Cottrell, David John · Archives of disease in childhood. Education and practice edition · 2016 · DOI
This article discusses how doctors can better understand and manage symptoms that don't have an obvious medical cause, which is common in children. It explains that anxiety about missing a serious illness can sometimes get in the way of good care, and provides a practical model for how doctors should assess and treat these patients based on the best available evidence.
For ME/CFS patients, this guideline is relevant because ME/CFS is frequently encountered as a medically unexplained syndrome, and clinician anxiety about missed diagnoses can delay or complicate appropriate management. Understanding evidence-based frameworks for managing such conditions may help reduce diagnostic delays and improve clinical outcomes.
This guideline does not prove that any specific symptom cluster is or is not organic in nature, nor does it establish diagnostic criteria for ME/CFS specifically. It addresses the broader category of medically unexplained symptoms without ME/CFS-specific evidence, and the management model is general rather than condition-specific.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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