The
Need to Abolish the Fatigue Model and to Establish Precise Subsets
One of the main goals of the M.E. Society is to see the inaccurate, vague,
demeaning word "fatigue" eliminated not only from names but also from
descriptions of the disease and from scientific discussion. We hold that
scientific progress cannot be made when researchers focus on and blend the
patients together by the poorly defined symptom of fatigue, which muddies
understanding of the disease because it is a symptom of many diseases, of
psychiatric diseases, as well as a normal physiological state. We hold that
the community of interested parties should use more precise language and
focus instead on the neurological, neurocardiac, myocardiac,
endocrinological, immunologic, and circulatory models that are now being
developed based on current research. We hold that working on subsets using
these models and selecting subsets of patients with homogeneous variables --
as opposed to lumping heterogeneous patients together by the vague, poorly
defined symptom of "chronic fatigue"--is the key to scientific progress in
this area of research. Lumping heterogeneous patients according to fatigue
is what has resulted in the failure to find consistent biomarkers and to the
conclusion that the disease is medically unexplained and hence a disease of
"perception of effort," as is currently held by Dedra Buchwald, Simon
Wessely, and others who support the psychopathological paradigm.
When patients are selected according to large groups, data cannot be
replicated; when data are not replicated and consistent biomarkers are not
found, this leads to the view that M.E./CFS is not a disease and is, rather,
a problem of perception. Therefore, we recommend that researchers attempt to
develop precise subsets based on the neurocardiac and other models as
described above, and abolish the fatigue model completely. For our views on
abolishing the fatigue model, see our
"M.E. Definitional Framework".