1. Guest, click here and read the 'News in Brief' post for w/c 8th July.
    Dismiss Notice

Medscape: "New Clinical Practice Guidelines, August 2018 Edition"

Discussion in 'General ME/CFS News' started by ahimsa, Aug 9, 2018.

  1. ahimsa

    ahimsa Senior Member (Voting Rights)

    Messages:
    611
    Likes Received:
    4,893
    Location:
    Oregon, USA
    I saw this on the Medscape website today. I think it's just a summary of recent changes posted on CDC website but I'm not sure.
    Full article (may require Medscape registration/login) - https://reference.medscape.com/viewarticle/900291_5
     
  2. Hutan

    Hutan Moderator Staff Member

    Messages:
    4,898
    Likes Received:
    22,481
    There's quite a bit to like in this brief guideline.


    I'm not sure what happened to the last paragraph though - it seems to have been cut off mid-word.
     
  3. Webdog

    Webdog Senior Member (Voting Rights)

    Messages:
    1,528
    Likes Received:
    10,318
    Location:
    California
    You'd think with 7 authors, someone would have noticed. ;)

    Agreed it's a very nice summary. Hopefully they will fix the cut-off ending. I'd like to share this with some doctors when it's corrected.

    I sent quick notes to WebMD (ETA: and Medscape) editors. If they don't respond, I will send notes to the authors.

    Edit: Still no response from editorial, so I will start contacting the 7 authors one by one until I get a response.
     
    Last edited: Aug 10, 2018
  4. Trish

    Trish Moderator Staff Member

    Messages:
    13,535
    Likes Received:
    74,195
    Location:
    UK
    It starts very well, then vanishes mid word (strategies to ma...) at the crucial point of what I assume is 'strategies to manage ...'. So does it advise pacing, rest, activity management, GET??? Or is it just going to leave us with a vague 'manage symptoms' without saying how?
     
  5. Webdog

    Webdog Senior Member (Voting Rights)

    Messages:
    1,528
    Likes Received:
    10,318
    Location:
    California
    Just spoke on the phone with one of the listed article authors (turns out he's an editor), Brian Feinberg. Brian said he would take care of getting it fixed and send me an email when it's done.
     
    Last edited: Aug 10, 2018
  6. Webdog

    Webdog Senior Member (Voting Rights)

    Messages:
    1,528
    Likes Received:
    10,318
    Location:
    California
    Looks like the article has been fixed. The final sentence now reads: "Each patient’s program typically includes a combination of therapies to address symptoms, techniques to help patients cope, and strategies to manage daily activities."
     
  7. Andy

    Andy Committee Member & Outreach

    Messages:
    6,689
    Likes Received:
    49,800
    Location:
    Hampshire, UK
    I understand you may prefer not to but Medscape logins can be had by anyone, it's a free sign-up.
     
    Invisible Woman, Joh, rvallee and 3 others like this.
  8. Andy

    Andy Committee Member & Outreach

    Messages:
    6,689
    Likes Received:
    49,800
    Location:
    Hampshire, UK
  9. Andy

    Andy Committee Member & Outreach

    Messages:
    6,689
    Likes Received:
    49,800
    Location:
    Hampshire, UK
    Selected excerpts from the CFS series of pages
    Under Epidemiology
    Quoting this bit in full as it's less good
    References are
    14 - Longitudinal follow-up of employment status in patients with chronic fatigue syndrome after mononucleosis, 2014, Nyland et al, https://bmjopen.bmj.com/content/4/11/e005798
    15 & 16 - The prognosis of chronic fatigue and chronic fatigue syndrome: a systematic review., 1997, Joyce J; Hotopf M; Wessely S, https://reference.medscape.com/medline/abstract/9093600

    All pages say they were updated Aug 9th 2018. Apart from the couple of uses of CSF when CFS is meant, and the prognosis bit, my scan through tells me that otherwise it's pretty much as we would want it at the moment.
     
  10. Keela Too

    Keela Too Senior Member (Voting Rights)

    Messages:
    668
    Likes Received:
    5,993
    Location:
    Sally Burch - Northern Ireland
    Sure a load of stakeholders said GET should go, but NICE themselves haven’t yet changed their recommendation for GET. Sadly.
     
  11. Sly Saint

    Sly Saint Senior Member (Voting Rights)

    Messages:
    3,096
    Likes Received:
    26,079
    Location:
    UK
    A Revised Approach for Chronic Fatigue Syndrome | The Morning Report
    [​IMG]
    Medscape

    Published on Dec 12, 2018
    Currently, chronic fatigue syndrome, which is now called myalgic encephalomyelitis syndrome or ME/CFS, has no cure. But a recent summit concluded that there is much we can do to improve patients' symptoms and quality of life. The multispecialty group endorsed the 2015 Institute of Medicine diagnostic criteria of unexplained fatigue with substantial functional impairment, postexertional malaise, unrefreshing sleep, and either cognitive dysfunction or orthostatic intolerance.

     
  12. Webdog

    Webdog Senior Member (Voting Rights)

    Messages:
    1,528
    Likes Received:
    10,318
    Location:
    California
    But the 2015 IOM (NAM) proposed diagnostic criteria actually say:
    So, is it substantial functional impairment with fatigue (IOM), or fatigue with substantial functional impairment (Medscape)? These are not equivalent and the distinction is important.

    Medscape is not alone in this. UpToDate, Healthwise, even Cort's recent blog characterize ME/CFS as primarily a fatigue disorder. But that is not what the IOM report says.

    Here's how the CDC breaks down the first IOM ME/CFS diagnostic criterion:
    Note that the CDC bolds functional impairment and places it first, but does not bold fatigue which is also under a subcategory.
     
    rvallee, Sly Saint, Sean and 5 others like this.

Share This Page