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An exploratory study into chronic fatigue syndrome/myalgic encephalomyelitis and fibromyalgia

Discussion in 'General ME/CFS News' started by MeSci, Jun 25, 2018.

  1. MeSci

    MeSci Senior Member (Voting Rights)

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    Can anyone get hold of this, i.e. does anyone here have the necessary log-in permissions?
    Or isn't it worth bothering with?

    Source: University of the West of Scotland

    Date: November 16, 2017

    URL: http://ethos.bl.uk/OrderDetails.do?did=1&uin=uk.bl.ethos.738487

    An exploratory study into the symptoms of chronic fatigue syndrome/myalgic encephalomyelitis and fibromyalgia
    ----------------------------------------------------------
    Pamela Gair McKay

    - School of Health, Nursing, and Midwifery, University of the West of Scotland
     
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  2. Amw66

    Amw66 Senior Member (Voting Rights)

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    I have just asked my son's girlfriend ( about to graduate from UWS) if she can save a PDF copy - will let you know
     
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  3. Trish

    Trish Moderator Staff Member

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    Looks like it's a PhD thesis. Given that most people who do PhD's try to get at least one paper publication out of their research, it might be worth contacting the university and asking whether there is any.

    I find it hard to imagine someone spending 3 years and producing enough original research on the symptoms of ME. I guess they did a literature search and some questionnaires...
     
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  4. Amw66

    Amw66 Senior Member (Voting Rights)

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    remember this is the land of Dr Pelosi...
     
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  5. Trish

    Trish Moderator Staff Member

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    All the more reason to find out what is going on.
     
  6. Dolphin

    Dolphin Senior Member (Voting Rights)

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    I logged into my ethos account which anyone anywhere can get and was able to get a full copy. In general as I recall they ask for you not to share files as I recall so don’t think I will post file but anyone can get as I say.
     
  7. adambeyoncelowe

    adambeyoncelowe Senior Member (Voting Rights)

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    I'd like to see this too.
     
  8. Dolphin

    Dolphin Senior Member (Voting Rights)

