Talk:Alternative names for chronic fatigue syndrome
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Totally disputed tag, removal
editI will remove the totally disputed tag. The content is not totally disputed, it is also referenced good. People that think a tag should be on article can discuss here and add another tag, totally disputed is not right tho! Thx, RetroS1mone talk 04:11, 4 November 2008 (UTC)
- Well i made some changes, more references i think their good, more viewpoints. RetroS1mone talk 06:00, 4 November 2008 (UTC)
- Totally disputed still applies to this article. None of the terms listed are alternative names to CFS, they are alternative diagnoses. I.e., not only the name differs, but also the content. Guido den Broeder (talk, visit) 09:46, 24 November 2008 (UTC)
- That is your opinion, even Jason says they are just different names. The diagnosis is the same, the names are different. RetroS1mone talk 22:58, 25 November 2008 (UTC)
- Please. Elsewhere, you claim that Jason isn't that important because it suits you there. But yes, that is my - non-personal - opinion, based on my knowledge of the literature. Yours is different, which is fine. It means that we have a dispute, not that your opinion should by definition prevail. Are you willing to help find a solution that we both can live with, or will you keep reverting all my attempts? Guido den Broeder (talk, visit) 01:11, 26 November 2008 (UTC)
- That is your opinion, even Jason says they are just different names. The diagnosis is the same, the names are different. RetroS1mone talk 22:58, 25 November 2008 (UTC)
- Totally disputed still applies to this article. None of the terms listed are alternative names to CFS, they are alternative diagnoses. I.e., not only the name differs, but also the content. Guido den Broeder (talk, visit) 09:46, 24 November 2008 (UTC)
- The majority opinion among researchers is that they are just different names for the same condition. Currently the article says (in the ME section) "At least one older report is said to suggest ME could be a distinct condition, but CFS and ME are usually used as synonyms.". If you can find a good reference saying that some patient groups believe ME is a different diagnosis, you might want to add it there. --sciencewatcher (talk) 01:27, 26 November 2008 (UTC)
- That is your conclusion, which I do not share. Please try to comprehend the difference between 'different conditions' and 'different diagnoses'; perhaps I should explain better. ME and CFS are different diagnoses, but for the same condition, so the fact that most researchers think they are for the same condition (a few do not) is not relevant to our dispute. There is no relation to patient advocacy either. Guido den Broeder (talk, visit) 01:32, 26 November 2008 (UTC)
- I've been over this at least twice now. I have never seen anything convincing that they are considered different conditions by a significant majority or even minority in the medical community. Once again, without references explicitly stating they are different (and ideally how), this is a waste of time. This, and other postings, are preventive to avoid WP:SILENCE concerns that there may be some support for this. There is not, and this is a waste of time. WLU (t) (c) (rules - simple rules) 02:33, 26 November 2008 (UTC)
- That is your conclusion, which I do not share. Please try to comprehend the difference between 'different conditions' and 'different diagnoses'; perhaps I should explain better. ME and CFS are different diagnoses, but for the same condition, so the fact that most researchers think they are for the same condition (a few do not) is not relevant to our dispute. There is no relation to patient advocacy either. Guido den Broeder (talk, visit) 01:32, 26 November 2008 (UTC)
- The majority opinion among researchers is that they are just different names for the same condition. Currently the article says (in the ME section) "At least one older report is said to suggest ME could be a distinct condition, but CFS and ME are usually used as synonyms.". If you can find a good reference saying that some patient groups believe ME is a different diagnosis, you might want to add it there. --sciencewatcher (talk) 01:27, 26 November 2008 (UTC)
[unindent]Okay, I see the distinction Guido is trying to make. He agrees that most researchers think CFS and ME are the same condition, but he is saying that ME and CFS are different diagnoses. I see his point - they are all defined differently. However isn't that already covered by the "clinical criteria" sub-article? Is there a case for merging that sub-article with this one? They seem to cover the same ground and it is maybe slightly confusing having them separate as at present. --sciencewatcher (talk) 03:36, 26 November 2008 (UTC)
- I agree about merging. About condition and diagnosis, there is a syndrome, may be one condition or twenty different ones, no one knows. Most doctors and researchers call the syndrome CFS, that is what WP has to call it by wp:medmos and wp:medrs. Some people call it ME or ME/CFS or CFS/ME. These are different names they are used as synonnyms. Very very few people say they are different diagnoses, it is a different diagnosis when you say ok patient you have chronic fatigue that is caused by XX, you can't do that w/o evidence, there is very little evidence about literal ME, that is why that only paper we found where they say ME being seperate condition is citing the Acheson paper, nothing else. RetroS1mone talk 07:34, 26 November 2008 (UTC)
- Thanks Sciencewatcher for understanding, hopefully WLU and RetroS1mone will one day, too, and we could finally make some progress. RetroSimone: you may have found just the one source, but I have found hundreds of sources, and more importantly, so have the IACFS/ME, whose chairperson Nancy Klimas states that inflammation can be confirmed in 80% of all cases of ME/CFS.
- Merging is fine with me. As the title changes by WLU reduce the scope of both pages, the combination won't get too long, and perhaps it helps if you can all see what name goes with what definition(s). Guido den Broeder (talk, visit) 11:08, 26 November 2008 (UTC)
- At one point I reviewed the one document in the JCFS that seemed to discuss the difference in diagnosis between ME and CFS. Essentially it was one of degree - CFS requires 8 out of a list of 12, ME requires 10/12 (that's a bit of a charicature, there's more than that). But if researchers are using different diagnoses, rather than simply using ME and CFS as synonyms with only a single diagnostic criteria, it should be obvious within the articles (i.e. we used the X criteria, and not the Y).
- This page would be quite useful in my opinion, to capture the fight over the different names - rather than discussing clinical guidelines and whatnot, I would focus it on that aspect of naming, the dispute. I would guess there's plenty there to work with. WLU (t) (c) (rules - simple rules) 16:45, 26 November 2008 (UTC)
- Somewhere I read a suggestion to create a table for easy overview of all the differences. I think that is an excellent idea. Guido den Broeder (talk, visit) 19:01, 26 November 2008 (UTC)
I'm not sure I fully understand Guido's argument here, and I admit I'm a bit confused myself regarding diagnosis/criteria, etc. The different criteria (what I called "diagnoses" above, but perhaps that's not the right term) such as Oxford/CDC/Canadian are all slightly different, and the clinical criteria sub-article already discusses this. As WLU says, whether or not there are multiple illnesses is another issue which we don't know for sure, although most researchers think that CFS and ME are the same illness. So I'm just a bit confused about Guido's argument about "different diagnoses". It would seem to me that although CFS and ME (and the various criteria for CFS) may have slightly different definitions, most researchers use them interchangably, and therefore they think they are the same diagnosis and the same illness even though the definition is different. --sciencewatcher (talk) 21:37, 26 November 2008 (UTC)
That would be an own synthesis, which we are not supposed to make. We should consider only sources that investigate the matter. Trying to clarify further:
- The mainstream view is that ME and CFS target the same condition, with only a small minority disagreeing.
- ME is a disease diagnosis, with an assumed cause, say, a type 1 diagnosis. CFS is a working case diagnosis, with no assumed cause, say, a type 3 diagnosis. Therefore, they cannot be synonymous already by definition, regardless of content, because the types differ; that is not a medical issue, but straightforward, simple logic.
- As a corollary, there can in essence be only one definition of ME, while definitions of CFS can differ widely depending on their specific purpose and progress in cheap ways of testing.
- Definitions of CFS, for being working case definitions, do not capture the full clinical picture of ME. They also have a limitation though, requiring chronicity which is not always present in ME.
- People can therefore have ME yet not qualify for a given set of criteria of CFS.
- People can therefore get a diagnosis of CFS without actually having ME.
- There are an existence dispute over ME, a naming dispute over CFS that is unrelated to it, but a classification dispute over CFS that is related to it, a diagnosing dispute between ME and CFS, and a whole lot of diagnosing disputes over CFS and between its various definitions. What there is not, however, is a naming controversy between ME and CFS. The two names do not bite each other.
Hope this helps, Guido den Broeder (talk, visit) 23:02, 26 November 2008 (UTC)
- Okay, I think where we disagree is [2]. The general consensus among researchers is that ME is NOT a well-defined disease diagnosis. Using your terminology most researchers think that both CFS and ME are "type 3" (i.e. vague, ill-defined with no assumed cause). It is only a minority fringe of researchers who believe that ME is an accurate disease definition. Even Acheson himself didn't believe this. I would ask you to re-read Acheson and other references that are critical to the ME diagnosis. It is certainly worth mentioning the minority view that still believes ME is an accurate disease diagnosis (and I think it is already mentioned in the article somewhere), but it is definitely a fringe/minority viewpoint among researchers and therefore it should not get prominent space in the article or influence the name of the article, its content, etc. --sciencewatcher (talk) 23:40, 26 November 2008 (UTC)
- Thanks, now we may be getting somewhere. Could you provide a source for your contention that ME is not generally considered well-defined? Are there any notable rival definitions to Ramsay's? Has his definition been criticized? Are there any rival interpretations of the name? I submit that what you are saying relates to the existence of ME, or whether this diagnosis fits the reported cases, rather than to its definition. Regards, Guido den Broeder (talk, visit) 23:56, 26 November 2008 (UTC)
- Just the refs that are already in the article (Acheson, Royal College of Physicians, etc.) There is no single ref you can point to to resolve this - you need to look at the refs on both sides of the debate, look at the quality, reliability and other factors and come to a conclusion. You have obviously come to a different conclusion to me. --sciencewatcher (talk) 00:49, 27 November 2008 (UTC)
- Well, I wouldn't have known either way if I hadn't read a good part of the ME/CFS literature (i.e. the full texts, not just the abstracts, those are often misleading, and including commentaries). To me, as a scientist, that is the only way to establish quality and reliability; where something is published is not more than a first indication. Then you find that institutes with grand names like Royal College often lag hopelessly behind, and that the frontier of knowledge is found elsewhere. In this case a.o. at the IACFS/ME, whose chairperson Nancy Klimas states that we now can identify CNS inflammation in 80% of all cases of ME/CVS (Canadian definition). But what the Royal College said actually supports my take: they tried to forbid using the diagnosis, rather than to redefine it, i.e. like me they consider the definition of ME a given, they just didn't believe at the time that it existed (they may have caught up by now). Guido den Broeder (talk, visit) 11:58, 27 November 2008 (UTC)
- Never seen any evidence that the mainstream considers them useful. Statements from a chairperson is an opinion without a medically reliable source, and shouldn't have weight. If Klimas' statement is true, then in time we will be able to verify it eventually. Since wikipedia is not done, there's no reason to do so until this is clear.
