How have selection bias and disease misclassification undermined the validity of myalgic encephalomyelitis/chronic fatigue syndrome studies?
- PMID: 28810428
- PMCID: PMC5581258
- DOI: 10.1177/1359105317695803
How have selection bias and disease misclassification undermined the validity of myalgic encephalomyelitis/chronic fatigue syndrome studies?
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome has been a controversial diagnosis, resulting in tensions between patients and professionals providing them with care. A major constraint limiting progress has been the lack of a 'gold standard' for diagnosis; with a number of imperfect clinical and research criteria used, each defining different, though overlapping, groups of people with myalgic encephalomyelitis or chronic fatigue syndrome. We review basic epidemiological concepts to illustrate how the use of more specific and restrictive case definitions could improve research validity and drive progress in the field by reducing selection bias caused by diagnostic misclassification.
Keywords: chronic fatigue syndrome; diagnosis; epidemiology; misclassification; myalgic encephalomyelitis/chronic fatigue syndrome; selection bias.
Conflict of interest statement
References
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- Beth Smith ME, Nelson HD, Haney E, et al. (2014, addendum 2016) Diagnosis and Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Evidence Reports/Technology Assessments (ed Center PNE-bP). Rockville, MD: US Department of Health and Human Services.
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- Carruthers B, Jain AK, De Meirleir KL, et al. (2003) Myalgic encephalomyelitis/chronic fatigue syndrome: Clinical working case definition, diagnostic and treatment protocols. Journal of Chronic Fatigue Syndrome 11: 7–115.
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