Finland: Duodecim ME/CFS Guideline: Draft Published for Consultation

mango

mango

Senior Member (Voting Rights)
strategist said:
The link is to a page for commenting on them. Where can we read these guidelines?
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It says that if you fill out the form and click through, you will be able to access the material.

ETA:
Duodecim said:
Pyydämme Teitä antamaan lausunnon Krooninen väsymysoireyhtymä (ME/CFS) Hyvä käytäntö -konsensussuosituksesta. Vastaajan tiedoissa pakolliset kysymykset on merkitty (*) tähtimerkillä. Mikäli annatte lausunnon yksityishenkilönä, merkitkää siitä tieto kohtaan Taustayhteisöt / toimipaikka. Lausuntokierroksen materiaaleihin pääsee sivulta 2 tunnistautumisen jälkeen.
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Yes I found it. I got a copy in Finnish and Google can translate the entire document. Some of what they are recommending

Recommendation 1.3.1: We recommend that when examining chronic fatigue syndrome (ME / CFS) in Finland incidence and incidence, criteria containing PEM Symptom are used.

Recommendation 1.4.1: We recommend that the possibility of chronic fatigue syndrome (ME / CFS) be taken into account when a patient has any of the following and cannot be explained by other diseases: Prolonged fatigue / fatigue that impairs Everyday life, impaired functional ability on a large scale

o deterioration in well - being after relatively little physical or Cognitive exertion, and worsening of symptoms (PEM Symptom, post-exertional malaise)
o Diverse and long-lasting syndrome that is not normally relieved at rest and may include unrestrained sleep, pain, Cognitive difficulties, and autonomic nervous system or immune system symptoms.

Recommendation 1.7.1: Recommended in adults for the diagnosis of chronic fatigue syndrome (ME / CFS) for use in diagnostic criteria with PEM Symptom. Such are the Canadian criteria (CCC, 2003) and its updated version (CCC2010) and the International Consensus Criteria (ICC, 2011). Diagnostic criteria are described in the supplementary information.

Recommendation 1.7.2: We do not recommend using the CDC / Fukuda or Oxford criteria for chronic in the diagnosis of fatigue syndrome (ME / CFS).

Recommendation 1.7.3: IOM criteria can be used in primary care in suspected disease to guide the treatment chain, but we do not recommend using it for chronic fatigue syndrome (ME / CFS) in diagnosis.

Recommendation 2.3.1: We recommend an individually designed exercise and rest plan as part of the rest treatment and Rehabilitation.

Recommendation 2.3.2: We recommend that an individual exercise and rest plan be developed Multidisciplinary together with the patient

Recommendation 2.5.1: We recommend that Psychological methods such as reporting illness (psychoeducation) can be used as part of a patient with chronic fatigue syndrome (ME / CFS) multifaceted treatment and Rehabilitation.

Recommendation 2.5.2: We recommend that methods based on Cognitive behavioral therapy discussed and informed in patients with chronic fatigue syndrome (ME / CFS), who have concomitant mental stress symptoms. Those who want treatment are offered the opportunity to do so.
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There are many more recommendations.

Overall it seems good but as usual there is a bit of an obsession with exercise. The problem is that they recommend exercise to increase functional capacity when we know this doesn't work.

 
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Duodecim publishes evidence-based medical guidelines that are taken over by other countries (for example here in Belgium). I have sent a mail asking if this will also be the case for these ME/CFS recommendations or whether they are intended for Finland only.
 
The new guideline has now been published:

https://www.terveysportti.fi/apps/ltk/article/hsu00019?toc=476592



EMEA said:
Finland's Duodecim Publishes New Guidelines for ME

EMEA Finland (Suomen lääketieteellinen ME/CFS-yhdistys ry) has been involved in recent ME guidelines development that has been conducted by the Finnish agency Duodecim.

The guidelines have just been published - the link is here.

These guidelines promise to be a pragmatic and useful set of guidelines.

Last year four members of the European ME Alliance were invited to review the guidelines and participate in a review meeting with the Duodecim team.
These EMEA members submitted comments on the guidelines as part of this review process.
Many of the comments from EMEA were taken on board and have been integrated in the published guidelines.

EMEA members participating were EMEA Finland (Suomen lääketieteellinen ME/CFS-yhdistys ry), EMEA Sweden (RME), EMEA Denmark (ME Foreningen) and EMEA UK (Invest in ME Research).
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http://www.europeanmealliance.org/news-Q12021-002.shtml
 
mango said:
News article in the Finnish Medical Journal:

Uusi suositus määritteli kroonisen väsymysoireyhtymän
https://www.laakarilehti.fi/ajassa/...itus-maaritteli-kroonisen-vasymysoireyhtyman/

Google Translate, English
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Thank you for providing these links, @mango !

It doesn't sound like they're quite there yet. Here are some quotes from the google translated article from the Finnish Medical Journal:
- It is not known whether this is a functional or biological disorder. This is one of the traditional, partly artificial border crossings that has hampered this field, says Risto Vataja , Chief Physician of Neurology and Psychiatry, Chief Physician of Psychiatry at a press conference remotely.

Vataja was a member of the expert panel.

...

The cause of the disease is unknown. According to the plaintiff, it is likely to be a multifactorial disturbance for which no single cause can be found. It is also unclear whether this is a single disease or whether there are many different disease states within the same heading.

There is no evidence-based treatment.

- Still, we know how to treat patients. There are multidisciplinary therapies that treat patients 'symptoms and affect their physical and social functioning, which can improve patients' quality of life and ability to function, Vataja says.
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