- To make the table, see Help:Table. Please present it for review before putting it into mainspace. WLU (t) (c) (rules - simple rules) 12:16, 27 November 2008 (UTC)
- Naturally. With regard to evidence: you may not have seen it, but I have, and I fully agree with her estimate. The remaining 20% would for the moment be diagnosed with myalgic encephalopathy, btw, a diagnosis that could also be included in the table. Guido den Broeder (talk, visit) 12:23, 27 November 2008 (UTC)
- I am most interested in the table for the references that will be used. If it is comprehensive, it will finally be a chance to unambiguously pin down the support for the ME contention and hopefully end the discussion about names and naming. WLU (t) (c) (rules - simple rules) 15:03, 27 November 2008 (UTC)
- Note that the results of a Dutch survey, with respondents from all three patient organizations, will become public within a few weeks (I'm checking the final draft as we speak). The questionnaire includes several questions that have some bearing on this discussion. The survey, carried out by the NIVEL institute, is part of the process that leads to a guideline for The Netherlands. Guido den Broeder (talk, visit) 16:14, 27 November 2008 (UTC)
- I am most interested in the table for the references that will be used. If it is comprehensive, it will finally be a chance to unambiguously pin down the support for the ME contention and hopefully end the discussion about names and naming. WLU (t) (c) (rules - simple rules) 15:03, 27 November 2008 (UTC)
- Naturally. With regard to evidence: you may not have seen it, but I have, and I fully agree with her estimate. The remaining 20% would for the moment be diagnosed with myalgic encephalopathy, btw, a diagnosis that could also be included in the table. Guido den Broeder (talk, visit) 12:23, 27 November 2008 (UTC)
- Well, I wouldn't have known either way if I hadn't read a good part of the ME/CFS literature (i.e. the full texts, not just the abstracts, those are often misleading, and including commentaries). To me, as a scientist, that is the only way to establish quality and reliability; where something is published is not more than a first indication. Then you find that institutes with grand names like Royal College often lag hopelessly behind, and that the frontier of knowledge is found elsewhere. In this case a.o. at the IACFS/ME, whose chairperson Nancy Klimas states that we now can identify CNS inflammation in 80% of all cases of ME/CVS (Canadian definition). But what the Royal College said actually supports my take: they tried to forbid using the diagnosis, rather than to redefine it, i.e. like me they consider the definition of ME a given, they just didn't believe at the time that it existed (they may have caught up by now). Guido den Broeder (talk, visit) 11:58, 27 November 2008 (UTC)
- Just the refs that are already in the article (Acheson, Royal College of Physicians, etc.) There is no single ref you can point to to resolve this - you need to look at the refs on both sides of the debate, look at the quality, reliability and other factors and come to a conclusion. You have obviously come to a different conclusion to me. --sciencewatcher (talk) 00:49, 27 November 2008 (UTC)
Undent, I would be very wary of giving any weight to such a survey unless published in a peer-reviewed journal. In the end, a patient survey is a survey of patients, not doctors, is not guaranteed to impact medical practice significantly, if it is to be published soon that means it is impossible now to assess how it affects the point of view of mainstream medical practitioners, and on top of all that, it's for a single country. WLU (t) (c) (rules - simple rules) 17:32, 27 November 2008 (UTC)
- There is no need to assess its impact at this point in time. I'd rather focus on what we can use it for, instead of what we can't. Guido den Broeder (talk, visit) 18:36, 27 November 2008 (UTC)
- WP:UNDUE is part of determining what it can be used for. It can be used to support the opinions of a substantial minority. It can't be used to re-write an entire set of articles shortly after it is published and it can't be used to re-name those articles. WLU (t) (c) (rules - simple rules) 19:08, 27 November 2008 (UTC)
- A good thing then, that nobody was suggesting that. Guido den Broeder (talk, visit) 19:12, 27 November 2008 (UTC)
- I include it because your interpretation of policy is often unusual. Consider it a pre-emptive consensus. WLU (t) (c) (rules - simple rules) 19:18, 27 November 2008 (UTC)
- I'll consider it bad faith instead. Drop it. Guido den Broeder (talk, visit) 19:21, 27 November 2008 (UTC)
- As you like. If you are the one "checking the final draft as we speak" then you are in a position of conflict of interest and it should certainly be vetted on the talk page or added to the main page by another editor. WLU (t) (c) (rules - simple rules) 19:28, 27 November 2008 (UTC)
- Remember medrs, this article is not for patients or doctors or to give the views of patients, it is to come from reliable sources most secondary peer-review sources. If and when the patients survey goes in a review or gets in other major peer review article it can go in. RetroS1mone talk 01:18, 28 November 2008 (UTC)
- Yes, the article is to give the view of patients, too. Wikipedia is not owned by doctors. But - sigh - I wasn't saying anything about patients' view or including it in the article, so let's save that discussion for when we get to it. Guido den Broeder (talk, visit) 01:39, 28 November 2008 (UTC)
- The view of patients would be in the History or Society and culture section of pages adhering to medmos guidelines, and would certainly not take precedence over the opinions published in peer-reviewed journals. And it would have to be notable views published in reliable sources. How that impacts this page is a question since the patients' reactions to the naming of CFS is a large part of one controversy within CFS. WLU (t) (c) (rules - simple rules) 16:03, 28 November 2008 (UTC)
- Yes, the article is to give the view of patients, too. Wikipedia is not owned by doctors. But - sigh - I wasn't saying anything about patients' view or including it in the article, so let's save that discussion for when we get to it. Guido den Broeder (talk, visit) 01:39, 28 November 2008 (UTC)
- Remember medrs, this article is not for patients or doctors or to give the views of patients, it is to come from reliable sources most secondary peer-review sources. If and when the patients survey goes in a review or gets in other major peer review article it can go in. RetroS1mone talk 01:18, 28 November 2008 (UTC)
- As you like. If you are the one "checking the final draft as we speak" then you are in a position of conflict of interest and it should certainly be vetted on the talk page or added to the main page by another editor. WLU (t) (c) (rules - simple rules) 19:28, 27 November 2008 (UTC)
- I'll consider it bad faith instead. Drop it. Guido den Broeder (talk, visit) 19:21, 27 November 2008 (UTC)
- I include it because your interpretation of policy is often unusual. Consider it a pre-emptive consensus. WLU (t) (c) (rules - simple rules) 19:18, 27 November 2008 (UTC)
- A good thing then, that nobody was suggesting that. Guido den Broeder (talk, visit) 19:12, 27 November 2008 (UTC)
- WP:UNDUE is part of determining what it can be used for. It can be used to support the opinions of a substantial minority. It can't be used to re-write an entire set of articles shortly after it is published and it can't be used to re-name those articles. WLU (t) (c) (rules - simple rules) 19:08, 27 November 2008 (UTC)
(unindent) I have created a table at Talk:Clinical descriptions of chronic fatigue syndrome. Guido den Broeder (talk, visit) 17:56, 29 November 2008 (UTC)
Quotes from Whiting et al
editGuido reverts my edits based from Whiting et al, where i was trying to support him!! I was trying to show from real medrs some people think ME and CFS are different, and Guido reverted said it was not in source!
I wrote at least one older report is said to suggest ME could be a distinct condition, but CFS and ME are usually used as synonyms"
OK here is what Whiting et al says, "There are reports in the literature that myalgic encephalomyelitis (ME) is a syndrome separate from CFS that is characterized by muscle weakness—more specifically, gross abnormal muscle fatigue after relatively mild activity—pain, and a disturbed nervous system" and there source is the Acheson paper from 1959. That is the "older report" I guess i was wrong on saying at least one, they only give one, i changed it to A report from 1959.
OK more "However, in the literature CFS is commonly referred to as being the same illness as ME, postviral fatigue syndrome (PVFS), and all similar symptom complexes." that is for the second part of sentence. RetroS1mone talk 11:01, 30 November 2008 (UTC)
- What I removed is the statement that ME and CFS are usally considered synonymes, which is not in this source. His opinion that ME and CFS are separate syndromes seems ambiguous (is a syndrome a diagnosis or a condition?) and I'd rather refer to a more clearer and notable source for this. Guido den Broeder (talk, visit) 11:15, 30 November 2008 (UTC)
- A more clearer and and notable source then JAMA, i'll get right on that!! heh heh. RetroS1mone talk 11:18, 30 November 2008 (UTC)
- Guido, let it die. JAMA is among the most respected medical publications on the planet and repeatedly you have sought consensus that there is a difference and repeatedly failed to demonstrate there is any reason to think so. WLU (t) (c) (rules - simple rules) 14:35, 30 November 2008 (UTC)
- A more clearer and and notable source then JAMA, i'll get right on that!! heh heh. RetroS1mone talk 11:18, 30 November 2008 (UTC)
Totally disputed (3)
editI've tagged the article as totally disputed since RetroS1mone keeps blocking every improvement, thereby protecting all kinds of original research, bias and false attributions explained in my edit summaries and above on talk. Guido den Broeder (talk, visit) 11:20, 30 November 2008 (UTC)
- Totally disputed by you does not mean you can just go adding tags. There was alot of progress here when you were blocked and now you are doing sour on it, pls stop revenging on me. RetroS1mone talk 11:21, 30 November 2008 (UTC)
- Actually it does. That is what the tag is for. What you see as progress, I see as deterioration. Guido den Broeder (talk, visit) 11:26, 30 November 2008 (UTC)
- That is bc you have big COI and you have a med fringe POV you push on articles. RetroS1mone talk 11:30, 30 November 2008 (UTC)
- Not really. It's because I've read the literature, and since I've never been diagnosed with CFS, my COI is minimal. Discuss any edits I made that you think are incorrect, but if you want to discuss editor motives, do that elsewhere. Guido den Broeder (talk, visit) 11:38, 30 November 2008 (UTC)
- You started a ME/CFS organization, you write stuff outside WP for med fringe POV, you have very obvious COI I am sorry you do not get it, it is the cause from all the many problems you have here and you cause for other people. RetroS1mone talk 11:41, 30 November 2008 (UTC)
- If you think that something is fringe point that out, but stop attacking me as a person and assume good faith as you're supposed to. Also, stop canvassing. Guido den Broeder (talk, visit) 11:49, 30 November 2008 (UTC)
- You started a ME/CFS organization, you write stuff outside WP for med fringe POV, you have very obvious COI I am sorry you do not get it, it is the cause from all the many problems you have here and you cause for other people. RetroS1mone talk 11:41, 30 November 2008 (UTC)
- Not really. It's because I've read the literature, and since I've never been diagnosed with CFS, my COI is minimal. Discuss any edits I made that you think are incorrect, but if you want to discuss editor motives, do that elsewhere. Guido den Broeder (talk, visit) 11:38, 30 November 2008 (UTC)
- That is bc you have big COI and you have a med fringe POV you push on articles. RetroS1mone talk 11:30, 30 November 2008 (UTC)
- Actually it does. That is what the tag is for. What you see as progress, I see as deterioration. Guido den Broeder (talk, visit) 11:26, 30 November 2008 (UTC)
The tag states that the neutrality and factual accuracy are of the page are disputed. So, what are the neutrality issues, and what are the content issues? WLU (t) (c) (rules - simple rules) 13:52, 30 November 2008 (UTC)
- Thanks for asking. I'll start with one issue, which concludes my effort for today. More to follow later. Guido den Broeder (talk, visit) 14:13, 30 November 2008 (UTC)
