Excerpt

The guideline covers care provided by healthcare professionals who have direct contact with and make decisions about the care of people with chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy) (CFS/ME). It covers care provided in primary and secondary care, and in specialist centres/teams.

The Guideline Development Group (GDG) developed this guideline with the aims of: increasing the recognition of CFS/ME; influencing practice in the ‘real world’; improving access to appropriate services, and supporting consistent service provision; emphasising the need for multidisciplinary working; improving care for patients, particularly for those with severe CFS/ME; providing guidance on ‘best practice’ for children with CFS/ME; balancing clinical guidance with flexibility and management tailored to the needs of the patient; facilitating communication between practitioners and patients, and their families or carers, as appropriate.

Contents

• Preface
• Acknowledgements
• Abbreviations
• Glossary of terms
• Guideline Development Group (GDG)
• Executive summary and recommendations
• Structure of the guideline documentation
• Development of the guideline
• Scope
• 1. Introduction to chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy)
  • 1.1 Introduction
  • 1.2 Clinical need for the guideline
  • 1.3 Aetiology
  • 1.4 Diagnosis
  • 1.5 Management
  • 1.6 Prognosis
  • 1.7 Epidemiology
  • 1.8 Existing service provision
• 2. Methodology
  • 2.1 Introduction
  • 2.2 The developers
  • 2.3 The Guideline Development Group (GDG)
  • 2.4 Developing key clinical questions
  • 2.5 Layout of chapters 4–7
  • 2.6 Identifying the evidence
  • 2.7 Reviewing and grading the evidence
  • 2.8 Developing evidence statements and recommendations using formal consensus methods
  • 2.9 Use of the consensus methodology in guideline development
  • 2.10 Developing recommendations
  • 2.11 External review
• 3. The experience of people with CFS/ME
  • 3.1 Introduction
  • 3.2 Summary of submissions by stakeholder organisations
  • 3.3 Personal testimonies from people with CFS/ME
• 4. General principles of care
  • 4.1 Introduction
  • 4.2 Recommendations
  • 4.3 Information
  • 4.4 Support
• 5. Making a diagnosis of CFS/ME
  • 5.1 Introduction
  • 5.2 Arriving at a diagnosis
  • 5.3 Referral to specialist CFS/ME care
  • 5.4 A conceptual framework for patients, carers and healthcare professionals when making a diagnosis of CFS/ME
• 6. Management
  • 6.1 Introduction
  • 6.2 Key clinical question 3 and subquestion 3
  • 6.3 CBT, GET, activity management and other therapeutic interventions
  • 6.4 Pharmacological interventions
  • 6.5 Dietary interventions and supplements
  • 6.6 Complementary therapies
  • 6.7 Review and ongoing management
• 7. People with severe CFS/ME
  • 7.1 Introduction
  • 7.2 Purpose and context of this chapter
  • 7.3 General recommendations
  • 7.4 Additional information related to Chapter 4 – General principles of care
  • 7.5 Additional information related to Chapter 5 – Making a diagnosis of CFS/ME
  • 7.6 Additional information related to Chapter 6 – Management
• References
• Appendix 1 Systematic Evidence Review to support the development of the NICE clinical guideline for CFS/ME in adults and children
• Appendix 2 Data extraction tables
• Appendix 3 Questionnaires
• Appendix 4 Background letters and instructions related to the questionnaire

Suggested citation:

Turnbull N, Shaw EJ, Baker R, Dunsdon S, Costin N, Britton G, Kuntze S and Norman R (2007). Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management of chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy) in adults and children. London: Royal College of General Practitioners.