Prevalence of functional somatic syndromes and bodily distress syndrome in the Danish population: the DanFunD study, 2019, Petersen et al

M commentary on this study has now been published: “Letter to the Editor: A misleading CFS prevalence estimate in DanFunD”
https://journals.sagepub.com/doi/full/10.1177/1403494819893240

Thanks to @Graham and @Robert 1973 for their feedback on early drafts.

Social media summary:

It’s a commentary on a Danish study by the research team of Marie Peterson and Per Fink who are looking at functional somatic syndromes. In this study, they report a prevalence rate for Chronic Fatigue Syndrome (CFS) of 8.6%, which is probably the highest CFS prevalence rate ever reported in the literature.

In my commentary, I argue that the authors have measured fatigue symptoms in the general population, not CFS and that it would be more accurate if their terminology reflected this. In addition, I note that their study could have used other information to estimate CFS prevalence as for 77% of the sample, the prevalence of self-reported CFS was available, reaching an average of 1,19%.

The commentary is behind a paywall, but you can view the submitted version on my Researchgate profile:
https://www.researchgate.net/publication/339181335_A_misleading_CFS_prevalence_estimate_in_DanFunD

The authors have written a response to my commentary, which can be found here:
https://journals.sagepub.com/doi/full/10.1177/1403494819893241
 
Michiel Tack said:
In this study, they report a prevalence rate for Chronic Fatigue Syndrome (CFS) of 8.6%, which is probably the highest CFS prevalence rate ever reported in the literature.
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Which makes me wonder why as a rheumatologist seeing hundreds of new patients a year for thirty years I can recall seeing no more than a dozen people who I now realise had ME/CFS. Maybe ME/CFS is not referred specifically to rheumatologists but at least I should have seen more people with CFS just by coincidence. By their estimate it seems I should have seen 500.
 
Michiel Tack said:
It’s a commentary on a Danish study by the research team of Marie Peterson and Per Fink who are looking at functional somatic syndromes. In this study, they report a prevalence rate for Chronic Fatigue Syndrome (CFS) of 8.6%, which is probably the highest CFS prevalence rate ever reported in the literature.
Click to expand...

Notably, the finding that 8.6% of the population has "severe and abnormal fatigue" due to a variety of causes creates doubt over the validity of the cutoffs of the SF-36 used by certain authors describing "normal" cutoffs based on general population means and SDs (where the normal population is defined as being above the ~15th percentile).
 
Well, they agree with Michiel that the number is inflated and they should have indicated it was a number for CF and not CFS, and they also agree that the fatigue could be because of having had a baby or house renovations. Then there's more yaba-yaba and then they say they will consider more specific CFS criteria in future analyses. They blinked--and then pretended they didn't.

Well done, Michiel!
 
We agree, however, that our obtained prevalence
of 8.6% is high compared with other studies on
CFS, and concur that this is easily explained by our
use of a measure of severe fatigue for assigning case
status of CFS. Consequently, one could argue that
the reported prevalence describes the number of
individuals with severe and abnormal fatigue rather
than accounts for the number of individuals with
CFS. This should have been described more clearly
in the paper.
Click to expand...
 
Trish said:
Sci hub link to @Michiel Tack's letter:
https://sci-hub.se/https://doi.org/10.1177/1403494819893240

Sci hub link to authors' response:
https://sci-hub.se/https://doi.org/10.1177/1403494819893241

Edited to add second link.
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Complete BS answer and justification. These people are utterly clueless and lost in the maze of their own minds.
In order to achieve this aim, we included standard criteria for five common syndromes, which:
(1) were manageable and validated for use in large epidemiological studies on general populations
(2) did not have symptom overlap (many definitions of CFS also include pain and various other symptoms)
Click to expand...
Yes, definitions of ME/CFS include the symptoms of ME/CFS. That is literally the idea and deciding otherwise out of personal preference is exactly as absurd as changing your criteria mid-trial because you prefer the results.

Seriously this field is by far the least serious, least capable and most woo-filled field in all of science and nothing even comes close.
 
Well, that was a bit of woolly waffle in the reply, wasn't it. Unavoidable I suppose, given the undefined (imaginary?) nature of so-called functional somatic disorders. That they keep on presenting themselves as open-minded would be almost funny if it wasn't so damaging. The DanFunD could have great potential for valuable epidemiological insights if it was left to genuinely open-minded researchers who don't try to pigeonhole everybody with any not immediately explainable symptoms into the FSD box.

But they still had to agree with @Michiel Tack:
We agree, however, that our obtained prevalence of 8.6% is high compared with other studies on CFS, and concur that this is easily explained by our use of a measure of severe fatigue for assigning case status of CFS. Consequently, one could argue that the reported prevalence describes the number of individuals with severe and abnormal fatigue rather than accounts for the number of individuals with CFS. This should have been described more clearly in the paper.
Click to expand...
Good one Michiel :thumbup:
 
Michiel Tack said:
M commentary on this study has now been published: “Letter to the Editor: A misleading CFS prevalence estimate in DanFunD”
https://journals.sagepub.com/doi/full/10.1177/1403494819893240

Thanks to @Graham and @Robert 1973 for their feedback on early drafts.