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    Table of Contents
    Abstract i
    List of Tables x
    List of Figures xiii
    List of Appendices xv
    Abbreviations xvi
    Publications Arising
    from this study
    xix
    Chapter 1 Introduction Page 1
    Chapter 2 Literature Review Page 5
    2.0 Introduction to literature review Page 5
    2.1 Historical Perspectives Page 7
    2.2 Epidemiology Page 11
    2.3 Prevalence Page 11
    2.4 Diagnosing CFS/ME Page 12
    2.4.1 Diagnostic criteria available for CFS/ME Page 15
    2.4.2 Management of CFS/ME Page 17
    2.4.2.1 Pharmacological approaches to CFS/ME Page 18
    2.4.2.2 Non-pharmacological approaches to CFS/ME Page 19
    2.5 Impact of the attitudes of professionals towards diagnosis
    and management of CFS/ME
    Page 22
    2.6 Diagnostic criteria for FM Page 22
    2.6.1 Diagnosing FM Page 23
    2.6.2 Management of FM Page 27
    2.6.2.1 Pharmacological approaches to FM Page 27
    2.6.2.2 Non-pharmacological approaches to FM Page 30
    2.6.3 Impact of attitudes of professionals towards diagnosis and
    management of FM
    Page 31
    2.7 Debating the single syndrome Page 32
    2.8 The proposed study into CFS/ME and FM Page 36
    v
    Chapter 3 Background Literature for the Questionnaires Page 38
    3.0 Introduction to the literature review for the questionnaires to
    measure the symptoms
    Page 38
    3.1 Overview of questionnaires suitable for measuring the
    symptoms of CFS/ME and FM
    Page 38
    3.2 Consideration of the Psychometric properties of the
    Questionnaires
    Page 39
    3.2.1 Reliability Page 39
    3.2.2 Validity Page 41
    3.3 Reviewed questionnaires Page 44
    3.4 Questionnaires Page 49
    3.5 Specific Questionnaires and Criteria for CFS/ME and FM Page 50
    3.5.1 American CDC Diagnostic criteria for CFS/ME and
    Symptom Inventory
    Page 50
    3.5.2 American College of Rheumatology diagnostic criteria for
    FM
    Page 53
    3.5.3 Fibromyalgia Impact Questionnaire Page 54
    3.6 Generic Questionnaires to measure the symptoms of
    CFS/ME and FM
    Page 57
    3.6.1 Questionnaire to measure Pain Page 57
    3.6.2 Questionnaire to measure Fatigue Page 60
    3.6.3 Questionnaire to measure Sleep Page 63
    3.6.4 Questionnaire to measure Health Related Quality of Life Page 66
    3.6.5 Questionnaire to measure Anxiety and Depression Page 70
    3.6.6 Questionnaire to measure Locus of Control Page 72
    3.6.7 Questionnaire to measure Self Esteem Page 76
    Chapter 4 Methods Page 81
    4.0 Introduction to methods Page 81
    4.1 Hypothesis/ Objectives Page 81
    4.2 Defining the Research Methodology Page 82
    4.2.1 Methodology Page 84
    4.3 Study Design Page 86
    4.3.1 Inclusion and Exclusion criteria of the sample Page 86
    vi
    4.4 Recruitment process Page 87
    4.5 Ethical Considerations Page 89
    4.6 Study Consent Procedure Page 90
    4.7 Anonymity/Confidentiality/Data Storage Page 93
    4.8 Sample Size Page 94
    4.9 Protocol for Questionnaire Selection Page 99
    4.10 Data Analysis Page 101
    4.10.1 The CFS/ME and FM sample background Page 101
    4.10.2 Reliability of the questionnaires in the CFS/ME and FM
    groups
    Page 102
    4.10.3 The t-tests for comparing the Means of the CFS/ME and
    FM groups
    Page 103
    4.11 Confirmatory Factor Analysis (CFA) Structural Equation
    Modelling (SEM)
    Page 105
    4.11.1 Creation of the graphical model Page 107
    4.11.2 Formulation of the Reflective Models Page 110
    4.12 The procedure for performing SEM Page 113
    4.12.1 Specify the model to be measured Page 113
    4.12.1.2 Estimation of the model Page 114
    4.12.1.3 Improving Model Fit Page 116
    4.13 The Multi-group Invariance test procedure Page 118
    4.13.1 The Unconstrained model Page 119
    4.13.2 Measurement Weights model Page 120
    4.13.3 The Measurements Intercepts model Page 120
    4.13.4 The Weights Intercepts and Covariance model Page 121
    4.13.5 The cause of Non Invariance Page 121
    4.14 Model Fit assessment Page 122
    Chapter 5 Results Page 126
    5.0 Introduction Page 126
    5.1 Part One Website Activity Page 126