- Is the tag based essentially on this diff? The first use of Jason isn't exactly rocket science, and would be one of the uses of JCFS that I would suggest is OK. I would suggest a posting at MEDRS to ask if it's appropriate for this use alone. I just looked at the CFIDS of America page, and it appears to be extremely non-notable (I've prodded) - I don't think much is added by including their opinion sourced to Jason. The J R Soc Med I haven't looked at yet. I don't know why JAMA would be deleted, particularly since the naming issue of CFS and ME being synonymous has been covered extensively and repeatedly, with no support found. Guido - you have to get over it or get new sources, there's no reason to treat them as anything but synonymous and despite all your efforts, you have not been convincing. This is tendentious to continue disputing. As for the CFIDS section, I would remove all adjectives, leave the association in for now but review in the future and use pubmed sources instead (which incidentally suggest that CFIDS hasn't had much play since the late 90s). WLU (t) (c) (rules - simple rules) 14:31, 30 November 2008 (UTC)
- OK, I based my willingness to discuss the issue on the belief that it was something new. Since the only objections that have been raised so far are the samme "ME=/=CFS" that have been dealt with repeatedly, I'm removing the tag. If new objections are to be added tomorrow, add them below and we'll discuss. If discussion can't come to a consensus on this, then the tag can be re-added and we can look into dispute resolution. WLU (t) (c) (rules - simple rules) 15:16, 30 November 2008 (UTC)
- Is the tag based essentially on this diff? The first use of Jason isn't exactly rocket science, and would be one of the uses of JCFS that I would suggest is OK. I would suggest a posting at MEDRS to ask if it's appropriate for this use alone. I just looked at the CFIDS of America page, and it appears to be extremely non-notable (I've prodded) - I don't think much is added by including their opinion sourced to Jason. The J R Soc Med I haven't looked at yet. I don't know why JAMA would be deleted, particularly since the naming issue of CFS and ME being synonymous has been covered extensively and repeatedly, with no support found. Guido - you have to get over it or get new sources, there's no reason to treat them as anything but synonymous and despite all your efforts, you have not been convincing. This is tendentious to continue disputing. As for the CFIDS section, I would remove all adjectives, leave the association in for now but review in the future and use pubmed sources instead (which incidentally suggest that CFIDS hasn't had much play since the late 90s). WLU (t) (c) (rules - simple rules) 14:31, 30 November 2008 (UTC)
Neutrality
edit- The title suggests that the alternative diagnoses are mere synonymes, while in reality they represent a different take on the condition. Thus, the page obscures the biomedical nature of the disorder. Guido den Broeder (talk, visit) 14:13, 30 November 2008 (UTC)
- An assertion you have repeatedly made, but failed consistently to support. This has been closed, so wait for consensus to change or just leave it, please. WLU (t) (c) (rules - simple rules) 14:31, 30 November 2008 (UTC)
Accuracy
edit- The title is at odds with the content. Alternative names for CFS do not exist, these are alternative diagnoses. Guido den Broeder (talk, visit) 14:13, 30 November 2008 (UTC)
- Which you have never proven sufficient to convince anyone else. WLU (t) (c) (rules - simple rules) 14:31, 30 November 2008 (UTC)
Guido tags
editGuido, please stop placing invalid tags in the articles again. This article is not "totally disputed". It is only disputed by you, and the consensus is against you. You can't just keep placing dispute tags on the article because you don't like it. The consensus is that ME and CFS are synonyms (i.e. alternative names). You may not agree with this, but you have to accept it. --sciencewatcher (talk) 16:28, 30 November 2008 (UTC)
- Yup. As a courtesy to other editors, please discuss before placing tags to avoid having to deal with the same issues again and again. This is getting disruptive. WLU (t) (c) (rules - simple rules) 18:05, 30 November 2008 (UTC)
- Thank you very good edits WLU. RetroS1mone talk 19:35, 30 November 2008 (UTC)
What is wrong with this article
editTable
editApparently I have to make this clearer - in complete agreement with WP:VOTE, I do not agree with the simple voting that this table supports. I do not wish my username to appear in this table as it misrepresents my opinions as a simple agreement or disagreement with the table. After two reverts to this point, I apparently must be clearer on this than simple common sense would suggest. Accordingly, please do not replace my name in the agree or disagree columns, and if any other editor sees my name in the columns, please do me the courtesy of removing it. My reasoning for each point is laid out in the #Discussion section below, that is how I want my opinions to be represented. WLU (t) (c) (rules - simple rules) 19:47, 1 December 2008 (UTC)
- The table does not count votes, as explained in the table itself. Guido den Broeder (talk, visit) 21:18, 1 December 2008 (UTC)
- If that's a reference to the statement "The table works the same as other dispute resolutions. It is not a count of votes, but an indication of positions. Consensus is based on the arguments provided in the discussion, which is not in the table but below.", that's factually false as the table represents only one position - yours. I would suggest section headings, but not including any entries that contest the idea that CFS and ME or any of the other names are anything but synonyms. Consensus has indicated ME and CFS and PVFS and CFIDS and all the other names are currently used as different labels for the same condition, though this is recognized in the scholarly community as a flawed understanding and can change pending further research. This has been verified, even if it is not the truth. WLU (t) (c) (rules - simple rules) 21:37, 1 December 2008 (UTC)
- Sorry, my call. You can always start your own table. Guido den Broeder (talk, visit) 22:11, 1 December 2008 (UTC)
- If that's a reference to the statement "The table works the same as other dispute resolutions. It is not a count of votes, but an indication of positions. Consensus is based on the arguments provided in the discussion, which is not in the table but below.", that's factually false as the table represents only one position - yours. I would suggest section headings, but not including any entries that contest the idea that CFS and ME or any of the other names are anything but synonyms. Consensus has indicated ME and CFS and PVFS and CFIDS and all the other names are currently used as different labels for the same condition, though this is recognized in the scholarly community as a flawed understanding and can change pending further research. This has been verified, even if it is not the truth. WLU (t) (c) (rules - simple rules) 21:37, 1 December 2008 (UTC)
Code | Text | Problem | Agree | Disagree | Status |
The table works the same as other dispute resolutions. It is not a count of votes, but an indication of positions. Consensus is based on the arguments provided in the discussion, which is not in the table but below. | |||||
TITLE | "Alternative names for chronic fatigue syndrome" | A biased and inaccurate title. The terms listed are alternative diagnoses, each with its own definition, with no reference to CFS or vice versa. | GdB | disputed | |
SET | "a condition or set of conditions" | Unsubstantiated, biased claim, at odds with the text of the various definitions. So far, there is no indication that CFS is more than one condition. | GdB | disputed | |
PVFS | "what most believe to be the same condition include post-viral fatigue syndrome" | Unsubstantiated claim, at odds with the WHO classification and common usage where this is not one disease, but a group name. | GdB | disputed | |
PIFS | "PVFS has also been called post-infectious fatigue syndrome and is considered a subtype of CFS that may have shorter duration" | Source does not say this at all. According to Sharpe, PIFS indicates a subtype of CFS, in the context of the article, but PVFS is a WHO-classified term that is higher up in the pyramid. Note also that not all infections are viral. | GdB | disputed | |
NAMING | "The naming of the disorder is one of several controversies about the diagnosis." | Unsubstantiated claim. Controverses include: the name of the diagnosis CFS, and the accuracy of each of the diagnoses CFS and ME, but not e.g. the naming of ME or of CFIDS. | GdB | disputed | |
CAUSE | "the cause ... remains unknown" | After thousands of publications, a lot is known about the cause of CFS, 'remains unknown' is a biased statement. Accurate would be 'not fully understood' or equivalent. | GdB | disputed | |
ACCEPT | "CFS is "the term that is generally accepted by scientists and mostly by clinicians"" | At odds with next sentence. Based on an unreliable source: authors that apply a deviant model and definition and have not investigated the matter. It happens to be used a lot because it is easy and cheap, not because it is a preferred term. | GdB | disputed | |
MECNS | "Current researchers question the term's accuracy since no pathology has been recognized in the muscles or central nervous system." | Source itself says the opposite re CNS; what Royal Colleges claim is wrongly attributed to source. | GdB | disputed | |
MESYN | "but CFS and ME are usually used as synonyms" | The source does not say this at all, it only says "CFS is commonly referred to as being the same illness". | GdB | disputed | |
PATHY | "Others use myalgic encephalopathy as a synonym" | The source does not say this at all. ME-pathy is an umbrella term, like PVFS, containing any number of diseases. It could be used in those cases of ME when inflammation has not (yet) been confirmed (Klimas). | GdB | disputed | |
NEURA | "Neurasthenia or undifferentiated somatoform disorder (from DSM-IV) are alternative names for CFS with a presumably psychological association" | Unsubstantiated, biased claim at odds with WHO classification which explicitly excludes post-viral fatigue syndromes from these diagnoses. | GdB | disputed | |
Do not alter the table, other than to add or delete your own name. Discussion takes place below. All other maintenance of the table will be done by me. Guido den Broeder (talk, visit) 09:56, 1 December 2008 (UTC) instructions amended Guido den Broeder (talk, visit) 22:12, 1 December 2008 (UTC)
- The table was difficult to read and near-impossible to edit. The wikitable formatting works fine and people can now contribute opinions. WLU (t) (c) (rules - simple rules) 12:40, 1 December 2008 (UTC)
- Again: please don't edit the table, but discuss below. A table is not large enough to hold everybody's comments, there are more users involved than just you and I. Guido den Broeder (talk, visit) 14:55, 1 December 2008 (UTC)
- There's an obvious difference between adjusting a table to a more editor-friendly formatting, and substantially changing actual content. My changes preserved all your information and subsequent edits, while creating a table that is easier to work with for any wikipedia. But whatever. Per WP:VOTE, just having a username is inappropriate as it is the reasoning that is important. Since I'm not allowed to edit the table, I'll have to put my comments below, making the table pretty useless. Accordingly, I've removed my !votes from the table and do not wish them replaced. WLU (t) (c) (rules - simple rules) 15:47, 1 December 2008 (UTC)
- Again: please don't edit the table, but discuss below. A table is not large enough to hold everybody's comments, there are more users involved than just you and I. Guido den Broeder (talk, visit) 14:55, 1 December 2008 (UTC)
- The table was difficult to read and near-impossible to edit. The wikitable formatting works fine and people can now contribute opinions. WLU (t) (c) (rules - simple rules) 12:40, 1 December 2008 (UTC)
Note: since the table may be growing, 'I don't agree with any of them' can't be processed. Be specific! Guido den Broeder (talk, visit) 15:30, 1 December 2008 (UTC)
- You can't just have a list of pet peeves and keep adding to it when you think of a new one and because of that say "there is still a dispute". It's fine for you to discuss these here, and if anything hasn't been resolved then please point it out, but as WLU says putting "totally disputed" tags in the article would appear to be disruptive because the article isn't disupted. Also, see below where WLU, unlike me, has taken the time to respond to each individual point. --sciencewatcher (talk) 16:35, 1 December 2008 (UTC)
- Actually, I can.
