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Development of further case definitions of CFS/ME should be given a low priority.
Development of further case definitions of CFS/ME should be given low priority.
On the basis of our review, we argue that development of further case definitions of CFS/ME should be given low priority, as long as causal explanations for the disease are limited.
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Any clinical feature rated 7, 8 or 9 by all panelists for all 3 criteria will be retained for further case definition development and removed from the next survey round.
A further case definition (the HPDI) was developed from outbreak data, by comparing data from 16 cases of biopsy proven MWF-HP, with that from the 14 workers in the outbreak thought least likely to have the disease [Dangman et al., 2002].
Further, our case definition required a clinic visit with a diagnosis of AS (ICD-10 code M45) made by a physician during the years 1999 to 2011 133 calendar years), at least once at a rheumatology clinic or internal medicine clinic, or at least twice at any other clinic including general practice.
Following our initial analyses examining cases with both RD and LI, we further examined RD and LI case definitions individually (i.e. LI excluding those with comorbid RD, and RD excluding those with comorbid LI).
Future research should focus on further validating depression case definitions using additional data sources (eg. linkage with outpatient and pharmacy data, where available), with an eventual goal of increased sensitivity and specificity and consistent application of ICD codes for depression across disciplines.
The generalizability of the results should be further enhanced by employing case definitions and study methods that were accepted by experts in the field and disclosed in a detailed and transparent way.
The present study is also unusual in that, in addition to adherence with current diagnostic criteria [1], extensive histological evaluations of entire lung explants were available for the many disease subjects here who had lung transplantations, thereby further ensuring accuracy of these case definitions.
This study provides insight into limitations and challenges for data quality in primary care EMR data and case definitions and further analyzed underlying causes for discrepancy.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com