    5.2 Characteristics of the sample Page 127
    5.3 Part 2 Results for the Mean and Standard Deviation from
    the questionnaires for CFS/ME and FM
    Page 132
    vii
    5.3.1 Introduction Page 132
    5.3.2 American CDC Symptom Inventory Page 132
    5.3.3 The American ACR number of pain points Page 136
    5.3.4 Results from the FIQ Page 138
    5.3.5 Results from the McGill Pain Questionnaire Page 138
    5.3.6 Results from the Multidimensional Fatigue Inventory Page 150
    5.3.7 Results from the Pittsburgh Sleep Quality Index Page 151
    5.3.8 Results from the Health Related Quality of Life Page 152
    5.3.9 Results from the Hospital Anxiety and Depression Scale Page 153
    5.3.10 Results from the Multidimensional Health Locus of Control Page 155
    5.3.11 Results from the Rosenberg Self esteem Scale Page 156
    5.4 Part Three results Introduction Page 157
    5.4.1 Reliability testing of the questionnaires measuring CFS/ME
    and FM
    Page 158
    5.4.2 Exploring differences between CFS/ME and FM t-tests and
    Mann-Whitney U tests
    Page 160
    5.4.3 The American CDC Symptom Inventory results Page 161
    5.4.4 The Fibromyalgia Impact Questionnaire results Page 164
    5.4.5 The McGill Pain Questionnaire results Page 166
    5.4.6 The Multidimensional Fatigue Inventory results Page 168
    5.4.7 The Pittsburgh Sleep Quality Index results Page 169
    5.4.8 The Health Related Quality of Life SF-36 V2 results Page 170
    5.4.9 The Hospital Anxiety and Depression Scale results Page 172
    5.4.10 The Multidimensional Health Locus of Control results Page 173
    5.4.11 The Rosenberg Self Esteem Scale results Page 174
    5.5 Measuring the constructs across CFS/ME and FM using
    SEM and Invariance Testing
    Page 176
    5.5.1 The American CDC Symptom Inventory SEM results Page 176
    5.5.2 The Fibromyalgia Impact Questionnaire SEM results Page 182
    5.5.3 The McGill Pain Questionnaire SEM results Page 187
    5.5.4 The Multidimensional Fatigue Inventory SEM results Page 190
    5.5.5 The Pittsburgh Sleep Quality Index SEM SEM results Page 193
    5.5.6 The Health Related Quality of Life SF-36 V2 SEM results Page 197
    viii
    5.5.7 The Hospital Anxiety and Depression Scale SEM results Page 202
    5.5.8 The Multidimensional Health Locus of Control SEM results Page 207
    5.5.9 The Rosenberg Self Esteem Scale SEM results Page 213
    5.6 CFS/ME and FM Reconciled Page 216
    Chapter 6 Discussion Page 221
    6.1 Introduction Page 221
    6.2 Characteristics of the sample of CFS/ME and FM
    participants
    Page 221
    6.3 Confirmation of a diagnosis of CFS/ME and/or FM Page 223
    6.4 Confirmation of fulfilling the opposing criteria for CFS/ME
    and FM
    Page 225
    6.4.1 The relationship between the CFS/ME group and the ACR
    criteria for FM
    Page 226
    6.4.2 The relationship between the FM group and the American
    CDC Criteria for CFS
    Page 228
    6.5 Questionnaire Reliability Page 229
    6.5.1 Reliability of the questionnaires confirmed Page 230
    6.5.2 Reliability of the questionnaires Page 230
    6.5.2.1 Reliability of the American CDC Symptom Inventory Page 230
    6.5.2.2 Reliability of the McGill Pain Questionnaire Page 231
    6.5.2.3 Reliability of the Multidimensional Fatigue Inventory Page 232
    6.5.2.4 Reliability of the Pittsburgh Sleep Quality Index Page 233
    6.5.2.5 Reliability of the Multidimensional Health Locus of Control Page 234
    6.6 Discussion of the Symptoms Page 235
    6.6.1 The symptoms recorded by the American CDC Symptom
    Inventory for CFS
    Page 237
    6.6.2 The symptoms recorded by the Fibromyalgia Impact
    Questionnaire
    Page 238
    6.6.3 The symptoms recorded by the McGill Pain Questionnaire Page 239
    6.6.4 The symptoms recorded by the Multidimensional Fatigue
    Inventory
    Page 243
    6.6.5 The symptoms recorded by the Pittsburgh Sleep Quality
    Index
    Page 245
    6.6.6 The symptoms recorded by the Health Related Quality of
    Life SF-36 V2
    Page 246
    ix
    6.6.7 The symptoms recorded by the Hospital Anxiety and
    Depression Scale
    Page 248
    6.6.8 The symptoms recorded by the Multidimensional Health
