Can physical assessment techniques aid diagnosis in people with chronic fatigue syndrome/myalgic encephalomyelitis? A diagnostic accuracy study
Can physical assessment techniques aid diagnosis in people with chronic fatigue syndrome/myalgic encephalomyelitis? A diagnostic accuracy study
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DOI：
10.1136/bmjopen-2017-017521
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发表时间：
2017-11-01
期刊：
影响因子：
2.9
通讯作者：
Perrin, Raymond N.
中科院分区：
文献类型：
--
作者：
Hives, Lucy;Bradley, Alice;Perrin, Raymond N.
目的评估5项体征是否有助于慢性疲劳综合征/肌痛性脑脊髓炎（CFS/ME）患者的筛查，并可能导致更快的治疗。从两家国家卫生服务医院，当地CFS/ME支持团体和社区招募的参与者在同一天由三名医生以随机顺序进行检查。两名专职医疗人员（AHPs）对体征进行了独立检查，包括：胸椎姿势/机械障碍、乳房静脉曲张、压痛Perrin点、压痛腹腔神经丛和颅内血流受阻。医生进行了标准的临床神经和流变学评估，同时寻找疾病行为模式。每次检查持续约20 min。结果94名参与者进行了评估，52例CFS/ME和42非CFS/ME对照，年龄18 - 60。Cohen's kappa分析显示，对于腹腔神经丛触痛的存在，AHP之间的一致性是实质性的（kappa = 0.65，p
Objective To assess five physical signs to see whether they can assist in the screening of patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and potentially lead to quicker treatment.Methods This was a diagnostic accuracy study with inter-rater agreement assessment. Participants recruited from two National Health Service hospitals, local CFS/ME support groups and the community were examined by three practitioners on the same day in a randomised order. Two allied health professionals (AHPs) performed independent examinations of physical signs including: postural/mechanical disturbances of the thoracic spine, breast varicosities, tender Perrin's point, tender coeliac plexus and dampened cranial flow. A physician conducted a standard clinical neurological and rheumatological assessment while looking for patterns of illness behaviour. Each examination lasted approximately 20 min.Results Ninety-four participants were assessed, 52 patients with CFS/ME and 42 non-CFS/ME controls, aged 18-60. Cohen's kappa revealed that agreement between the AHPs was substantial for presence of the tender coeliac plexus (kappa=0.65, p