- I can't count WLU's position as yours as a matter of course, you need to give your own view. What you wrote below is rather vague and ambiguous so I don't know where you stand yet. But there's no hurry, there are many users who don't have the opportunity to participate 24/7 and I'll give everyone time to respond. Guido den Broeder (talk, visit) 18:11, 1 December 2008 (UTC)
- My view is that the table isn't working, and is disputed. Where does that fit? Verbal chat 19:56, 1 December 2008 (UTC)
- @ WLU - comment added by WLUThe table is not intended to count votes, only to indicate the positions. Stop changing other people's talk. Guido den Broeder (talk, visit) 20:45, 1 December 2008 (UTC)
- My comments do a far better job of representing my position than a simple name in a column, particularly when I do not necessarily agree or disagree, but am ambivalent. Not to mention expressly stating I don't wish my username to be there. I agree with Verbal, the table isn't working and how you are protecting a certain version is creating conflict to absolutely no gain. WLU (t) (c) (rules - simple rules) 21:11, 1 December 2008 (UTC)
- The table would be working perfectly if only you wouldn't insist on disrupting the normal procedure. Names in table for quick overview, discussion below because it can't possibly fit. If you want another table to put your comments in, create it as your own contribution, but don't destroy my talk. Guido den Broeder (talk, visit) 21:16, 1 December 2008 (UTC)
- My comments do a far better job of representing my position than a simple name in a column, particularly when I do not necessarily agree or disagree, but am ambivalent. Not to mention expressly stating I don't wish my username to be there. I agree with Verbal, the table isn't working and how you are protecting a certain version is creating conflict to absolutely no gain. WLU (t) (c) (rules - simple rules) 21:11, 1 December 2008 (UTC)
- @ WLU - comment added by WLUThe table is not intended to count votes, only to indicate the positions. Stop changing other people's talk. Guido den Broeder (talk, visit) 20:45, 1 December 2008 (UTC)
- My view is that the table isn't working, and is disputed. Where does that fit? Verbal chat 19:56, 1 December 2008 (UTC)
Here's my laundry list. Please bear with me:
- TITLE - we have repeatedly demonstrated that CFS is the most common name used in both professional and lay publications. Let's move on.
- SET - numerous sources indicate that CFS may be a container of a number of conditions. I don't think there is anything wrong with labeling it as such.
- PVFS - clearly if someone with CFS doesn't have premonitory infectious symptoms, this label cannot be applied.
- PIFS - in the relevant section, Sharpe et al refer to this as a subtype of CFS "which either follows an infection or is associated with a current infection". It doesn't say that it may have a shorter duration. PIFS seems to be a broader term than PVFS, because viral infectious are only a member of the larger set of infectious in general.
- NAMING - the diagnosis is not what is disputed, but the etiology. This could be rephrased.
- CAUSE - if no definite cause is known, the cause is unknown; we cannot engage in hairsplitting. The cause of idiopathic intracranial hypertension is unknown, despite the fact that there are research studies supporting various possible etiologies. I'm quite happy with the "unknown" label unless we can say anything for definite (quod non).
- ACCEPT - Prins seems to indicate that the CFS term is widely supported by clinicians and scientists. I'm not sure what Guido's objection is here.
- MECNS - so perhaps we need a better source; the fact is that CNS and muscle inflammation cannot be demonstrated in most patients who would meet criteria for ME
- MESYN - I don't see the difference between the two sentences. If the terms refer to the same illness, they must be synonyms.
- PATHY - this term seems to be used interchangeably with ME-itis and the NICE guideline mentions this as a synonym.
- NEURA - what does the Sharpe source actually say?
So I'm with Guido on a couple of points, but mostly I'm in agreement with the content of this article. JFW | T@lk 22:37, 1 December 2008 (UTC)
- Comment Should this table now be archived? It has proven useless and is cluttering the page. Verbal chat 11:02, 2 December 2008 (UTC)
- How 'bout we archive the whole section except for those issues that have been judged to have merit? WLU (t) (c) (rules - simple rules) 12:33, 2 December 2008 (UTC)
- I agree on that. A table first was not a bad idea but a table is a tool not a comment it is a bad tool when people can't use it in a debate and only one person is dictator of it. I think the "issues" are minor they are mostly when a new source is needed or a change to wording for making clearer and we should discuss. Are these the right issues,
- How 'bout we archive the whole section except for those issues that have been judged to have merit? WLU (t) (c) (rules - simple rules) 12:33, 2 December 2008 (UTC)
- TITLE - RESOLVED, consensus, literature says is right title
- SET - RESOLVED, consensus, literature possibility CFS is more then one condition
- PVFS - MINOR CHANGES, should be it is a synonym for CFS when viral infection goes before
- PIFS - MINOR CHANGES, we need confirm source about shorter duration, is that right, and show better relation PVFS and PIFS
- NAMING - ?? I think even diagnosis has been disputed see my comment, JFW thinks it is not, we should discuss.
- CAUSE - RESOLVED, literature, consensus
- ACCEPT - RESOLVED, literature, consensus
- MECNS - RESOLVED ?? But JFW says may be better source needed?
- MESYN - RESOLVED
- PATHY - RESOLVED
- NEURA - Clarification needed on Sharpe source or need other source RetroS1mone talk 13:40, 2 December 2008 (UTC)
Discussion
edit- "Title" - more accurately the page name. This is beating a dead horse and disruptive given all input on this item. The name is fine since all are considered different names for the same diagnoses. WLU
- "Set of conditions" - Guido, you may think you know what the cause is, but apparently science hasn't caught up with you. Thus. CFS is used now because they can't identify or agree on an actual cause. I see no reason to use set of conditions since AFAIK there are those who believe it could be one word for multiple separate conditions. WLU
- "PVFS" - does the citation justify this statement? WLU
- "Naming" - There are many controversies about CFS. There's a page about the controversies related to chronic fatigue syndrome. Calling this "unsubstantiated" makes me wonder why we have the controversies page. Should we delete that page? If we delete the controversies page, I'll happily remove this comment. WLU
- "Cause" - Does anyone know the cause? Can you point to a publication that states "this is what causes CFS"? Have they developed a treatment based on that cause, or even hypothesized one? But it doesn't matter since I've removed this clause. I consider it resolved. WLU
- "Accepted" - this is sourced to The Lancet, a highly respected publication, in 2006, which is recent, and is quite apparent from the uses in the publications that CFS is pretty much the standard term. Since wikipedia is about verifiability, not truth, without a counter-source of comparable reliability I think we're done here. Analysis of the author's model is WP:OR. WLU
- "Neurasthenia" - I don't know, the Sharpe citation isn't available on pubmed or google scholar, so we need clarification on this. WLU
- "MESYN" - "but CFS and ME are usually used as synonyms" and "CFS is commonly referred to as being the same illness" are, as far as I'm concerned, the same idea. I can't think of another way of phrasing this without making a copyright violation or using a quote. WLU
I don't agree with any of these disputes. As we have said before, the consensus is that most scientists and researchers believe these to be alternative names for the same illness. And you can't use the WHO classification to argue any point as it is just a classification. If you look at what researchers and health authorities are saying, it is that we don't really know what CFS is and whether or not it is multiple illnesses, but they believe that CFS/ME/CFIDS are just different names from the same thing(s), or at least there is a big overlap. There may be different sub-types (viral/psychological/others) or there might not, we don't really know. That is the majority view, and the consensus on wikipedia, and unless you can come up with some new argument then you really should accept the situation and move on. If you just want to reword the article to help clarify the disagreements and ambiguities, that's fine, but it isn't a dispute. --sciencewatcher (talk) 15:26, 1 December 2008 (UTC)
- I agree with what SW says here, and my own replies can be seen in the earlier section. At least three of these are resolved as far as I'm concerned, and raising the naming issue yet again is disruptive as far as I'm concerned. WLU (t) (c) (rules - simple rules) 15:49, 1 December 2008 (UTC)
The table was just a new way for Guido showing ownership of all articles related to ME/CFS. Only he can edit the table, only he decides what peoples positions are, only he can revert and revert and it is not edit warring. I should just do like SW and say i oppose it all but JFW and WLU make good points and i respond, o well.
- TITLE - no one says different diagnoses, all rs i have seen say different "terms" and "also known as" and stuff like that, these are different names for the same condition, that is a syndrome with unknown causes that can be many different conditions.
- SET - sources say things like CFS is not well defined, it is not a single diagnosis
- PVFS - it is obvious a synonym for CFS but it is not a synonym for all CFS just CFS where people think it may be is caused by a virus, but of course no good evidnece on that.
- PIFS - JFW is right there are other infections then viral but i think most from the infections they postulate are viral, the shorter duration thing i thought was in that source, is it another one??
- NAMING - i think people were still disputing CFS exists 10 years ago, at least here is from Prins2006, "practitioners have disagreed whether the illness really exists" i think that means the diagnosis even is disputed. I think that is minority opinion but still all aspects are conteroversial
- CAUSE - Cause is not known. Every review says it. 4000 articles, alot of ideas, not much eidence. still not known.
- ACCEPT - Totaly accepted. Guido talking about Prins and authors is probably a blp vio, i think some person should delete that out from his comments, he says they have not investigated CFS, that is a lie, they have all kinds of papers about it, Guido i think has a personal problem w/ them, that is not good.
- MECNS - people just assume inflammation. Alot of times patients just self-diagnose bc they prefer ME to other names and there doctors go along w/it bc they do not want to make things worse w/ conforntation, look at Surawy et al Behav Res Ther. 1995 Jun;33(5):535-44
- MESYN - Only Guido can think these two sentences don't mean same thing. He does this all time, he says, "that is not in source" and it really is, its just if you don't quote exact he says it is not in source. If you say I like orange juice and it says I like citrus drinks that are orange he says it is not in source, that is just mis-leading and tendentious and my opinion dishonest.
- PATHY - Jason says pathy is ME. Jason is waaaaay over-used in these articles by Guido and other people, lots from Jason's papers are in minor journals or even nonmedrs, i am saying Jason here NOT bc i think Jason is a great source, i am saying even author that agrees with Guido about so much says this.
- NEURA - The Lancet article has a history about this, WHO 1992 split the names against objections, symptoms are still overlapping.