    Locus of Control Form C
    Page 250
    6.6.9 The symptoms recorded by the Rosenberg Self Esteem
    Scale
    Page 252
    6.7 Confirming the relationships between CFS/ME and FM Page 254
    6.7.1 Invariance confirmed Page 255
    6.7.2 Non Invariance confirmed Page 258
    6.8 CFS/ME and FM Reconciled Page 264
    6.9 Study Limitations
    Page 267
    Chapter 7 Conclusions and Recommendations Page 270
    7.0 Introduction Page 270
    7.1 Contribution to Knowledge Page 270
    7.2 Implications for the future Page 273
    References Page 277
    Bibliography Page 346
    Appendices Page 360
    x
    List of Tables
    Table 1 Cronbach’s alpha levels for reliability (Polit and Beck, 2013). Page 41
    Table 2 Questionnaires selected for Study Page 49
    Table 3 Summary of Reliability and Validity of the Questionnaires Page 80
    Table 4 Key for HADS Questions Page 109
    Table 5 Classification of selected Goodness of Fit indexes Page 125
    Table 6
    Total number of people who attempted each section of the 100
    questionnaires
    Page 127
    Table 7 Gender and age distribution of the CFS/ME and FM participants Page 128
    Table 8 Educational achievement of participants Page 129
    Table 9 Mean and Standard Deviation for the CFS/ME and FM groups for the
    American Centre for Disease Control Symptom Inventory (Fukuda et al,
    1994)
    Page 133
    Table 10
    Number of participants who responded that they had experienced each
    symptom of the American CDC Symptom Inventory in the past 6 months
    Page 134
    Table 11
    The symptom which participants confirmed bothered them the most
    during the past six months on the American CDC Symptom Inventory
    Page 134
    Table 12
    Results of the Mean and Standard Deviations on the Fibromyalgia
    Impact Questionnaire for CFS/ME and FM
    Page 138
    Table 13
    The Mean and Standard Deviation of the scores for each of the four
    domains and the total score of the MPQ
    Page 139
    Table 14
    The MPQ most popular pain descriptor words selected from each group
    of words by the CFS/ME and FM participants
    Page 140
    Table 15
    First grouping of words to describe how participants pain changes over
    time on the MPQ
    Page 141
    Table 16
    Second grouping of words to describe how participants pain changes
    over time on the MPQ
    Page 142
    Table 17
    Third grouping of words to describe how participants pain changes over
    time on the MPQ
    Page 142
    Table 18 Description of Pain at its worst on the MPQ for CFS/ME and FM Page 143
    Table 19 Description of Pain at its best on the MPQ for CFS/ME and FM Page 143
    Table 20 Total Mean and Standard Deviation for the MFI Page 150
    Table 21 Mean and Standard Deviation for the total score of the PSQI for CFS/ME
    and FM
    Page 151
    xi
    Table 22 Means and Standard Deviation for the Totals of the SF-36 V2 for
    CFS/ME and FM
    Page 152
    Table 23 Number and % of participants of the sample with poor Health Related
    Quality of Life measured by the SF-36 V2 for CFS/ME and FM
    Page 153
    Table 24 Mean and Standard Deviation for the total HADS scores for CFS/ME
    and FM
    Page 154
    Table 25 Mean and Standard Deviation for the total score of the MHLOC form C
    for CFS/ME and FM
    Page 155
    Table 26 Mean and Standard Deviation for the Rosenberg Self Esteem Scale for
    CFS/ME and FM
    Page 156
    Table 27 Reliability results for the questionnaires measuring the symptoms of
    CFS/ME and FM
    Page 158
    Table 28 The American CDC Symptom Inventory Levene’s test and t-test results Page 161
    Table 29 The Fibromyalgia Impact Questionnaire (FIQ) Levene’s test and t-test
    results
    Page 164
    Table 30 The McGill Pain Questionnaire Levene’s test and t-test results Page 166
    Table 31 Multidimensional Fatigue Inventory Levene’s test and t-test results Page 168
    Table 32 Pittsburgh Sleep Quality Index Levene’s test and t-test results Page 169
    Table 33 Health Related Quality of Life SF-36 V2 Levene’s test and t-test results Page 170
    Table 34 Hospital Anxiety and Depressions Scale Levene’s test and t-test results
