Chronisch Vermoeidheidssyndroom: diagnose, behandeling en ...

KCE Reports 88 Chronic Fatigue Syndrome 1
Table of contents
Scientific summary
1 INTRODUCTION............................................................................................................ 5
1.1 DEFINITION.................................................................................................................................................. 5
1.2 MANAGEMENT OF CFS IN BELGIUM AND CONTEXT OF THE CURRENT STUDY ........... 5
1.3 RESEARCH..................................................................................................................................................... 6
1.3.1 Research questions .......................................................................................................................... 6
1.3.2 Patient issues..................................................................................................................................... 7
1.3.3 International comparison and Belgian data ................................................................................. 7
2 DEFINITION, DIAGNOSIS AND TREATMENT: A LITERATURE REVIEW.......... 8
2.1 LITERATURE REVIEW: METHODOLOGY............................................................................................ 8
2.1.1 Search methodology........................................................................................................................ 8
2.1.2 Search results.................................................................................................................................... 9
2.1.3 Critical appraisal: methodology...................................................................................................11
2.2 DEFINITIONS OF CHRONIC FATIGUE SYNDROME ....................................................................12
2.2.1 Main definitions of chronic fatigue syndrome ..........................................................................12
2.2.2 Validation of the existing case definitions for CFS..................................................................16
2.2.3 Commonly observed symptoms in CFS and similarities to other disorders.....................17
2.2.4 Severity.............................................................................................................................................18
2.3 DIAGNOSIS OF CHRONIC FATIGUE SYNDROME........................................................................19
2.3.1 Literature review by NICE...........................................................................................................19
2.3.2 Incremental search about diagnostic tests................................................................................20
2.3.3 Recommendations for diagnosis .................................................................................................21
2.4 EPIDEMIOLOGICAL DATA ABOUT CFS ...........................................................................................23
2.4.1 Prevalence of CFS in adults..........................................................................................................24
2.4.2 Prevalence of CFS in children......................................................................................................25
2.4.3 Prevalence: discussion ...................................................................................................................29
2.4.4 Incidence of CFS in adults ............................................................................................................29
2.4.5 Incidence of CFS in children and adolescents ..........................................................................30
2.4.6 Incidence: discussion......................................................................................................................30
2.4.7 Gender, Social Class, Ethnicity and Geographical Variation .................................................32
2.5 TREATMENT: A LITERATURE REVIEW ..............................................................................................33
2.5.1 Aims of intervention......................................................................................................................33
2.5.2 Outcomes measured .....................................................................................................................33
2.5.3 Therapeutic strategies...................................................................................................................34
2.5.4 Recommendations for treatment ...............................................................................................48
2.5.5 Pacing, cognitive behavioural therapy or graded exercise therapy: current research and
therapy manuals developed by experts..................................................................................................50
2.5.6 Occupational management...........................................................................................................56
3 ECONOMIC EVALUATION OF CFS EVIDENCE-BASED TREATMENTS: A
LITERATURE REVIEW................................................................................................. 57
3.1 INTRODUCTION AND LITERATURE SEARCH...............................................................................57
3.2 MAIN CHARACTERISTICS OF THE ECONOMIC EVALUATIONS.............................................57
3.2.1 Analytical technique and outcome measures ...........................................................................58
3.2.2 Perspective.......................................................................................................................................58
3.2.3 Time horizon and discount rate..................................................................................................58