So, basicly i think there can be some minor word changes but the article is most accurate and aggrees with medrs. I advice Guido, pls stop pretending you own this article and talk page. RetroS1mone talk 01:51, 2 December 2008 (UTC)
Archived
editI've archived the page, and tried to keep the most recent discussions here. Please bring unaddressed sections out of the archive if needed or start a section with a summary of the progress made there. WLU (t) (c) (rules - simple rules) 19:51, 1 December 2008 (UTC)
Unresolved and suggestions
editOK here are unresolved issues again and pls make suggestions
- PVFS/PIFS
I suggest this to replace last sentence, "The "Oxford 1991" diagnostic criteria for CFS refer to a subtype of CFS called post-infectious fatigue syndrome (PIFS), which is broader than PVFS since it can include any infection, not just viral infections."
Does that resolve, i am wondering.
- I believe you've made the edit. Now nearly ever single sentence is sourced. So long as the source back up the statements, I'm satisfied. WLU
- NAMING - ?? I think even diagnosis has been disputed see my comment, JFW thinks it is not, we should discuss.
- MECNS - RESOLVED ?? But JFW says may be better source needed?
- How respected is JIM? If this is well-known, a second source, ideally more recent, would be good to confirm. WLU
- NEURA - Clarification needed on Sharpe source or need other source
I suggest, add "epidemic neuromyasthenia" (Oxford 1991 source) as historic term beside Appell source in last sentence, I am looking for Sharpe source. RetroS1mone talk 13:58, 2 December 2008 (UTC)
RetroS1mone talk 13:54, 2 December 2008 (UTC)
I can't get the Sharpe review, the journal is not on PubMed, we should not use it i think as non medrs like JCFS. David and WEssely 1993 criticize ICD-10, they say the neurasthenia and PVFS descriptions are identical. That is what the Sharpe review says also, we should use David and WEssely instead. I would say, move neurasthenia into history section, but ICD-10 is still current, so neurasthenia is still a current name. What do people think about it.
Also two sources calling neurasthenia "pure" CFS are
- Psychosom Med. 1997 Nov-Dec;59(6):592-6. Do patients with "pure" chronic fatigue syndrome (neurasthenia) have abnormal sleep? Sharpley A, Clements A, Hawton K, Sharpe M.
- Biol Psychiatry. 1998 Feb 1;43(3):236-7. Basal activity of the hypothalamic-pituitary-adrenal axis in patients with the chronic fatigue syndrome (neurasthenia). Young AH, Sharpe M, Clements A, Dowling B, Hawton KE, Cowen PJ.
Luthra and Wesseley 2004 call neurasthenia "predecessor" for CFS, also Wessely's "Old Wine in New Bottles" from 1990.
Another review talks about relation, neurasthenia and CFS, J Anal Psychol. 1997 Apr;42(2):191-9. Chronic fatigue syndrome/myalgic encephalomyelitis as a twentieth-century disease: analytic challenges. Simpson M, Bennett A, Holland P. RetroS1mone talk 14:27, 2 December 2008 (UTC)
- "Neurasthenia is considered to be a historical synonym for CFS" or something similar. Excise Sharpe, replace it with better sources. WLU (t) (c) (rules - simple rules) 14:59, 2 December 2008 (UTC)
- TITLE: How about using the word "comparable" rather than "alternative"? How can PVFS necessarily be an "alternative" name for CFS if they aren't purely synonymous? Are there any sources which state that the majority of researchers and organizations actually view CFS and neurasthenia as synonymous, or even a significant minority? Also see my comment under "NEURA". Guido makes an interesting point about "alternative diagnosis".
- MECNS: The statement "no pathology has been recognized in the muscles or central nervous system" is potentially misleading. The proposed disease process ME-itis isn't universally "recognized", but to imply that there is no evidence whatsoever of pathology in muscles and CNS is incorrect. Although, if "recognized" means established in the sense that it's universally accepted rather than a hypothesis with some evidence, then I guess it's technically correct.
- NEURA: On the Sharpe source, does it actually say that neurasthenia (dropped from DSM) and undifferentiated somatoform disorder (currently in DSM) are equivalent, which is implied in the CFS article? It is understandable why some view neurasthenia as an alternative name to CFS ("chronic fatigue" syndrome), however, equating CFS with "undifferentiated somatoform disorder", an even more dubious catch-all diagnosis, is a longer stretch. CFS has surprisingly low rates of anxiety disorders for a supposed "anxiety neurosis" (neurasthenia), and let's not forget that the validity of neurasthenia is in doubt.
- _Tekaphor (TALK) 03:28, 8 December 2008 (UTC)
With an inaccurate edit summary of (revert POV edits), the edit reintroduced WP:SYNTH and removed content from cited RS. It also reinserted peacock terms for the two researchers. The edit should be reverted. Ward20 (talk) 05:35, 1 January 2009 (UTC)
- I do not agree, a peacock term is, hey every one! these gueys are THE BEST RESEARCHERS EVER!! They are totally leading reasearchers, they have published alot on CFS and they have good reputations, it is OK to say that. I am sorry you do not like them, that is your POV, try it some where like a blog not WP. Thx, RetroS1mone talk 00:08, 2 January 2009 (UTC)
- What were they 'leading' in 1993? The tone/term is inappropriate and anti-science in an article about contested scientific nomenclature. Sam Weller (talk) 10:54, 3 January 2009 (UTC)
- They were some of most published researchers on CFS and they are now to, why is that anti-science, pls keep your personal dislikes for people out of WP and do not call respected scientists anachronism. Also the nomenclature is not longer serious disputed scientifically just by activists. Thx, RetroS1mone talk 06:01, 4 January 2009 (UTC)
- RetroS1mone you wrote, "a peacock term is, hey every one! these gueys are THE BEST RESEARCHERS EVER!!"
- At Thesaurus.com leading:
- Definition: chief, superior
- Synonyms: arch, BEST, champion, dominant, dominating, famous, first, foremost, governing, greatest, headmost, highest, inaugural, initial, main, noted, notorious, number one, outstanding, popular, preeminent, premier, primary, principal, prominent, ruling, stellar, top, well-known
- Leading is a synonym for the wording RetroS1mone stated is a peacock term. Please read WP:PEACOCK. It specifically states "lead" is often used as a peacock term. Applying superlative adjectives for certain researchers over others that are well published on CFS will bias the reader. That violates the policy of WP:NPOV.
- It is interesting that David A in the discussed citation has 14 CFS articles on PubMed and Klimas N has 20 CFS articles on PubMed. The same Klimas N that edited the Journal of Chronic Fatigue Syndrome that RetroS1mone said did not get cited a lot, only 3648 times on PubMed. Ward20 (talk) 07:51, 4 January 2009 (UTC)
- RetroS1mone I noticed you reverted a direct quote from a source without comment. Why? Ward20 (talk) 09:45, 4 January 2009 (UTC)
- Give me a break Ward20, we are talking about Simon Wessely the one people you edit with has tried on smearing for so long.
I reverted leading not a direct quote, your attitude is tiring on me.Oh that is weird i was just trying on reverting Sam Weller, sorry. RetroS1mone talk 21:19, 4 January 2009 (UTC)
- Simon Wessely is one of the top names in field of CFS research, you know that, I know that, the WP reader does not know and can get a context from leading, this is not a average guy with ten PubMed hits. David is not as big but what is the point. This is a silly debate Wessely and his colleagues are leading researchers and JCFS is not medrs, you can do all OR you want to it is still silly. RetroS1mone talk 21:37, 4 January 2009 (UTC)
- RetroS1mone, a suggestion, use the wording in this edit [2] and link Wessely. It improves the article in a number of ways as it dates and tells the reader the form of the criticism, it specifies exactly who were the critics without editorial judgment, and the reader can read Wessely's accomplishments if they use the link. Ward20 (talk) 22:23, 4 January 2009 (UTC)
- Using "leading CFS researchers" as plural without specification is vague, how many researchers? Due to such ambiguity, I was about to suggest that perhaps you could write "two leading CFS researchers at the time", but if only Wessely is "leading", then that would be "one leading CFS researcher at the time". - Tekaphor (TALK) 09:18, 6 January 2009 (UTC)
Thank you for the suggestsions, i think leading is out now. RetroS1mone talk 13:08, 6 January 2009 (UTC)
- I removed it a few days ago. Sorry I didn't mention it here. It didn't quite seem appropriate, and unless anyone else has a good reason, it looks like the consensus is that it should be removed. --sciencewatcher (talk) 16:13, 6 January 2009 (UTC)
fact tag
editSee Talk at Chronic_fatigue_syndrome. Ward20 (talk) 04:31, 23 June 2009 (UTC)
I don't believe this section is accurate, "Neurasthenia or undifferentiated somatoform disorder (from DSM-IV) are alternative names for CFS". Googling the source[3] (which I don't have) reveals, "similar conditions have been termed neurasthenia". Ward20 (talk) 01:39, 28 June 2009 (UTC)
It was added by RetroS1mone here. Ward20 (talk) 01:48, 28 June 2009 (UTC)
- I removed neuromyasthenia, which was never similar to neurasthenia, to its own section "Epidemic neuromyasthenia", and included appropriate historical refs from the 1950s. You beat me to querying what's left. Is the ref MEDRS? Sharpe M. Chronic fatigue syndrome (review). Psychiatric Problems in General Medicine. 2004. No PMID, virtually no web presence, the abstract doesn't mention neurasthenia, although interestingly it acknowledges the political debate about ME vs CFS. I think Wessely has claimed neurasthenia was a historical dx for what he regards as CFS, so I suggest moving it to the historical section, but making clear that it has been applied speculatively and retrospectively by Wessely et al. with a better reference. Sam Weller (talk) 10:23, 28 June 2009 (UTC)
- What I'm noticing is that in the ICD-10, Neurasthenia is also referred to as "Fatigue Syndrome"—not "Chronic Fatigue Syndrome"—and specifically excludes Post-viral Fatigue Syndrome. I think that makes it a bit dubious, but as WLU points out in the thread that sent me here, if Neurasthenia's a common name for Chronic Fatigue Syndrome, it should be easy to source. I'll see if I can find anything on PubMed or elsewhere and post back shortly. --RobinHood70 (talk) 20:47, 16 August 2009 (UTC)
- Just looking at the top 10 abstracts in a PubMed search for
neurasthenia "chronic fatigue syndrome"
, here are the entries that seemed most-relevant (italicized emphasis/commentary added is my own; bolded "neurasthenia" throughout to make it easy to spot):- PMID 18801465: Similar disorders have been described for at least two centuries and have been differently named neurasthenia, post-viral fatigue, myalgic encephalomyelitis and chronic mononucleosis.
- PMID 18236904: The standard professional diagnostic formulations of these disorders, namely, chronic fatigue syndrome and neurasthenia, are not used widely in India, perhaps due to lack of research and poor appreciation of their clinical significance.
- PMID 18214210: Subsyndromal short episodes of chronic fatigue are many more frequent as three or six month during clearly diagnosed episodes of "neurasthenia" or "chronic fatigue syndrome".
- PMID 17693979: (Title of work, not a quote from it) Not in the mind of neurasthenic lazybones but in the cell nucleus: patients with chronic fatigue syndrome have increased production of nuclear factor kappa beta.