    Page 172
    Table 35 Multidimensional Health Locus of Control Levene’s test and t-test results
    Page 173
    Table 36 Rosenberg Self Esteem Scale Levene’s test and t-test results Page 174
    Table 37 Summary of the results from the t-tests and Mann Whitney U tests for all
    the questionnaires used to measure the symptoms of CFS/ME and FM
    Page 175
    Table 38 Goodness of Fit tests for the American CDC Symptom Inventory
    Baseline Model for CFS/ME and FM
    Page 177
    Table 39 Goodness of Fit Statistics Invariance testing for the American CDC
    Symptom Inventory Baseline model for CFS/ME and FM
    Page 180
    Table 40 Significance level of individually constrained items of the American CDC
    Symptom Inventory
    Page 181
    Table 41 Goodness of Fit tests for the Fibromyalgia Impact Questionnaire
    Baseline Model for CFS/ME and FM
    Page 182
    Table 42 Goodness of Fit Test for the FIQ results for Invariance Testing for
    CFS/ME and FM
    Page 186
    Table 43 Chi-square tests of the FIQ results of the significance level with each
    item constrained individually for CFS/ME and FM
    Page 187
    Table 44 Goodness of Fit Tests for the McGill Pain Questionnaire Baseline Model
    for CFS/ME and FM
    Page 188
    Table 45 Invariance testing results for the Goodness of Fit Tests for the MPQ for
    the CFS/ME and FM groups
    Page 190
    xii
    Table 46 Results for the Baseline Model Goodness of Fit Tests for the
    Multidimensional Fatigue Inventory for the CFS/ME and FM groups
    Page 191
    Table 47 Results for Invariance Testing of the Multidimensional Fatigue Inventory Page 192
    Table 48 Goodness of Fit Tests for the PSQI Baseline Model for the CFS/ME and
    FM groups
    Page 193
    Table 49 Goodness of Fit Statistics for Invariance Testing for the PSQI Page 196
    Table 50 Goodness of Fit Test for the SF-36 V2 Baseline Model for CFS/ME and
    FM
    Page 197
    Table 51 Goodness of Fit Statistics of the Invariance testing for the Health
    Related Quality of Life SF-36 V2 questionnaire
    Page 200
    Table 52 Goodness of Fit Tests for the Hospital Anxiety and Depression Scale
    Baseline Model
    Page 202
    Table 53 Goodness of Fit Statistics for Invariance Testing for the HADS for the
    CFS/ME and FM group
    Page 206
    Table 54 The significance level when each item on the HADS is constrained
    individually
    Page 206
    Table 55 Goodness of Fit Tests for the MHLOC Form C Page 207
    Table 56 Goodness of Fit Indices for Invariance testing for the MHLOC Form C for
    CFS/ME and FM
    Page 212
    Table 57 Goodness of Fit Tests for the RSES Baseline Model without
    modifications
    Page 213
    Table 58 Goodness of Fit Indices for Invariance testing for the RSES for CFS/ME
    and FM
    Page 216
    Table 59 Goodness of Fit Tests for the Syndrome Model Baseline without
    Modifications
    Page 217
    Table 60 Goodness of Fit Indices for Invariance testing for Syndrome Model for
    CFS/ME and FM
    Page 218
    Table 61 Summary of the results from the Invariance testing of the questionnaires
    used to measure the symptoms of CFS/ME and the FM groups
    Page 220
    xiii
    List of Figures
    Figure 1 Image of the 18 tender points used to diagnose Fibromyalgia as
    recommended by the American College of Rheumatology (Wolfe et al.,
    1990)
    Page 24
    Figure 2 Consent Procedure for Study Page 91
    Figure 3 Example Baseline SEM Model for the HADS (Zigmond and Snaith,
    1983).
    Page 109
    Figure 4 Direct Reflective Model Page 110
    Figure 5 Marital Status of CFS/ME and FM participants Page 128
    Figure 6 Employment status of CFS/ME and FM participants Page 130
    Figure 7 Country of residence of CFS/ME and FM participants Page 131
    Figure 8 Medical professionals who diagnosed CFS/ME and FM participants Page 131
    Figure 9 American CDC Symptom Inventory number of symptoms selected by
    CFS/ME and FM participants
    Page 135
    Figure 10 The ACR diagnostic criteria. Number of pain points selected by the
    CFS/ME and FM participants
    Page 137
    Figure 11 Results from the posterior view of the body adapted from the MPQ
