS.

User-Usable Inferences

  • Fatigue severity in ME/CFS patients is generally high, averaging around 78 on a 100-point scale.
  • Adolescents with ME/CFS may experience slightly higher fatigue levels compared to adults.
  • Non-pharmacological treatments may result in higher perceived fatigue compared to pharmacological treatments.
  • Significant variations in fatigue severity scores are observed depending on the diagnostic criteria and assessment tools used.

This systematic review provides the first detailed analysis of fatigue severity in ME/CFS patients. The findings offer valuable insights for clinicians in terms of diagnosis, therapeutic assessment, and patient management, as well as for researchers conducting fatigue-related studies.

Original Article: J Transl Med. 2024 Jun 3;22(1):529. doi: 10.1186/s12967-024-05349-7.

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