Oxford criteria: Difference between revisions

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The '''Oxford criteria''' are a criteria for the diagnosis [[Chronic Fatigue Syndrome]] published in 1991 by a group of psychiatrists. They identify two broad syndromes and are used primarily for research purposes.<ref>[http://www.meassociation.org.uk/about/the-symptoms-and-diagnosis-of-mecfs Symptoms and diagnosis of ME/CFS - ME Association]</ref>
The '''Oxford criteria''' are a set of criteria for the diagnosis [[Chronic Fatigue Syndrome]] published in 1991 by a group of psychiatrists. They identify two broad syndromes and are used primarily for research purposes.<ref>[http://www.meassociation.org.uk/about/the-symptoms-and-diagnosis-of-mecfs Symptoms and diagnosis of ME/CFS - ME Association]</ref> The Oxford criteria was used for [[PACE trial]] participation.<ref>[http://www.wolfson.qmul.ac.uk/current-projects/pace-trial#patients  Pace Trial - Centre for Psychiatry - QMUL]</ref><ref>[http://www.meassociation.org.uk/2011/02/pace-study-trial-%e2%80%93-medical-research-council-uk-news-report-18-february-2011/ PACE study results – Medical Research Council (UK) news report, 18 February 2011 - ME Association]</ref>
 
==Authors==
[[Michael Sharpe]], [[Len Archard]], [[Jangu Banatvala]], [[Leszek Borysiewicz]], [https://en.wikipedia.org/wiki/Anthony_Clare Anthony Clare], [[Anthony David]], [[Richard Edwards]], [[Keith Hawton]], [[Harold Lambert]], [[Russell Lane]]


==Definition==
==Definition==
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===Chronic fatigue syndrome===
===Chronic fatigue syndrome===


* fatigue is the principal symptom: it is severe, disabling and affects physical and mental functioning; it should have been present for a minimum of 6 months during which it was present for more than 50% of the time.
* [[fatigue]] is the principal symptom: it is severe, disabling and affects physical and mental functioning; it should have been present for a minimum of 6 months during which it was present for more than 50% of the time.
* other symptoms may be present: particularly myalgia, mood swings and sleep disturbances.
* other symptoms may be present: particularly [[myalgia]], [[mood swings]] and [[sleep disturbance]]s.
* definite onset of symptoms, not life-long.
* definite onset of symptoms, not life-long.
* exceptions: patients with established medical conditions known to produce chronic fatigue; also patients with a current diagnosis of schizophrenia, manic depressive illness, substance abuse, eating disorder or proven organic brain disease.
* exceptions: patients with established medical conditions known to produce [[chronic fatigue]]; also patients with a current diagnosis of [[schizophrenia]], [[manic depressive illness]], [[substance abuse]], [[eating disorder]] or proven organic brain disease.


===Post-infectious Fatigue Syndrome (PIFS)===
===[[Post-infectious Fatigue Syndrome]] (PIFS)===


A sub-type of CFS which either follows an infection or is associated with a current infection (although whether such associated infection is of aetiological significance (i.e. whether it is the cause of the symptoms) is a topic for research).
A sub-type of [[CFS]] which either follows an infection or is associated with a current infection (although whether such associated infection is of aetiological significance (i.e. whether it is the cause of the symptoms) is a topic for research).


To meet the research criteria for PIFS patients must:
To meet the research criteria for PIFS patients must:
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* (c) the infection has been corroborated by laboratory evidence.
* (c) the infection has been corroborated by laboratory evidence.


===PDF for Oxford Definition CFS and PIFS===


PDF: '''A report - chronic fatigue syndrome: guidelines for research''' - ''Journal of the Royal Society of Medicine'' - Volume 84 February 1991 118-121<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1293107/ A report - chronic fatigue syndrome: guidelines for research Journal of the Royal Society of Medicine Volume 84 February 1991 118-121]</ref>


==Criticisms==
==Criticisms==
*[[How have selection bias and disease misclassification undermined the validity of myalgic encephalomyelitis/chronic fatigue syndrome studies?]] For every 15 patients selected under Oxford criteria, 14 will be false positives when compared to [[Canadian Consensus Criteria]]. The [[Pace trial]] and [[FINE trial]] used Oxford criteria.
*[[Post-exertional malaise]] is not a listed symptom. When this symptom is not mandatory, patients with [[Chronic Fatigue]] and not the grossly misnamed disease [[Chronic Fatigue Syndrome]] are swept into the study.<ref>[https://voat.co/v/CFS/comments/254402 Chronic Fatigue is NOT Chronic Fatigue Syndrome - VOAT]</ref>
*Depression is not an absolute exception for a possible cause of Chronic Fatigue (not to be confused with Chronic Fatigue Syndrome.) This allows for patients with depression to be misdiagnosed with [[CFS]].<ref>[http://arthritis.about.com/od/fatigue/f/chronicfatigue.htm Chronic Fatigue Versus Chronic Fatigue Syndrome - About.com HEALTH By: Carol Eustice]</ref>
*Many psychiatric disorders are not excluded. Although schizophrenia, substance abuse, bipolar disorder, eating disorders, and verified organic brain disorders are excluded from diagnosis in the Oxford criteria, anxiety disorders, depressive disorders, and hyperventilation can be included. This allows for a more heterogeneous patient sample which can render clinical study results indeterminate.<ref name="Njoku, 2016"/>