    incorporating the American College of Rheumatology Pain points for
    CFS/ME and FM
    Page 145
    Figure 12 Results from the anterior view of the containing the American College of
    Rheumatology Pain points for CFS/ME and FM
    Page 146
    Figure 13 Results MPQ anterior view of body with no pain points indicated for
    CFS/ME and FM
    Page 148
    Figure 14 Results MPQ posterior view of head with no pain points indicated for
    CFS/ME and FM
    Page 149
    Figure 15 Unconstrained Structural Equation Model of the American CDC
    Symptom Inventory
    Page 177
    Figure 16 Unconstrained Modified Model American CDC Symptom Inventory Page 178
    Figure 17 Fully Constrained modified model American CDC Symptoms Inventory
    for both CFS/ME and FM
    Page 180
    Figure 18 Unconstrained Model of the FIQ Page 183
    Figure 19 Modified Unconstrained Model of the FIQ Page 184
    Figure 20 Fully Constrained Modified FIQ Model Page 185
    Figure 21 Unconstrained Baseline Model of the MPQ for both CFS/ME and FM Page 188
    Figure 22 Fully Constrained MPQ Model for CFS/ME and FM Page 189
    Figure 23 Unconstrained Baseline Model for the MFI Page 191
    Figure 24 Fully Constrained MFI Model for CFS/ME and FM Page 192
    Figure 25 Unconstrained Baseline Model for the PSQI Page 194
    xiv
    Figure 26 Modified Unconstrained PSQI Model Page 195
    Figure 27 Fully Constrained Modified Model for the PSQI Page 196
    Figure 28 Unconstrained Baseline Model for the SF-36 V2 Health Related Quality
    of Life Questionnaire
    Page 198
    Figure 29 Modified Unconstrained Model for the SF-36 V2 Health Related Quality
    of Life for CFS/ME and FM
    Page 199
    Figure 30 Fully Constrained Modified Model for the Health Related Quality of Life
    Questionnaire SF-36 V2 for CFS/ME and FM
    Page 200
    Figure 31 Fully Constrained Modified Measurements and Intercepts Model for the
    SF-36 V2
    Page 201
    Figure 32 Baseline Unconstrained Model for the HADS Page 203
    Figure 33 Unconstrained Modified Model for the HADS for CFS/ME and FM Page 204
    Figure 34 Fully Constrained Modified Model for the HADS for CFS/ME and FM Page 205
    Figure 35 Baseline Unconstrained Model MHLOC Form C Page 208
    Figure 36 Unconstrained Modified Model for the MHLOC Form C Page 210
    Figure 37 Fully Constrained Modified Model for the MHLOC Form C Page 211
    Figure 38 Unconstrained Baseline Model for the RSES Page 214
    Figure 39 Fully Constrained Model for the RSES Page 215
    Figure 40 Unconstrained Syndrome Model Page 217
    Figure 41 The Unconstrained Modified Syndrome Model Page 218
    xv
    List of Appendices
    Appendix 1 Tests for CFS/ME a Process of Elimination Page 360
    Appendix 2 Criteria for Diagnosing CFS/ME (NICE, 2007) Page 361
    Appendix 3 Current US Case Definition of Chronic Fatigue Syndrome (Fukuda
    et al., 1994) and Symptom Inventory
    Page 362
    Appendix 4 Fibromyalgia Impact Questionnaire (Burckhardt, 1997) Page 370
    Appendix 5 McGill Pain Questionnaire (Melzack, 1975) Page 372
    Appendix 6 Screen Shot from Website of MPQ with ACR pain points Page 373
    Appendix 7 Multidimensional Fatigue Inventory (Smets, 1985) Page 374
    Appendix 8 Pittsburgh Sleep Quality Index (Buysse et al., 1989) Page 375
    Appendix 9 SF-36 V2 Health Related Quality of Life Page 378
    Appendix 10 Hospital Anxiety and Depression Scale (Zigmond and Snaith, 1983)
    Page 381
    Appendix 11 Multidimensional health Locus of Control Form C (Wallston, 1995) Page 382
    Appendix 12 Rosenberg Self Esteem Scale (Rosenberg, 1967) Page 383
    Appendix 13 Advert for Research Page 384
    Appendix 14 Ethical Approval Letter Page 385
    Appendix 15 Screen Shot of Welcome page from Website Page 386
    Appendix 16 Participant Information Sheet Page 387
    Appendix 17 Scholarship Letter Page 390
    Appendix 18 Demographic Questionnaire Page 391
    Appendix 19 Revised ACR Criteria Page 396
    Appendix 20 Journal Article Arising from Research Page 398
    xvi
    Abbreviations
    American CDC
    Symptoms
    Inventory
    American Centre for Disease Control Symptoms Inventory
     