- PMID 17561685: Similar morbidities have been known as different names since past several centuries. For example, neurasthenia, epidemic neuromyasthenia, myalgic encephalomyelitis, Akureyri disease, Royal Free disease, chronic EBV disease, post-viral fatigue syndrome etc.
- PMID 17476439: Poor concordance among the four diagnostic systems studied indicates the need for reviewing the nosology of these disorders. (This was an interesting one - it basically looks at diagnostic differences between Neurasthenia, CFS, etc., and introduces a new term, "Neurasthenia Spectrum Disorders". I thought the quote said a lot, though.)
- PMID 17024614: The pattern of complaints differed clearly between diagnostic subgroups (neurasthenia, affective disorders, adjustment disorders) before treatment. (Note that this mentions "chronic fatigue", "chronic exhaustion" and "chronic fatigue syndromes", possibly implying a wider criteria for inclusion.)
- Note that I haven't included all 10 hits here because one was a false hit and the others were repeating similar information. Also note that several of these were in foreign languages, so translation errors are a possibility.
- Just looking at the top 10 abstracts in a PubMed search for
- What I get from the above is that some people see it as a similar condition to CFS, others see it as the same as CFS, and still others see it as a subgrouping of CFS or the broader concept of chronic fatigue. I found no secondary sources in a quick search that stated unambiguously that Neurasthenia was or wasn't a synonym for CFS. (Though in point of fact, I think most of the above are primary.) --RobinHood70 (talk) 21:18, 16 August 2009 (UTC)
- Also of note is that in several of "Sharpe M" 's works on PubMed, there's an assumption of equality between Neurasthenia and CFS, but in PMID 8491104, the abstract states "It (CFS) also resembles historical descriptions of neurasthenia." This would seem to imply that CFS and Neurasthenia might be seen as the same thing, but that the term is historical now (or at least that he considers it to be so). Again, though, this is contradicted by its continued use in ICD-10. UGH! Confusing, to say the least! --RobinHood70 (talk) 21:31, 16 August 2009 (UTC)
- Your right, it's a bit of a mess, but I believe the historical context is the most correct. I believe one of the most inluential papers is by Wessely Old wine in new bottles: neurasthenia and'ME'. PMID 2181519 is not even a review but cited 151 times. I've never seen the full paper though. And to make it more interesting the CDC 1994 criteria states you can have a diagnosis of neurasthenia and unexplained chronic fatigue at the same time, somewhat implying it is different than CFS. Ward20 (talk) 21:57, 16 August 2009 (UTC)
- Wessley wrote a lengthy article on the social and medical parallels between the two conditions, but avoids saying they are the same: PMID 1794091 Sam Weller (talk) 10:40, 17 August 2009 (UTC)
Fibrositis
editJust wondering, did the term "fibrositis" cover any of the same territory as either "fibromyalgia" or "Chronic Fatigue Syndrome"? From some reading a while ago (forget exactly where ATM), it seems to have named almost exactly what today is covered by "fibromyalgia". If this is so, would it be appropriate to include "fibrositis" as an historical name for "fibromyalgia"? Or for "Chronic Fatigue Syndrome"? yoyo (talk) 07:26, 21 September 2009 (UTC)
- Fibromyalgia used to be called fibrositis, so it belongs in fibromyalgia. Definitely not here, though. Sam Weller (talk) 07:01, 22 September 2009 (UTC)
On the Origin of "Yuppie Flu"
editThe material on Yuppie Flu may be technically accurate but the Newsweek usage is not the origin of the term. I watched "Yuppie Flu" born in and spread out from my home, San Francisco, then later heard my observations confirmed by the physician who inadvertently inspired the term.
A headline editor at one of the San Francisco newspapers, likely the Examiner, coined the term. The paper's story was built around an interview with Carol Jessop, a young physician at the women's clinic at the Mount Zion hospital. A few years later I heard her give an excellent talk about her first CFS patients and her subsequent deep involvement with CFS. Her patients were not stereotypical depressed suburban housewives but young business women on the fast track in the downtown financial district. Their symptoms, however, looked like depression minus affective symptoms.
In the interview she stressed that CFS patients were untypical of depressed 20-30-year-old non-working females by repeatedly using the word yuppie.
The article must have appeared in the late eighties. I may have a photocopy of it, but finding it might take forever. I first read about Jessop in my neighborhood newspaper in 1986 which was my introduction to CFS. During that time I subscribed to the San Francisco Examiner. "Yuppie Flu" should be in the headline and "Carol Jessop" in the body. Last I saw a reference, Dr Jessop was in the East Bay in the employ of a hospital.
I've just tried to google up corroborating evidence, but failed. There's a lot of material but no connection between Jessop and the term. Dr. Jessop is THE corroborating source. When I saw her, she did an excellent job of explaining complicated research questions to a very mixed general public audience. She also jokingly accepted responsibility for starting "Yuppie Flu".
There's an apparent connection via 2 genes, PON1 and NTE, between Parkinson's, ADHD, GWS, CFS, Multiple Chemical Sensitivity, and COPIND, or Dipper's Flu. A couple years ago I wrote about this at a neuroscience researcher's blog Pesticide-induced dysfunction of dopaminergic neurons. I just updated it with a summary of and links to Dipper's Flu research.
May I suggest an addition to the alt names page. "Yuppie Flu" is considered offensive because for many years it was broadly used as a derisive and sarcastic term, often to argue sufferers were all hypochondriacs. With my front row seat I watched it's spread carefully. It became, to encapsulize the phenomena, the stuff of late-night talk show monologues. That pervasive and negative environment doesn't come through in the article's present form.
And a barely related bit. A lot of unintentional misinformation gets spread by headlines, due to their nature. This is a good classroom for studying how effective mass communication works. I've written more than a few headlines myself.
@Justito's edits
editThere are a lot of good points in the recent edits. However, I believe many points need sources or tweaking to be verifiable or agree with cited sources. Please try to work through the edits to make sure they agree with sources. Thanks. Ward20 (talk) 05:31, 24 October 2009 (UTC)
- Agreed. I'm also concerned about the edits giving undue weight to as-yet unproven theories, such as its relation to XMRV, mean age of those affected, social status of those affected, and so on and so forth. It also changes the context of referenced material significantly in some cases, which may or may not agree with the actual source. While I don't have time to go through each one individually right now, I would tend to err on the side of reversion, given the "controversial" banner that heads the talk page. If there's any doubt at all as to the weight or accuracy of the information, it should be discussed here first before adding it to the main page. —RobinHood70 (talk • contribs) 08:08, 24 October 2009 (UTC)
- Sorry, I was tired last night. Some of the above comments were probably more applicable to the main CFS article, which it appears has now been reverted. —RobinHood70 (talk • contribs) 20:09, 24 October 2009 (UTC)
- I'm sorry, but the recent (Oct 24, around 04:00) edits changing a referenced statement about the term ME being controversial, to an unfounded claim that "some" are "wrong" to "claim" this doesn't seem constructive to me. If there is evidence of inflammation in CFS patients, could we please have the references? Justitio appears to me to just replace sound text with his/her own biased, unfounded and vague views. 85.200.87.9 (talk) 21:55, 16 November 2009 (UTC)
Immune function
editReading the reviews in the PVFS section from 1994-2007 about immune function, "some" studies is not correct, they're "extensive". PMID 18177602 concludes:
"The preponderance of available research confirms that immune dysregulation is a primary characteristic of CFS. New research has further elucidated our understanding of the genomics of the illness and the role of viral infection and reactivation in the pathogenesis. Advances in the field should result in targeted therapies to impact immune function, HPA axis regulation, and persistent viral reactivation in CFS patients." Ward20 (talk) 21:24, 28 October 2009 (UTC)
X Associated Neuro-Immune Disease (XAND)
editThe WPI have introduced the proposed term X Associated Neuro-Immune Disease (XAND) to classify their XMRV positive CFS patients and I believe that this was used in their recent Science Paper. It has certainly been used in their supporting public literature. Perhaps a brief mention is worthwhile at this stage just in case any CFS patients are searching the Wikipedia for this. This page is probably appropriate for this. TerryE (talk) 00:09, 21 November 2009 (UTC)
- It seems a bit premature. Remember they were saying that XMRV was linked to prostate cancer? Then lots of other research teams found no XMRV in prostate cancer patients? --sciencewatcher (talk) 15:47, 21 November 2009 (UTC)
- It was only two months ago (September 2009) when an association was last published (PMID 19805305). By "lots of other research teams", I'm guessing you really mean a single study (the recent large PMID 19835577)? The strength of the association was also questioned by PMID 18823818 (a smaller study from 2008) which found a limited association with XMRV just in a subset only. - Tekaphor (TALK) 12:09, 22 November 2009 (UTC)
- Two German studies and an Irish study found no XMRV in prostate cancer - see the XMRV page for details. --sciencewatcher (talk) 16:25, 22 November 2009 (UTC)
- The earlier German study is the one I referred to above as PMID 18823818. "Forty percent (8/20) of familial prostate cancer patients homozygous for a mutation in RNase L (R462Q) were positive for XMRV, while the virus was rarely (1/66) detected in familial prostate cancer patients heterozygous for R462Q or carrying the wild type allele." The Irish study is not listed in PubMed, although it is cited by the other more recent German study. I'm not interested enough yet to look into any methodological differences/issues. - Tekaphor (TALK) 22:53, 22 November 2009 (UTC)
- "Forty percent (8/20)" was the 2006 US study result. PMID 18823818 cites it as the background to their own failed replication. See also [4]. Sam Weller (talk) 09:22, 23 November 2009 (UTC)
- Oops, I must have read it too hastily, thanks. 3 research teams then, for different types of cohorts. - Tekaphor (TALK) 01:52, 24 November 2009 (UTC)
- Sorry, but I am a little confused by these responses. I am suggesting that we add a XAND reference to this "Alternative Names for chronic fatigue syndrome" article, which surely doesn't need to follow the same rigorous inclusion standards as the main CFS Article. Yes, its coinage is recent, but if you google +XAND AND (CFS OR XMRV OR "Chronic Fatigue"), then you will see thousands of hits, including mainstream newspaper websites. It is an alternative name in use. If you are applying this publication standard then you should drop Punta Gorda Fever and Contagious Multiple Sclerosis as these seem to have no supporting references at all. TerryE (talk) 18:23, 24 November 2009 (UTC) (outdented to the correct level as the most of the thread above was about sw's claim "lots of other research teams found no XMRV in prostate cancer patients" which is really nothing to do with whether XAND is in use as an alternative name for CFS. TerryE (talk) 18:29, 24 November 2009 (UTC))
- Yep, you're right - there are thousands of mentions of this on google, although none on google scholar yet. Perhaps we should wait until someone mentions it in a peer-reviewed journal, which I imagine won't be too long. But if you think it should be added now I won't object. Oh, and yes it's probably worth getting rid of Punta Gorda Fever and Contagious MS - there are no hits on google scholar and they are unreferenced in the article. --sciencewatcher (talk) 20:06, 24 November 2009 (UTC)
- I found two valid hits on the web for "Punta Gorda Fever" (including the quotes to make it search that exact term), one of which seemed to imply that it comes from the Osler's Web book. At the risk of doing some OR, however, looking at the description here, I can't say that the symptoms of PGF sound all that close to CFS. The only other hit I found for the term was in a scanned copy of JCFS here, which I believe it's been decided is less-than-ideal as a source. (You're on your own for searching; Google apparently converted it to text for search purposes, but didn't make that text available otherwise and I wasn't about to read through the whole thing.)
