Comparison of Diagnostic Criteria - discussion thread

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hallmarkOvME said:
To be clear, though, CFS is diagnosable by ICD, correct?
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There are lots of criteria and several disease categories used by different people. Most members here think CFS is not a helpful term and I agree. ME/CFS as defined roughly by Canadian Consensus Criteria 2003, IOM and NICE (inasmuch as it actually defines it) seems useful to most of us. Not sure what ICD is?
 
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Jonathan Edwards said:
There are lots of criteria and several disease categories used by different people. Most members here think CFS is not a helpful term and I agree. ME/CFS as defined roughly by Canadian Consensus Criteria 2003, IOM and NICE (inasmuch as it actually defines it) seems useful to most of us. Not sure what ICD is?
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Possibly this?


It's the International Classification of Diseases from the World Health Organization.
 
Jonathan Edwards said:
I guess so. I don't know if ICD has diagnostic instructions of its own.
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It doesn’t, it’s just a diagnostic code for billing purposes. @hallmarkOvME if you are the in US, you can get an ICD code for chronic fatigue syndrome or idiopathic chronic fatigue on your chart. Many physicians will use them interchangeably, unaware of any specific diagnostic criteria for (ME)/CFS
 
Jonathan Edwards said:
There are lots of criteria and several disease categories used by different people. Most members here think CFS is not a helpful term and I agree. ME/CFS as defined roughly by Canadian Consensus Criteria 2003, IOM and NICE (inasmuch as it actually defines it) seems useful to most of us. Not sure what ICD is?
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Apologies. How about: Are there consensus dx criteria, or proposed consensus dx criteria, for ME? (I say "are" instead of "is" cuz MCAS, for example, has TWO consensus dx criteria.)
 
Jonathan Edwards said:
There are lots of criteria and several disease categories used by different people. Most members here think CFS is not a helpful term and I agree. ME/CFS as defined roughly by Canadian Consensus Criteria 2003, IOM and NICE (inasmuch as it actually defines it) seems useful to most of us. Not sure what ICD is?
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Ty! Pretend I said ME and I'll stick to ME/CFS hereon By "category" do you "nosology?"Please clarify your distinction between consensus criteria and actual definition.
 
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hallmarkOvME said:
I don't see any of these on our Fact Sheet?
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You're right. I don't see any direct mentions of any specific criteria, except listed at the bottom as references.

Maybe it'd be good to include something about specific existing criteria. It might be helpful for people who are curious if their symptoms align with a more "official" source.
 
hallmarkOvME said:
Apologies. How about: Are there consensus dx criteria, or proposed consensus dx criteria, for ME? (I say "are" instead of "is" cuz MCAS, for example, has TWO consensus dx criteria.)
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What are you meaning by 'ME', rather than ME/CFS? The only set of criteria I know of that claim to identify 'ME' are the Carruthers International Criteria from around 2012. Hardly anyone uses them and they don't really make any sense and were never validated in any meaningful way.

MCAS is probably not a useful category. There is no generally accepted definition and I know of no reason to add the concept to what we already have (allergy, mastocytosis etc.) It is a name invented by a physician called Afrin who has never substantiated it.

Diagnostic criteria are by and large valueless, except for standardising certain types of research. I spent my career researching rheumatoid arthritis, working out mechanisms and developing treatments without ever remembering what the diagnostic criteria were supposed to be. I never used any criteria in a clinic. They are not relevant to real clinical care. Every patient has a slightly different problem. Treatment choice depends on much more complex distinctions.
 
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forestglip said:
Maybe it'd be good to include something about specific existing criteria. It might be helpful for people who are curious if their symptoms align with a more "official" source.
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Diagnostic criteria are just obsessions of third rate clinicians who in general do not understand what they are for anyway. These are the "official' sources and should be seen for what they are - empty authority.

Diagnosis in the clinic should have nothing to do with criteria. Patients need to understand that.
 
Jonathan Edwards said:
Diagnostic criteria are just obsessions of third rate clinicians who in general do not understand what they are for anyway. These are the "official' sources and should be seen for what they are - empty authority.

Diagnosis in the clinic should have nothing to do with criteria. Patients need to understand that.
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Do you believe official sources don't exist? If not, what would justify their authority?

What's the alternative to "empty" authority? Is it the same thing that enforces the "need" to understand criteria-less clinical diagnostics?
 
hallmarkOvME said:
You also said you've never used diagnostic criteria in clinic? What did you use? I've never received a diagnosis without one.
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There is a lot to learn about the way medicine works. Generally speaking doctors do not use diagnostic criteria. They may find they need to for filing in disability payment forms but that is another issue nd one which I fortunately never had to deal with.

I used accumulated experience and reading of lengthy textbook chapters to gain an understanding of prognostic groups - which are what medicine really works around. There is no point in diagnostic criteria that require four features if the patient hs three and plenty of time to develop of fourth later.

I appreciate you would like to understand how it works but medical training takes about ten years. After about six you begin to see the value of the categories. It is not very different from birdwatchng. Nobody has diagnostic criteria for Andean Flamingos. You get to recognise when it is definitely an Andean and when it might be but you cannot be sure. There are specific signs but you do not have lists you have to tick off. You might not be able to see the beak.
 
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