  9. Trish

    Trish Moderator Staff Member

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    You can join for nothing provided you're prepared to give your name and address.
    It's a copyrighted pdf document over 400 pages long. We are allowed to share the abstract of copyrighted documents.

     
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  10. Trish

    Trish Moderator Staff Member

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    I've skimmed through some of this. The following comments should be taken with caution - I haven't read the whole thesis, and may be accidentally misrepresenting it...

    On the plus side, the author seems to take ME/CFS and FM seriously. And she concludes that mental health problems are not the primary problem in either.

    BUT her whole analysis is based on the assumption that the main symptom of ME is fatigue and the main symptom of FM is pain, but that both syndromes experience both these symptoms.

    Using the collection of questionnaires available to her, she found no significant between-group differences and seemed to conclude that there is actually no discernible difference between ME/CFS and FM, and that diagnosis of one or the other is simply a result of which of fatigue or pain the patient presents with as their main symptom when they are diagnosed.

    On the basis of this, she concludes that, since the questionnaires couldn't distinguish between ME/CFS and FM, they must therefore be part of the same syndrome, and therefore should be offered the same treatment.

    The BIG problem with all of this, is that, as far as I could see in the parts I skimmed through, no mention is made of PEM.

    If none of the questionnaires you use are designed to pick up the presence of PEM, then it's not surprising you don't find it. I'm a bit shocked that she doesn't mention this as a limitation in her conclusion.

    It makes her leap of logic from similar symptoms on questionnaires to similar treatment required a dangerous leap.
     
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  11. Amw66

    Amw66 Senior Member (Voting Rights)

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    i have got a copy of this now .PM if of interest
     
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  12. Dolphin

    Dolphin Senior Member (Voting Rights)

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    Possibly people with fibromyalgia who go to a forum are more ill or even more likely to have ME/CFS than those with fibromyalgia on average? I’ve a relative with fibromyalgia who has always been able to work who wouldn’t go to fora.

    Some doctors have a tendency to give a diagnosis of fibromyalgia even when patient had ME/CFS. I know people who have gone to a pain clinic who have said “I have ME” and the doctor replied “No, you have fibromyalgia”/similar.

    I think our movement could be bigger if more of those with fibromyalgia were assessed for ME/CFS.

    I suspect this could happen with some other comorbidities also e.g. migraine, IBS, etc.
     
    Last edited: Jun 25, 2018
    ukxmrv, Hutan, alktipping and 6 others like this.

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