- While there were more hits on "Contagious Multiple Sclerosis", none that I saw appeared to be valid. Given that, I'll go ahead and remove both terms from the article. —RobinHood70 (talk • contribs) 21:08, 24 November 2009 (UTC)
- Any entry for XAND doesn't seem appropriate to "Current nomenclatures" as it isn't yet adopted in the mainstream and neither it is appropriate to "Historical nomenclatures". I suggest that we add another section "Proposed nomenclatures" between these, with a single brief entry for "X Associated Neuro-Immune Disease (XAND)". I'll dig up the references and put in a first cut tomorrow, if one of you doesn't beat me to it. At least that way searching Wikipedia for this will produce an appropriate hit. BTW, I don't think it's worth changing the CMS and PGF entries given RobinHood70's comments. TerryE (talk) 18:29, 25 November 2009 (UTC)
- Maybe create a XAND denialism page at the same time? Sam Weller (talk) 11:04, 27 November 2009 (UTC)
- Sam, I assume a degree of tongue-in-cheek in your reply, but I'll give a direct answer, nonetheless. Denialism is a valid concept as exemplified by the AIDS Denialism article. I think that for denialism to apply to a proposition or theory, said proposition must be adopted as a norm and supported by a majority of expert research or opinion. None of these apply in the case of XAND with is still a proposal based on as yet to be independently validated or subject to published secondary review. So why include it? My answer is that the paper and proposal has generated a huge amount interest in both the relevant research community and CFS sufferer communities. Searching Wikipedia should therefore return a hit, and I think that putting a paragraph in this article achieves this appropriately. TerryE (talk) 21:31, 30 November 2009 (UTC)
- Less tongue in cheek than you might imagine, and certainly not a criticism of your XAND inclusion. Sam Weller (talk) 08:39, 1 December 2009 (UTC)
Chronic fatigue syndrome/myalgic encephalomyelitis
editI've deleted this addition for a number of reasons. First, the MRC source clearly states 'Chronic fatigue syndrome or myalgic encephalomyelitis', i.e. CFS and ME are synonyms. Also the second sentence is clearly POV. And thirdly we already mention that the term CFS/ME is used in the UK. I will just expand that existing section to mention that the term CFS/ME is used by the UK government and health services. --sciencewatcher (talk) 15:55, 20 June 2010 (UTC)
- The entire paragraph needs rewording. "Many patients, and some doctors, especially in the United Kingdom, prefer to use ME on its own or in conjunction with CFS (ME/CFS or CFS/ME) because they believe it implies a more serious illness than the term chronic fatigue syndrome which focuses simply on fatigue." Should not include the term CFS/ME, as that is the official term in the UK, and the term that many patients, and some doctor, do not like to use. Here is a patient example [5] Also 'extensively' is incorrect, as CFS/ME is the official term. Furthermore, this term has no place under the subheading of Myalgic encephalomyelitis, just as it would have no place under Chronic fatigue syndrome, or CFIDS, or PVFS. It needs it own subheading. Another example of the use of CF/ME comes from Wessey's department at Kings college [6] Notice how this term is used at the top of every source I have provided. Or are you saying that King's college are wrong? Or the NICE guidelines are wrong, or the CFS/ME clinics, or the DWP, or the Government?UYBS (talk) 16:14, 20 June 2010 (UTC)
- Nowhere does it say it is the 'official term'. The MRC document uses both CFS and ME and says they are the same thing. --sciencewatcher (talk) 16:31, 20 June 2010 (UTC)
- But it is the official term, hence why it is used as the name of each expert group, or clinical guideline. As CFS is another name for ME in the UK, they used the term CFS/ME, so as to not leave out those who only have an ME diagnosis.UYBS (talk) 16:47, 20 June 2010 (UTC)
- A quote from the Parliamentry 'Inquiry into the status of CFS/ME and research into causes and treatment', "The Group feels the condition deserves a name that reflects its pathology but in view of the contentions surrounding it, it is probably wise not to be over restrictive hence we have used the term CFS/ME. We have used this term as it is the recognised term in the UK. It does not reflect the groups’ opinion on what the name should be." [7] UYBS (talk) 16:51, 20 June 2010 (UTC)
The CMO's report, which is a better source, states 'The working party report uses both CFS and ME but declines to recommend one term over the other, preferring the compromise ‘CFS/ME’.' So they are just used interchangably and CFS/ME is not the 'official term'. Also you have reintroduced your unreferenced, POV edit about the WHO classification.
You seem to have an idea that you can use wikipedia to introduce your POV that ME is a different illness to CFS and that it is neurological. Unfortunately that is not how wikipedia works. I would recommend that you undo your edit and discuss it here. You can also undo my edit as I realised it is also WP:OR. --sciencewatcher (talk) 20:40, 20 June 2010 (UTC)
- The CMO report is from 2002, since then the name has been changed to CFS/ME, as stated by the Parliamentary 'Inquiry into the status of CFS/ME and research into causes and treatment', which was published in 2006. The term CFS/ME does not define two disease, it defines one disease called CFS/ME. It is the official name. The source for the blood ban does not state at any time what the official name is, but the Parliamentary Inquiry does. Not sure why you mention a POV about the WHO classification, the first source, states that this is the classification used in the UK. Wikipedia works on facts, I have presented the facts. This is not personal opinion. Write to Wessely and ask him.UYBS (talk) 22:06, 21 June 2010 (UTC)
- You don't give that reference in the text, and even if you did I'm not sure if it a reliable source. Also your second sentence is unreferenced and clearly POV. Please revert and stop pushing your POV. --sciencewatcher (talk) 22:18, 21 June 2010 (UTC)
- The UK Parliament is a reliable source, they control the NHS & DOH. Source added to text. Second sentence is referenced, it appears as reference 38, and states, "However, I want first to put on the record that we accept the World Health Organisation's classification of ME as a neurological condition of unknown cause." [8] Therefore it is not POV and is a fact.UYBS (talk) 23:07, 21 June 2010 (UTC)
- I changed the ref format to plain link format in the paragraphs above so links are easier to follow. Ward20 (talk) 23:45, 21 June 2010 (UTC)
- Sciencewatcher, you have either not read the source or are lying. This is a silly thing to do, as everyone can read the source and see that CFS/ME is the official name in the UK. You also removed the line about the UK accepting the WHO classification. Again the same explanations apply. You need to provide a good reason to change this, as it is an alternative name, but the only official name in the UK. Source for official definition, bottom of pg5 [9] "The Group feels the condition deserves a name that reflects its pathology but in view of the contentions surrounding it, it is probably wise not to be over restrictive hence we have used the term CFS/ME. We have used this term as it is the recognised term in the UK." Source for WHO classification,[10] "The truth is that the causes of ME are unknown. However, I want first to put on the record that we accept the World Health Organisation's classification of ME as a neurological condition of unknown cause. " Quotes are given, and clearly the refs do say this. Your argument that the Health minister says, 'we accept', but does not say how it is classified in the UK, is ridiculous, who do you think the 'we' is considering that she is speaking on behalf of the DOH, which controls the NHS, DWP, CFS/ME clinics, NICE. This is a Government Health minister. If you are ignorant to how the UK functions, or believe you do not need to read the sources provided, so that you can freely alter the page according to your own agenda, I suggest you remove yourself from the discussion. If you feel the wording needs to be altered you should say why, and provide sources, deleting factual information arbitrarily is not acceptable behaviour on wikipedia. UYBS (talk) 20:26, 23 June 2010 (UTC)
First of all, the Gibson Report isn't a WP:RS for saying whether or not CFS/ME is the 'official' term for the illness in the UK. I think we do use the Gibson Report, but only for comments. Second, please don't accuse people of lying - see WP:CIVIL. As for the second sentence, just because it is a factual piece of information doesn't mean it can/should be included in wikipedia. You need to consider WP:RS, WP:WEIGHT and WP:NPOV. This seems to fails WP:WEIGHT and WP:NPOV because it is giving excessive weight to a comment in parliament and pushing the POV that CFS is neurological. --sciencewatcher (talk) 21:39, 23 June 2010 (UTC)
Parsing the sources
edit- Kings College states "CFS has officially replaced the term M.E. (Myalgic Encephalomyelitis), because there is no consistent evidence for the swelling of nervous tissue that this name implies. It has also replaced the term Post Viral Fatigue Syndrome, as the symptoms are not always associated with an initial viral infection." Despite the use of CFS/ME in the title, this statement is explicit that CFS is actually the official terminology. Wikipedia follows this, by using CFS as the primary name, but references ME extensively. Though this may be held up as an example, you can't use an example to contradict an explicit statement, and aggregating examples is original research. This source does not suport the official name being CFS/ME.
- Meactionuk states "Terminology is confusing. Although it may seem merely pedantic, inverting the initials “ME/CFS” and “CFS/ME” may have far-reaching implications for patients: “CFS/ME” (Chronic Fatigue Syndrome / Myalgic Encephalomyelitis) is not the same as “ME/CFS” because in “CFS/ME”, the “CFS” refers to (chronic) “fatigue syndrome”, not to the Chronic Fatigue Syndrome (which is an officially recognised synonym for myalgic encephalomyelitis, hence the use of the term “ME/CFS”)." It's not a reliable source and patient groups get less weight than colleges - but should be acknowledged particularly since they speak with such volume in the CFS/ME debate. This can be used as a source of why patients dislike the use of the term, and propose an alternative, but unless most other authoritative sources agree with it, it's not the last word. It also takes the position (unsupported and certainly not the medical consensus) that ME is a neurological condition - it may be, but as with all arguments about this topic, it is not the world-wide consensus and it's still up in the air. The source also attempts to both conflate and destroy the clinical and lay uses of the words "chronic fatigue syndrome" - a medical syndrome versus "people are just tired". CFS the medical diagnosis isn't "people are just tired" but this attempts to charicature that point. This document should be used to portray a patient's perspective, not as an absolute about CFS. Also, waving about an interpretation of the WHO guidelines isn't particularly convincing - the WHO hasn't really weighed in on and officially clarified its position on CFS - mostly because the evidence base is still equivocal. This source should be clearly attributed when used, but can be used. It would be particularly vauable for verifying a discussion of why people think ME/CFS/ME is such an important point to fight over.