Social media summary:

It’s a commentary on a Danish study by the research team of Marie Peterson and Per Fink who are looking at functional somatic syndromes. In this study, they report a prevalence rate for Chronic Fatigue Syndrome (CFS) of 8.6%, which is probably the highest CFS prevalence rate ever reported in the literature.

In my commentary, I argue that the authors have measured fatigue symptoms in the general population, not CFS and that it would be more accurate if their terminology reflected this. In addition, I note that their study could have used other information to estimate CFS prevalence as for 77% of the sample, the prevalence of self-reported CFS was available, reaching an average of 1,19%.

The commentary is behind a paywall, but you can view the submitted version on my Researchgate profile:
https://www.researchgate.net/publication/339181335_A_misleading_CFS_prevalence_estimate_in_DanFunD

The authors have written a response to my commentary, which can be found here:
https://journals.sagepub.com/doi/full/10.1177/1403494819893241
Click to expand...
Thanks @Michiel Tack

Absolutely fantastic
 
Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD

Petersen, Per Fink et al
Published 24 Feb 2020

Abstract


Prevalence of functional somatic syndromes (FSS) in the general population varies with observed overlap between syndromes. However, studies including a range of FSS are sparse. We investigated prevalence and characteristics of various FSS and the unifying diagnostic construct bodily distress syndrome (BDS), and identified mutual overlap of the FSS and their overlap with BDS. We included a stratified subsample of 1590 adults from a randomly selected Danish general population sample (n = 7493). Telephonic diagnostic interviews performed by three trained physicians were used to identify individuals with FSS and BDS. Prevalence of overall FSS was 9.3%; 3.8% for irritable bowel, 2.2% for chronic widespread pain, 6.1% for chronic fatigue, 1.5% for whiplash associated disorders, and 0.9% for multiple chemical sensitivity. Prevalence of BDS was 10.7% where 2.0% had the multi-organ type. FSS were highly overlapping with low likelihood of having a “pure” type. Diagnostic agreement of FSS and BDS was 92.0%. Multi-syndromatic FSS and multi-organ BDS were associated with female sex, poor health, physical limitations, and comorbidity. FSS are highly prevalent and overlapping, and multi-syndromatic cases are most affected. BDS captured the majority of FSS and may improve clinical management, making the distinction between multi- and mono-syndromatic patients easier.
Click to expand...
https://www.nature.com/articles/s41598-020-60318-6
 
Isn't it circular reasoning to use fairly non-specific criteria and then claim that all the syndromes overlap?

Per Fink and colleagues said:
The considerable variation in prevalence may be attributed to the different diagnostic criteria used for each FSS.
Click to expand...
No shit!

In phase one, participants filled in symptom questionnaires for physical symptoms specific for FSS and BDS, social factors, and overall health, among others. Prevalence of FSS and BDS obtained from these questionnaires has been reported elsewhere. In phase two, the questionnaires formed the basis for identifying a stratified subsample invited to participate in the Research Interview for Functional somatic Disorders (RIFD), derived from a modified version of the comprehensive psychiatric interview Schedules of Clinical Assessment in Neuropsychiatry (SCAN)
Click to expand...

Post-hoc diagnostic criteria were used to assign case status on the basis of the obtained symptoms from the interviews (Table 4). The diagnostic criteria by Kay et al. for IBS/IB, the diagnostic criteria by White et al. (modified from the American College of Rheumatology 1990 FM criteria) for FM/CWP, the diagnostic criteria by Chalder et al. for CFS-like symptoms/CF, and the diagnostic criteria by Fink et al. for BDS.
Click to expand...

Wait, post-hoc?

And yes, they really cited the Chalder "Development of a fatigue scale" study as their "criteria" for Chronic Fatigue.
 
Last edited:
We investigated prevalence and characteristics of various FSS and the unifying diagnostic construct bodily distress syndrome (BDS), and identified mutual overlap of the FSS and their overlap with BDS.
Click to expand...

We invented a group of spurious syndromes to disappear certain illnesses then dumped them all together under one label then found that they overlapped and we were very surprised because even though the catch all category was designed to bury all other categories together... it did.

We did this by citing all of our own years of nonsense and it led us to a conclusion.

Next up

There's only one race..the human race.

All humans are mammals.

All mammals are animals.

All animals are on earth.

Earth is a category.


"I see so if you test someone for a broken arm in the future how will you do that?"

"We will look at the earth from space."
 
Snow Leopard said:
Isn't it circular reasoning to use fairly non-specific criteria and then claim that all the syndromes overlap?
Click to expand...
This stuff is beyond parody because unlike parody it's meant to be serious and people generally don't die or live a life of suffering because of one particular parody. Although, just like many parodies, this actually features a clown.

bbakRa2.jpg


Good things they aren't geologists or biologists because good luck arguing to people about your special science category of "massive gray things" that features (some) rocks, elephants and clouds. Experts are not supposed to be duped over superficial similarities. This is so pathetic.
 
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