Information for medical practitioners

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Diagnosis & Management

The latest internationally accepted criteria for diagnosis and management of ME, 2014

International Consensus Primer for Medical Practitioners‘ Developed by an international panel of ME experts from the IACFS/ME who have collectively more than 500 years of ME clinical experience and worked with over 50,000 patients with ME.

The Canadian Guidelines

Canadian ME/CFS Clinical Case Definition and Guidelines for Medical Practitioners‘ (overview – 28 pages), Curruthers, B & van de Sande, M (2005) . Full document (164 pages)

This document, often referred to as the ‘Canadian Guidelines’, is an internationally accepted standard for the clinical diagnosis of ME/CFS. It includes:

  • How to make an accurate diagnosis
  • Symptoms and effects upon the body
  • Clinical evaluation
  • Symptom management and treatment
  • Symptom severity check list
  • Sleep and pain profile
  • Assessing occupational disability
  • Tests for abnormalities

Paediatric Diagnosis

Jason, L (2006) ‘A Paediatric Case Definition of ME/CFS‘, Journal of Chronic Fatigue Syndrome, vol. 13, no. 2/3.

Differentiation between ME/CFS and depression

Stein, E (2005) ‘Clinical Guidelines for Psychiatrists: Assessment and Treatment of Patients with ME/CFS‘.

A brief overview of diagnosis and treatment

Stein, E (2009) ‘Beyond tired: Helping patients cope with chronic fatigue syndrome‘, Pharmacy Practice, Dec/Jan 2009, pp. 14-21. A handy, brief overview of etiology, diagnosis, symptoms, treatment, pharmacotherapy, & prognosis.

ME/CFS disability scale

It is useful for GPs and other medical practitioners to measure the level of activity and ability of patients with ME/CFS to function with a simple instrument on every visit – the ME/CFS (or CFIDS) Disability Scale. The ME/CFS Disability Scale assists in documenting improvements or otherwise in the condition and the effects of medications, as well as provding a useful marker for long-term changes. It may also serve as a key reference should you need to write a medical history or supporting letter for disability benefit claims.

In marking the score of patients on the scale, it is important to document as accurately as possible the severity of symptoms, the degree of activity impairment with both activity and rest, and the functional ability regarding full time work. The principle behind the ME/CFS Disability Scale is that the severity of symptoms is related to exertion – physical and mental.

The concept that severity of symptoms is related to exertion is not one necessarily understood by all doctors, Centrelink representatives, insurance companies and employers.

A copy of the scale is available on Fact Sheet 4 ‘Learning to Pace’.

Adapted from Bell, D S (1994) ‘The doctors guide to chronic fatigue syndrome: Understanding, treating and living with CFIDS’, Addison-Wesley, USA. (Page 123).


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