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".