{"id":14697,"date":"2017-10-25T07:22:02","date_gmt":"2017-10-25T07:22:02","guid":{"rendered":"http:\/\/wames.org.uk\/cms-english\/?p=14697"},"modified":"2017-10-25T07:25:47","modified_gmt":"2017-10-25T07:25:47","slug":"can-physical-assessment-techniques-aid-diagnosis-in-people-with-cfsme","status":"publish","type":"post","link":"https:\/\/wames.org.uk\/cms-english\/can-physical-assessment-techniques-aid-diagnosis-in-people-with-cfsme\/","title":{"rendered":"Can physical assessment techniques aid diagnosis in people with CFS\/ME?"},"content":{"rendered":"

Research abstract:<\/strong><\/h3>\n

Can physical assessment techniques aid diagnosis in people\u00a0with chronic fatigue syndrome\/myalgic encephalomyelitis?\u00a0 A diagnostic accuracy study<\/a>, by\u00a0Lucy\u00a0Hives,\u00a0Alice Bradley,\u00a0James Richards,\u00a0Chris J\u00a0Sutton, James\u00a0Selfe,\u00a0Bashkar Basu, Kerry Maguire, Gail Sumner, Tarek Gaber,\u00a0Annice Mukherjee,\u00a0and Raymond Perrin, Raymond in<\/span> BMJ Open<\/em>, October 2017 [Preprint].<\/p>\n

Objective:<\/strong>
\nTo assess 5 physical signs to see whether they can assist in the\u00a0screening of patients with CFS\/ME, and potentially lead to quicker\u00a0treatment.<\/p>\n

Methods:<\/strong>
\nThis was a diagnostic accuracy study with inter-rater agreement\u00a0assessment.<\/a> Participants recruited from 2 NHS hospitals, local CFS\/ME\u00a0support groups and the community were examined by three practitioners on\u00a0the same day in a randomized order. Two Allied Health Professionals\u00a0(AHPs) performed independent examinations of physical signs including;
\npostural\/mechanical disturbances of the thoracic spine, breast\u00a0varicosities, tender Perrin’s point<\/a>, tender coeliac plexus and dampened\u00a0cranial flow. A physician conducted a standard clinical neurological and\u00a0rheumatological assessment, whilst looking for patterns of illness
\nbehaviour. Each examination lasted approximately 20 minutes.<\/p>\n

Results:<\/strong>
\nNinety-four participants were assessed, 52 CFS\/ME patients and 42\u00a0non-CFS\/ME controls, aged 18-60. Cohen’s kappa revealed agreement\u00a0between the AHPs was substantial for presence of the tender coeliac\u00a0plexus (kappa=0.65, p<0.001) and moderate for postural\/mechanical\u00a0disturbance of the thoracic spine (kappa=0.57, p<0.001) and Perrin’s\u00a0point (kappa=0.56, p<0.001).<\/p>\n

A McNemar’s test found no statistically\u00a0significant bias in the diagnosis by the experienced AHP relative to\u00a0actual diagnosis, (p=1.0) and a marginally non-significant bias by the\u00a0newly trained AHP, p=0.052. There was however, a significant bias in the\u00a0diagnosis made by the physician relative to actual diagnosis, (p<0.001),\u00a0indicating poor diagnostic utility of the clinical neurological and\u00a0rheumatological assessment.<\/p>\n

Conclusions:<\/strong>
\nUsing the physical signs appears to improve the accuracy of identifying\u00a0people with CFS\/ME and shows agreement with current diagnostic\u00a0techniques, however the present study concludes that only 2 of these may\u00a0be needed. Examining for physical signs is both quick and simple for the\u00a0AHP and may be used as an efficient screening tool for CFS\/ME. This is a\u00a0small single centre study and therefore further validation in other\u00a0centres and larger populations is needed.<\/p>\n","protected":false},"excerpt":{"rendered":"

Research abstract: Can physical assessment techniques aid diagnosis in people\u00a0with chronic fatigue syndrome\/myalgic encephalomyelitis?\u00a0 A diagnostic accuracy study, by\u00a0Lucy\u00a0Hives,\u00a0Alice Bradley,\u00a0James Richards,\u00a0Chris J\u00a0Sutton, James\u00a0Selfe,\u00a0Bashkar Basu, Kerry Maguire, Gail Sumner, Tarek Gaber,\u00a0Annice Mukherjee,\u00a0and Raymond Perrin, Raymond in BMJ Open, October 2017 [Preprint]. … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[4059,4057,4058],"class_list":["post-14697","post","type-post","status-publish","format-standard","hentry","category-news","tag-diagnostic-accuracy","tag-lucy-hives","tag-raymond-perrin"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p5qkYK-3P3","_links":{"self":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/14697","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/comments?post=14697"}],"version-history":[{"count":4,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/14697\/revisions"}],"predecessor-version":[{"id":14701,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/posts\/14697\/revisions\/14701"}],"wp:attachment":[{"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/media?parent=14697"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/categories?post=14697"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wames.org.uk\/cms-english\/wp-json\/wp\/v2\/tags?post=14697"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}