The importance of a research case definition

Document Type

Article

Publication Date

10-12-2017

Publication Title

Fatigue: Biomedicine, Health & Behavior

Keywords

Case definitions, myalgic encephalomyelitis, chronic fatigue syndrome, diagnositic criteria

Abstract

All scientific activities with diseases rely on the selection of reliable and valid case definitions in order to accurately estimate prevalence rates, to identify biological markers, and to understand the outcomes of treatment trials. The failure to develop a consensus on which research case definition to use for defining Myalgic Encephalomyelitis (ME) and chronic fatigue syndrome (CFS) has had negative consequences for the scientific and patient community. If case definition criteria inappropriately select patients with symptoms due to primary affective disorders, other fatiguing medical conditions, burnout, or over-committed lifestyle issues, the scientific consequences are serious. For example, a case definition that is too broad would include individuals with other illnesses and conditions, complicating the tasks of estimating prevalence rates or identifying effective treatment programs. A consensus on a research case definition and its operationalization and assessment would enable investigators to select more homogenous samples that could expedite the identification of valid biological markers, and consequently reduce misperceptions regarding the role of psychogenic versus biomedical factors. Our editorial reviews the implications of previous research and clinical case definitions in CFS and ME domains.

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