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Diagnosing chronic fatigue syndrome: comparison of a protocol and computerised questionnaires
J B Prins1, L D Elving, H Koning
1Department of Medical Psychology, University Medical Centre St Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands. j.prins@cukz.umcn.nl
Background:
In the context of outpatient care and within the framework of scientific research, guidelines and measuring instruments have been developed to help improve CFS diagnostics. The purpose of this study was to measure the agreement between the evaluations of chronically fatigued patients by physicians using a CFS protocol and by researchers using computerised questionnaires.
Methods:
The sample consisted of 516 patients referred to an internal medicine outpatient clinic with complaints of chronic fatigue. Retrospectively the medical records and the computerised questionnaires were checked separately and compared to see whether the criteria for diagnosis of CFS had been met. In addition, the reasons for not diagnosing CFS were evaluated.
Results:
Agreement between the physicians' and the researchers' evaluations was 84%. Disagreement mostly concerned severity of fatigue and functional impairment, or premorbid exclusion criteria. A physical cause for the chronic fatigue was only found in 3% of the cases.
Conclusions:
For physicians, questionnaire assessment may be complementary to the CFS protocol in optimising the process of diagnosing CFS.