Thursday, November 8, 2012

International Consensus Criteria for ME/CFS

Source: Journal of Internal Medicine
Date: July 2011

Myalgic Encephalomyelitis: International Consensus Criteria
Bruce M Carruthers MD, CM, FRCP(C), Marjorie I van de
Sande BEd, Kenny L De Meirleir MD, PhD, Nancy G Klimas
MD, Gordon Broderick PhD, Terry Mitchell MA, MD, FRCPath,
Don Staines MBBS, MPH, FAFPHM, FAFOEM, AC Peter Powles
MRACP, FRACP, FRCP(C), ABSM, Nigel Speight MA, MB, BChir,
FRCP, FRCPCH, DCH, Rosamund Vallings MNZM, MB, BS, MRCS,
LRCP, Lucinda Bateman MS, MD, Barbara Baumgarten-
Austrheim MD, David S Bell MD, FAAP, Nicoletta Carlo-
Stella MD, PhD, John Chia MD, Austin Darragh MA, MD,
FFSEM. (RCPI, RCSI), FRSHFI Biol I (Hon), Daehyun Jo MD,
PhD, Don Lewis MD, Alan R Light PhD, Sonya Marshall-
Gradisbik PhD, Ismael Mena MD, Judy A Mikovits PhD,
Kunihisa Miwa MD, PhD, Modra Murovska MD, PhD, Martin L
Pall PhD, Staci Stevens MA


The label 'chronic fatigue syndrome' (CFS) has persisted
for many years because of lack of knowledge of the
etiological agents and of the disease process. In view of
more recent research and clinical experience that strongly
point to widespread inflammation and multisystemic
neuropathology, it is more appropriate and correct to use
the term 'myalgic encephalomyelitis' (ME) because it
indicates an underlying pathophysiology. It is also
consistent with the neurological classification of ME in
the World Health Organization's International
Classification of Diseases (ICD G93.3). Consequently, an
International Consensus Panel consisting of clinicians,
researchers, teaching faculty and an independent patient
advocate was formed with the purpose of developing
criteria based on current knowledge. Thirteen countries
and a wide range of specialties were represented.
Collectively, members have approximately 400 years of
both clinical and teaching experience, authored hundreds
of peer reviewed publications, diagnosed or treated
approximately 50,000 ME patients, and several members
coauthored previous criteria. The expertise and experience
of the panel members as well as PubMed and other medical
sources were utilized in a progression of suggestions/
drafts/reviews/revisions. The authors, free of any
sponsoring organization, achieved 100% consensus through
a Delphi type process.

The scope of this paper is limited to criteria of ME and
their application. Accordingly, the criteria reflect the
complex symptomatology. Operational notes enhance
clarity and specificity by providing guidance in the
expression and interpretation of symptoms. Clinical and
research application guidelines promote optimal
recognition of ME by primary physicians and other health
care providers, improve consistency of diagnoses in
adult and paediatric patients internationally, and
facilitate clearer identification of patients for
research studies.

(c) 2011 The Association for the Publication of the Journal of
Internal Medicine
Here you can find European translations of the International Consensus
ME Document, Journal of Internal Medicine, July 2011. With thanks to
Plataforma para la Fibromialgia, Síndrome de Fatiga Crónica y SSQM,
Reivindicación de Derechos for Spain, the Norwegian ME organisation for
Norway and ME/CVS-Net and Esther for the Netherlands and ME/CVS in
Belgium for Belgium, CFS -aktuelle for Germany. You can print the ME
document for your own doctor.

Spanish translation of the International Consensus ME Document:
Norwegian translation of the International Consensus ME Document:
German translation of the International Consensus ME Document:

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