- Erythos states "This inquiry was set up following discussions with constituents towards the end of 2005. There were clearly strong views about the condition known to some as ME (Myalgic Encephalomyelitis) and others as CFS/ME (Chronic Fatigue Syndrome)...ME was the term originally given to this illness in the 1950s. Some assert that the pathology of the term ME as given above is inaccurate. Their view is that there is not enough research evidence available to draw conclusions on whether there is widespread inflammation of the brain and spinal chord in ME sufferers. This led to the more general term term CFS also becoming prevalent in the late 1980s. However, others feel Chronic Fatigue syndrome is not a suitable alternative term because of the absence of pathology in the title and because fatigue can occur as a symptom in many other illnesses." The most important point is "until there is more evidence about the specific pathology of the illness it is of little use to consider alternative names." They just don't know. It sucks, but it just isn't clear what CFS is. Further, "The Group feels the condition deserves a name that reflects its pathology but in view of the contentions surrounding it, it is probably wise not to be over restrictive hence we have used the term CFS/ME. We have used this term as it is the recognised term in the UK. It does not reflect the groups’ opinion on what the name should be." This source can't be used to justify the use of CFS/ME except to note that it's a very inclusive label (and for this group, a label that actively refuses to take a position). The report actually alternates ME/CFS and CFS/ME throughout the document, but the latter term appears far, far more frequently.
- Parliamentary document is a debate transcript - in other words, the opinion of a single parliamentarian. Not a report. Even it conflates the two, while acknowledging the naming is controversial. In fact, this document actually uses CFS, ME and CFS/ME interchangeably throughout - pointing out some prefer one, some others, and that there's much debate over the terms and causes. This is pretty useless for much beyond the opinions of single people.
- DWP document "The term chronic fatigue syndrome (CFS) is used to describe an illness that is characterised by physical and mental fatigue and fatigability. A characteristic feature is fatigue/malaise that follows minimal exertion. People with CFS often describe the fatigue as being of a type and a scale beyond any other they have experienced. The illness may affect both physical and mental functioning, including cognitive function. Accompanying symptoms may include poor sleep, pain, poor concentration and memory, although this list is not exhaustive. Chronic fatigue syndrome (CFS) is also known as myalgic encephalomyelitis (ME) and post-viral fatigue syndrome. There is some difference of opinion over whether ME is different from CFS; however, most authorities refer to the condition as CFS/ME." CFS is still primary (as is on wikipedia) but this is a citation for people referring to the condition as CFS/ME. This is different from CFS/ME being the "official term". Also interesting - a related page states "For the purpose of DLA, however, the current law means that a claimant cannot be eligible for a higher rate of mobility unless his/her disability is considered "physical". For this purpose, CFS/ME is 'physical'" which means this is a classification, not a diagnostic issue. CFS still isn't considered or proven to be a physical disorder and it's an oversimplification (if not purely incorrect) to say otherwise.
- The NICE 317 page monster uses CFS/ME exclusively, and spells it out in such a way ("chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy) (CFS/ME)") that it's obvious this is a "big tent" definition meant to be inclusive. As far as I can tell, it doesn't even define CFS/ME in an explicit way (deferring to the diagnostic criteria) nor does it discuss the naming controversy.
In my opinion, these sources do little more than document the fact that the names and naming is still controversial, and still up in the air. These sources are used to provide "examples" of CFS/ME being the "official term". They do not do this. Though they do provide examples of the use of that abbreviation, there does not seem to be an explicit discussion of that abbreviation being the "CFS/ME is the official term used in the UK" - the statement they were meant to verify in the text I removed. Further, the edit attempted to push the POV that ME is a neurological condition - something that is still tentative and not universally accepted (though something commonly claimed by patients). From what I can tell, there still isn't a universal consensus that CFS/ME is a neurological condition. CFS should still be the primary term, and it should be noted that many prefer ME, while others use CFS/ME or ME/CFS as a compromise. There's nothing convincing and absolute about these sources, particularly the Parliamentary transcript. At best I would use this as a source for Annette Brooke's opinion, if I wanted an opinion from the Department of Health, I'd go to their website. WLU (t) (c) Wikipedia's rules:simple/complex 15:40, 25 June 2010 (UTC)
- They are synonyms. Please see the archives as this has been discussed many, many times. There is no reason to change, just see the references. I agree with what WLU states above. --CrohnieGalTalk 16:35, 25 June 2010 (UTC)
- This is the page that lists the alternative names such as ME and CFS/ME. However we already mention the terms CFS/ME and ME/CFS under myalgic encephalomyelitis so it would probably be better to just add extra info there. --sciencewatcher (talk) 17:15, 25 June 2010 (UTC)
- That's a point I forgot to make - this discussion should go under the ME heading I think, rather than the CFS heading. CFS should be clearly laid out as the current accepted name for the condition. ME should get into variations and modifications. But it's not cut and dried - it's certainly reasonable that these points are explored in the CFS section. However, that would mean you'd be using the term "ME" before you define it.
- One more point I forgot to make, most of these discussions are for the UK but CFS is a world-wide condition. Even if all these documents actually verified that CFS/ME was official term in the UK, it still deserves at most a mention in another section, not a separate section heading. And I don't think the documents actually verify that anyway. WLU (t) (c) Wikipedia's rules:simple/complex 17:50, 25 June 2010 (UTC)
- This is the page that lists the alternative names such as ME and CFS/ME. However we already mention the terms CFS/ME and ME/CFS under myalgic encephalomyelitis so it would probably be better to just add extra info there. --sciencewatcher (talk) 17:15, 25 June 2010 (UTC)
Arguments against: Kings College - Kings college are not Parliament and still have had to use the official term for their heading, CFS/ME. Also, Parliament controls the NHS and therefore the official term, unless you are saying that they are lying, which of course would be ridiculous. Meaction UK - Not relevant to the facts. WHO - Is not relevant to the official term used in the UK. It is however relevant to the UK classification, which is neurological in accordance with the WHO ICD-10. Parliamentary Inquiry - States that CFS/ME is the official term. (Use of any other name is not relevant to the facts, as they state that the official term is CFS/ME) Parliamentary document - The statement is not the opinion of a single parliamentarian. It is a statement by the Health Minister on behalf of the NHS. (ie. NICE, MRC, UK Blood service) The Health Minister at no time states which is the official term out of the alternative names she uses. DWP - Is controlled by the Parliament. This issue is not what other names are used elsewhere, but what is used officially in the UK. As proven, UK Parliament states the official term to be CFS/ME. NICE - The official guidelines use the official term, CFS/ME.
Again, Parliament has stated that "...hence we have used the term CFS/ME. We have used this term as it is the recognised term in the UK." There it is in black and white. Again, Parliament has stated that they accept the WHO classification of CFS/ME as neurological, they have not said that it is a neurological condition, but that they accept the WHO classification. Black and white fact again.
Annette Brooke is not the Health Minister so I suggest you re-read the source. The Health Minister, Gillian Merron, speaking for the DOH & NHS, states "I want first to put on the record that we accept the World Health Organisation's classification of ME as a neurological condition of unknown cause. " Fact.
This has no bearing on the ME, CFS, CFIDS, or PVF sections. It is about the official term in the UK.
As this is a world page, it has to reflect the terms used throughout the world. CFS/ME is the offical term in the UK, and therefore needs it's own section. It appears that you are ignorant to how the UK Parliament & NHS work. Parliament speaks for them, they control them, and all other bodies within the NHS. I again suggest you re-read the sources provided very slowly.UYBS (talk) 23:33, 25 June 2010 (UTC)
- If no one responds to these relevant points of fact, I will assume there is no disagreement and change the page. Another source [1] Clearly shows CFS/ME is the official term, it is used by the NHS, NHS clinics, Parliament, the MRC, everyone who has any authority in the UK. Consensus cannot be gained through ignorance, you must read the sources. AGAIN, THE HEALTH MINISTER IS GILLIAN MERRON.UYBS (talk) 01:01, 26 June 2010 (UTC)
- Those documents don't support the contention that ME/CFS is the official term, by any means. Consensus is against you, and you're edit warring on this. The very sources you cite don't support this being an "official term". The page reflects what most of the world uses, and that term is CFS - we've discussed this before, please review the archives.
- And do you know what's funny? The parliamentary transcript doesn't register Gillian Merron using CFS/ME at all. She uses ME throughout. MP Annette Brook does, but Merron doesn't. And again, as a comment in Parliament, it still carries far less weight than official documents produced by the organizations, and that in turn must bow to the overall weight of CFS and ME being considered essentially synonyms for a poorly-understood condition of uncertain etiology. These documents pretty clearly state that ME and CFS are the same thing - and on wikipedia, in the interest of consistency, we use CFS.
- You've very, very clearly got extensive disagreement about your point - demonstrated by both reverts to your edit, and by the discussions on the talk page. Accept it - consensus is against you. I've read and quoted the sources, and they don't support ME/CFS being the official term - they support the terms being interchangeable, with many parties deeply unhappy with CFS but still admitting that it is used - and using ME instead. WLU (t) (c) Wikipedia's rules:simple/complex 01:27, 26 June 2010 (UTC)
this statement lacks coherence and logic
edit"A report from 1959 suggested ME could be a distinct condition from CFS, but CFS and ME are usually used as synonyms.[12]" How can an article from 1959 reference a name/definition that didn't exist in 1959 since the term "chronic fatigue syndrome" didn't exist until 1988? — Preceding unsigned comment added by Synapse13 (talk • contribs) 21:20, 11 April 2011 (UTC)
- Well spotted! That was added by RetroS1mone here. As you can see Retro's original edit uses a 2001 source so it would probably make sense to use that source instead of the 1959 one. At the very least someone should read the JAMA review to see exactly what it says. --sciencewatcher (talk) 22:08, 11 April 2011 (UTC)
- Thanks, I think I got it corrected please review for content if you will. Ward20 (talk) 22:16, 11 April 2011 (UTC)
Fatigue not required in International Consensus Criteria for ME?
editIn the Myalgic Encephalomyelitis section, the paragraph on the International Consensus Criteria for ME, the following statement is made:
"[its author] criticized the primary emphasis on "fatigue" which is no longer a requirement."
I've seen this statement elsewhere too, but I cannot see how the paper can be interpreted as saying this. For one, fatigue is the very first entry in the document's list of criteria. Second, it is listed as "compulsory." So how can fatigue not be considered a requirement? Therefore I deleted that clause from the sentence. — Preceding unsigned comment added by SDLarsen (talk • contribs) 08:16, 15 May 2013 (UTC)
- Well spotted! You're right, fatigue is part of the ICC criteria (the second entry, as far as I can see - "fatiguability"). It looks like someone put their own (incorrect) interpretation on the paper. --sciencewatcher (talk) 14:25, 15 May 2013 (UTC)
Proposal to redirect
editProposal to redirect this article to main CFS page. see https://en.wikipedia.org/wiki/Talk:Chronic_fatigue_syndrome#Redirect_proposal_for_Alternate_names_subarticle for discussion. --In Vitro Infidelium (talk) 13:30, 15 January 2016 (UTC)