Nationwide epidemiological characteristics of chronic fatigue syndrome in South Korea, Lim et al. 2021

Abstract

Background: Chronic fatigue syndrome (CFS) is a long-term disabling illness accompanied by medically unexplained fatigue. This study aimed to explore the epidemiological characteristics of CFS in South Korea.

Methods: Using the nationwide medical records provided by the Korean Health Insurance Review & Assessment Service (HIRA), we analyzed the entire dataset for CFS patients diagnosed by physicians in South Korea from January 2010 to December 2020.

Results: The annual mean incidence of CFS was estimated to be 44.71 ± 6.10 cases per 100,000 individuals [95% CI: 40.57, 48.76], and the prevalence rate was 57.70 ± 12.20 cases per 100,000 individuals [95% CI: 49.40, 65.79]. These two rates increased by 1.53- and 1.94-fold from 2010 to 2020, respectively, and showed an increasing trend with aging and an approximately 1.5-fold female predominance.

Conclusions: This study is the first to report the nationwide epidemiological features of CFS, which reflects the clinical reality of CFS diagnosis and care in South Korea. This study will be a valuable reference for studies of CFS in the future.

Keywords: CFS; Chronic fatigue syndrome; Incidence; ME/CFS; Prevalence; South Korea; epidemiology.

Full text at: https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-021-03170-0

 

I think this is more evidence that ICD-10 type of insurance data is useless at capturing ME/CFS.

In 2019, there was this US study that looked at Insurance data registration using ICD-10 codes. @Simon M pointed out that the age structure for those diagnosed with code G93.3 Postviral fatigue syndrome (which includes ME), makes no sense. The prevalence kept on increasing with age.

We see the same thing here in this Korean study. For males the frequency was highest in the 80+ group, suggesting that doctors do not use this code to diagnose ME/CFS patients but rather old people who fail to recover from a viral infection.

 

I trust health record data on ME diagnoses like I trust closed-for-months gas station sushi. Or anything about chronic health problems in general.

At one point it will be necessary for medicine to decide how to deal with decades of garbage-in health records, how massively misleading they are for anything that isn't a reliable diagnosis with a validated test. Especially anything dealing with mental health, almost none of the data are reliable, almost none of the labels applied on health records are validated in any way.

The only way to move forward would be to accept that it's necessary to start over from scratch, to correct the failures moving forward and never use data before that date. I doubt it will happen, but the alternative is decades of misleading studies that will continue to hold back the field.

I have little confidence the hard but necessary decision will be made the right way. But anyone with minimal expertise of information science understands that you simply cannot trust garbage-in data, have to assume that it's best to drop it than use it in any way. But this has been pretty much a set of conscious decisions, made with full awareness of what it would mean to do this. And it still happened, at the point of entry, no less, the only place where you should be able to guarantee it. Amazing.

 

I would be curious to know what “treatment” these people got, it was not mentioned. People got it for a year only and then none. Their possible treatments at the end of article were the “nanoparticle anti-fatigue” agents like Zinc, Melatonin, Ginseng

I suspect the low incidence is also to do with cultural reporting factors.

 

Agreed. A more specific diagnostic process is needed for high quality epidemiology studies.