Comparing the DePaul Symptom Questionnaire with physician assessments: a preliminary study

Abstract

Background: Diagnostic assessment of chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME) is largely based on a two part process; screening patients who might meet criteria and following up this assessment with physicians’ clinical evaluation of a range of inclusionary symptoms and exclusionary illnesses. Purpose: The aim was to assess how well the DePaul Symptom Questionnaire (DSQ) screened for patients who were ultimately diagnosed by physicians using the Canadian Consensus Criteria (CCC). Methods: Sixty-four patients referred for evaluation of possible CFS or ME were screened initially using the DSQ, and then evaluated and subsequently diagnosed by physicians. To assess the consistency between the self-report DSQ and the physicians’ diagnosis, sensitivity and specificity as well as predictive values were calculated. Results: The DSQ identified 60 and the physicians identified 56 as having a CCC diagnosis. The overall agreement between the two ratings on the diagnostic assessment part was moderate (Kappa = 0.45, p < .001). The sensitivity of DSQ was good (98%) while the specificity was 38%. Positive and negative predictive values were 92% and 75%, respectively. Conclusion: DSQ is useful for detecting and screening symptoms consistent with a CCC diagnosis in clinical practice and research. However, it is important for initial screening of self-report symptoms to be followed up by subsequent medical and psychiatric examination in order to identify possible exclusionary medical and psychiatric disorders.

Keywords:

• chronic fatigue syndrome
• myalgic encephalomyelitis
• questionnaire
• diagnostic criteria
• validation
• exclusion

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Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Elin B. Strand

Elin B. Strand, PhD, is a community psychologist and head of research at CFS/ME Centre, Oslo University Hospital, Norway.

Kristine Lillestøl

Kristine Lillestøl, MD, PhD, CFS/ME Centre, Oslo University Hospital, currently holds a position as a postdoctoral research fellow at the Institute of Health and Society, University of Oslo, Norway.

Leonard A. Jason

Leonard A. Jason, PhD, and Professor of Psychology and Director, Center for Community Research, DePaul University, US.

Kari Tveito

Kari Tveito, MD, PhD, CFS/ME Centre, Oslo University Hospital , currently holds a position as coeditor in Journal of the Norwegian Medical Association, Norway.

Lien My Diep

Lien My Diep, is a Biostatistician/Statistician, Oslo Centre for Biostatistics and Epidemiology at Oslo University Hospital, Oslo, Norway.

Simen Strand Valla

Simen Strand Valla, is a research assistant at CFS/ME Centre, Oslo University Hospital, and currently a student at Gedimina Technical University in Vilnius, Lithuania.

Madison Sunnquist

Madison Sunnquist is a graduate research assistant at the Center for Community Research at DePaul University, US.

Ingrid B. Helland

Ingrid B Helland, MD, PhD, and leader of National Advisory Unit for CFS/ME at Oslo University Hospital, Norway.

Ingrid Herder

Ingrid Herder, MD, rheumatologist at CFS/ME Centre at Oslo University Hospital, Norway.

Toril Dammen

Toril Dammen, MD, PhD, and professor at Department of Behavioral Sciences at University of Oslo, Norway.