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Prognosis for myalgic encephalomyelitis and chronic fatigue syndrome
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=== Work-related outcomes and objective measures === Although research has generally used self-reported improvement to estimate prognosis, some studies included more objective measurements such as work-related outcomes. These have generally reported less improvement. [[Jan Vercoulen|Vercoulen]] et al.<ref name="Vercoulen1996" /> and Hill et al.<ref name="Hill1999">{{Cite journal | last = Hill | first = Nancy F. | last2 = Tiersky | first2 = Lana A. | last3 = Scavalla | first3 = Vanessa R. | last4 = Lavietes | first4 = Marc | last5 = Natelson | first5 = Benjamin H. | date = Sep 1999 | title = Natural history of severe chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/10489014|journal=Archives of Physical Medicine and Rehabilitation|volume=80|issue=9|pages=1090–1094|issn=0003-9993|pmid=10489014|quote= | author-link = Nancy Hill | authorlink2 = Lana Tiersky | authorlink3 = Vanessa Scavalla | authorlink4 = Marc Lavietes | authorlink5 = Benjamin Natelson|via=}}</ref> for example found no significant change in employment status. Another study from the research team of [[Benjamin Natelson|Benjamin Natelson]] found that unemployment rates increased after 3.5 year follow-up.<ref name="Tiersky2002">{{Cite journal | last = Tiersky | first = Lana A. | last2 = DeLuca | first2 = J. | last3 = Hill | first3 = Nancy | last4 = Dhar | first4 = S.K. | last5 = Johnson | first5 = S.K. | last6 = Lange | first6 = Gudrun | last7 = Rappolt | first7 = G. | last8 = Natelson | first8 = Benjamin H.| date = 2001 | title = Longitudinal assessment of neuropsychological functioning, psychiatric status, functional disability and employment status in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/11388123|journal=Applied Neuropsychology|volume=8|issue=1 | pages = 41–50|doi=10.1207/S15324826AN0801_6|issn=0908-4282|pmid=11388123|quote= | author-link = Lana Tiersky | authorlink2 = | authorlink3 = Nancy Hill | authorlink4 = | authorlink5 = |via= | authorlink7 = | authorlink8 = Benjamin Natelson | authorlink6 = Gudrun Lange}}</ref> A [[Denmark|Danish]] study followed up on 33 patients for an extensive period of 5 years. Though work disability was already high at baseline (77%), this increased even further to 91%.<ref name="Andersen2004">{{Cite journal | last = Andersen | first = M.M. | last2 = Permin | first2 = H. | last3 = Albrecht | first3 = F. | date = Feb 2004 | title = Illness and disability in Danish Chronic Fatigue Syndrome patients at diagnosis and 5-year follow-up | url =https://www.ncbi.nlm.nih.gov/pubmed/15016582|journal=Journal of Psychosomatic Research|volume=56|issue=2|pages=217–229|doi=10.1016/S0022-3999(03)00065-5|issn=0022-3999|pmid=15016582}}</ref> A trend towards a decrease in employment status was also reported by Collin & Crawley, as more patients reported a deterioration than an improvement in hours spent on work, education and social activities<ref name="Collin2017" /> (see table below). {| class="wikitable" | | colspan="4" |<small>Collin & Crawley 2017.</small> |- |<small> </small> |<small>return to work or increase their working hours</small> |<small>increased their hours of, education</small> |<small>increased unpaid work and domestic tasks</small> |<small>increased their social and leisure activities</small> |- |<small>Improvement</small> |<small>24%</small> |<small>12%</small> |<small>36%</small> |<small>35%</small> |- |<small>Decline</small> |<small>-27%</small> |<small>-13%</small> |<small>-32%</small> |<small>-39%</small> |} Other studies have shown that ME/CFS patients do experience improvement on objective measures. Tiersky et al. (2002) for example noted better results on [[neurocognitive testing]] after a period of 3.5 years.<ref name="Tiersky2002" /> [[Peter Rowe|Rowe]] et al. reported a significant improvement in range of motion (ROM) in 53 adolescents with ME/CFS after a two year follow-up.<ref name="Rowe2018">{{Cite journal | last = Rowe | first = Peter C. | last2 = Marden | first2 = Colleen L. | last3 = Flaherty | first3 = Marissa A.K. | last4 = Jasion | first4 = Samantha E. | last5 = Cranston | first5 = Erica M. | last6 = Fontaine | first6 = Kevin R. | last7 = Violand | first7 = Richard L. | date = Sep 2018 | title = Two-Year Follow-Up of Impaired Range of Motion in Chronic Fatigue Syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/29866593|journal=The Journal of Pediatrics|volume=200|pages=249–253.e1|doi=10.1016/j.jpeds.2018.05.012|issn=1097-6833|pmid=29866593}}</ref>
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