Doctors and Diagnosis – or not

Why Some Doctors Are Not Diagnosing ME/CFS

There are a number of reasons why medical practitioners are not reaching a diagnosis of ME/CFS. Many of these have their origins in the historical context in which ME/CFS was described before it was fully recognised by the government, the UN and the medical establishment.

  • Many doctors were not taught about ME/CFS at medical school or have incomplete, distorted, misleading or outdated views about the illness.
  • Some doctors are reluctant to make a diagnosis of ME/CFS because they believe it is an ill-defined condition which may be associated with unhelpful patient beliefs.
  • As yet, there is no specific blood or other bio-marker that can be used as a diagnostic test (there is much current research in this field see for example Klimas, Nancy G. et al., 2012 review, and 2010 articleSonya M. Marshall-Gradisnik et al. 2014, and 2011 articles). However, it must be remembered that ME/CFS is not the only condition for which there is no defining laboratory test, eg. MS, ALS, Parkinson’s and Alzheimer’s Disease are not diagnosed by bio-marker.
  • Although (in the UK) the NICE Guidelines recommend ME/CFS be diagnosed with 3-4 months and GPs do recognise the importance of making an accurate diagnosis, there is uncertainty amongst some doctors as to how to make a clinical diagnosis of ME/CFS. This has been compounded by the very limited availability (UK) of specialist referral services for ME/CFS patients. The most recent survey (UK) of GP attitudes and knowledge about ME/CFS reported that 48% of GPs (811 GPs were surveyed) did not feel confident with making a diagnosis of ME/CFS and 41% did not feel confident in treatment.

References

ME Alliance, ME/CFS Diagnosis: “Delay Harms Health Early diagnosis: why is it so important? A report from the M.E. Alliance“, Dr Charles Shepherd.

Bayliss, K., et al. “Overcoming the barriers to the diagnosis and management of chronic fatigue syndrome/ME in primary care: a meta synthesis of qualitative studies.” BMC Fam Pract, 2014, 15: 44.

Brenu, E. W., et al “High-Throughput Sequencing of Plasma MicroRNA in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.” PLoS One, 2014, 9(9): e102783.

Klimas, N. G., et al. “Biomarkers for chronic fatigue.” Brain, Behav., Immun., 2012, 26(8): 1202-1210.

Brenu, E. W., et al. “Immunological abnormalities as potential biomarkers in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.” J Transl Med, 2011, 9: 81.

Fletcher, M. A., et al. “Biomarkers in Chronic Fatigue Syndrome: evaluation of natural killer cell function and dipeptidyl peptidase IV/CD26.” PLoS, 2010, One 5(5).

Chew-Graham, C., et al. “Making the diagnosis of Chronic Fatigue Syndrome/Myalgic Encephalitis in primary care: a qualitative study.BMC Fam Pract, 2010, 11: 16.

 

Why early diagnosis is important

How should a diagnosis be made?

Diagnosis in acute onset ME/CFS

Diagnosis in gradual onset ME/CFS

The role of delayed diagnosis in the development of severe ME/CFS

Even further reading