*[[Post-exertional malaise]] is not a symptom.
*'''US NIH Report Calls for UK Definition of ME/CFS to be Scrapped''' - ''The Argus Report'' By: Penny Swift.
*Depression is not an exception for a possible cause of Chronic Fatigue (not to be confused with Chronic Fatigue Syndrome.)<ref>[http://arthritis.about.com/od/fatigue/f/chronicfatigue.htm Chronic Fatigue Versus Chronic Fatigue Syndrome - About.com HEALTH By: Carol Eustice]</ref>
 
:''Excerpt''
::The [https://en.wikipedia.org/wiki/National_Institutes_of_Health United States National Institutes of Health] (NIH) has issued a draft report that highlights the dire need for scientific research that will help find a cure for the millions of people suffering from myalgic encephalomyelitis/chronic fatigue syndrome ([[ME/CFS]]) worldwide. The report also highlights the fact that the decades-old UK Royal Society of Medicine’s '''Oxford criteria''' for ME/CFS are severely “flawed,” and that continuing to use these criteria may “cause harm.” Further, the NIH report says that the Royal Society definition should “be retired” and replaced with a single case definition agreed to by the ME/CFS community.<ref>[http://theargusreport.com/us-nih-report-calls-uk-definition-mecfs-scrapped/ US NIH Report Calls for UK Definition of ME/CFS to be Scrapped - The Argus Report By: Penny Swift]</ref>
 
==Learn more==
*2016, [http://occupyme.net/2016/08/16/ahrq-evidence-review-changes-its-conclusions/ AHRQ Evidence Review Changes Its Conclusions]
 
==See also==
*[[FINE trial]]
*[[PACE trial]]


==References==
==References==
<references>
<references>
<ref name="Njoku, 2016">{{citation
| author  = Mary Gloria C. Njoku
| title  = Myalgic, Encephalomyelitis/Chronic Fatigue Syndrome: History, Diagnostic Criteria and Prevalence
| type    = ebook
| date    = 2016
| ISBN    = 978-1-4689-7326-6
}}</ref>
</references>


[[Category:Definitions]]
[[Category:Definitions]]

Revision as of 23:54, March 27, 2017

The Oxford criteria are a set of criteria for the diagnosis Chronic Fatigue Syndrome published in 1991 by a group of psychiatrists. They identify two broad syndromes and are used primarily for research purposes.[1] The Oxford criteria was used for PACE trial participation.[2][3]

Authors[edit | edit source]

Michael Sharpe, Len Archard, Jangu Banatvala, Leszek Borysiewicz, Anthony Clare, Anthony David, Richard Edwards, Keith Hawton, Harold Lambert, Russell Lane

Definition[edit | edit source]

Chronic fatigue syndrome[edit | edit source]

Post-infectious Fatigue Syndrome (PIFS)[edit | edit source]

A sub-type of CFS which either follows an infection or is associated with a current infection (although whether such associated infection is of aetiological significance (i.e. whether it is the cause of the symptoms) is a topic for research).

To meet the research criteria for PIFS patients must:

  • i. fulfil the criteria for CFS as defined above (i.e. the Oxford definition)
  • ii. should also fulfil the following additional criteria:
  • (a) There is definite evidence of infection at onset or presentation (a patient’s self-report is unlikely to be sufficiently reliable).
  • (b) the syndrome is present for a minimum of 6 months after onset of infection.
  • (c) the infection has been corroborated by laboratory evidence.

PDF for Oxford Definition CFS and PIFS[edit | edit source]

PDF: A report - chronic fatigue syndrome: guidelines for research - Journal of the Royal Society of Medicine - Volume 84 February 1991 118-121[4]

Criticisms[edit | edit source]

  • US NIH Report Calls for UK Definition of ME/CFS to be Scrapped - The Argus Report By: Penny Swift.
Excerpt
The United States National Institutes of Health (NIH) has issued a draft report that highlights the dire need for scientific research that will help find a cure for the millions of people suffering from myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) worldwide. The report also highlights the fact that the decades-old UK Royal Society of Medicine’s Oxford criteria for ME/CFS are severely “flawed,” and that continuing to use these criteria may “cause harm.” Further, the NIH report says that the Royal Society definition should “be retired” and replaced with a single case definition agreed to by the ME/CFS community.[8]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]