Symptom-based survey diagnoses may serve to identify more homogenous sub-groups of fatigue and postviral diseases

Figures & data

Table 1. Fatigue patients fulfilling symptom-based survey diagnostic criteria and combinations.

n = 1904*	Diagnostic criteria						Combinations of diagnostic criteria
	Oxford	Fukuda	IOM/ NICE	CCC	ICC	DSQ-PEM	CCC & DSQ-PEM and/or ICC	Fukuda, IOM/ NICE and/or CCC, not DSQ-PEM nor ICC	Only fatigue and/or Oxford, Fukuda
Percentages	64	76	73	58	35	59	54	20	26
Number	1210	1454	1381	1110	672	1125	1026	384	494

Source: The MECOV online survey in Norway, June–August 2022, respondents with ME, CFS or fatigue, but not Long Covid.

Table 2. RAND-36 scores and number of treatments tried by diagnostic group.

Table 2a. RAND-36 Health related quality of life scores by diagnostic group
Diagnostic group*	Group 1		Group 2		Group 3
	Mean (SD)	N	Mean (SD)	n	Mean (SD)	n	F-value	p
Physical functioning	41 (24)	531	39 (22)	412	31 (20)	1110	46.18	<0.001
Bodily pain	52 (24)	530	53 (23)	413	43 (19)	1109	51.19	<0.001
General health	35 (17)	411	33 (15)	412	28 (15)	1110	40.56	<0.001
Role-emotional	72 (42)	515	72 (42)	404	72 (42)	1092	0.16	0.852
Mental health	73 (18)	412	74 (15)	413	72 (17)	1110	2.33	0.098
Table 2b. Number of treatments tried by diagnostic group.
Diagnostic group*	Group 1		Group 2		Group 3		F-value	p
Number of treatments tried	No (SD)	n	No (SD)	n	No (SD)	n
	1.85 (3.91)	494	5.05 (5.20)	384	7.13 (5.40)	1026	185.82	<0.001

*Diagnostic groups:

Group 1 Respondents with fatigue and possibly fulfilling Oxford and/or Fukuda criteria.

Group 2 Respondents fulfilling Fukuda, IOM/ NICE and/or CCC criteria, but not DSQ-PEM nor ICC criteria.

Group 3 Respondents fulfilling CCC & DSQ-PEM criteria and/or ICC criteria.

Table 3. Reported effect of 26 treatments by diagnostic group.

Treatment	Diagnostic group*	Reported effect in percentages 1 – Large deterioration to 5 – Large improvement
		Large det. 1	Det. 2	No eff. 3	Imp. 4	Large imp. 5	All	n	Mean	SD	F / sig.
Pacing below threshold	G 1	0	1	18	71	10	100	78	3.90	0.57	F
	G 2	1	1	25	64	9	100	170	3.78	0.67	6.142
	G 3	1	2	31	60	5	100	610	3.65	0.68	p
	All	1	2	29	61	6	100	858	3.70	0.67	0.002
Saline infusion – numbers	All	0	0	24	28	6		58	3.69	0.65
Immuno-globulin – numbers	All	1	3	10	13	6		33	3.61	1.00
Food mapping and diet	G 1	0	3	53	29	14	100	58	3.53	0.78	F
	G 2	1	2	55	37	6	100	123	3.45	0.67	0.419
	G 3	0	4	46	45	5	100	494	3.50	0.66	p
	All	0	3	48	42	6	100	675	3.49	0.67	0.658
Low dose naltrexone	G 1	3	6	53	35	3	100	34	3.29	0.76	F
	G 2	0	14	47	31	9	100	81	3.35	0.82	0.048
	G 3	3	8	49	35	6	100	313	3.33	0.82	p
	All	2	9	49	34	6	100	428	3.33	0.81	0.658
Abilify/ Att.-deficit hyperactivity disorder drugs – numbers	All	2	7	23	15	1		48	3.13	0.84
Amino acids	G 1	0	0	71	24	5	100	21	3.33	0.61	F
	G 2	2	4	68	21	4	100	47	3.21	0.51	0.366
	G 3	0	3	65	30	2	100	169	3.31	0.56	p
	All	0	3	66	27	3	100	237	3.30	0.55	0.694
B vitamins high dose B1 B12	G 1	0	1	66	28	5	100	76	3.37	0.58	F
	G 2	0	1	70	28	1	100	142	3.30	0.69	0.575
	G 3	0	1	68	28	3	100	503	3.33	0.57	p
	All	0	1	68	28	3	100	721	3.33	0.59	0.564
Mind-fulness	G 1	0	4	58	36	2	100	50	3.36	1.41	F
	G 2	1	2	61	36	1	100	115	3.34	0.30	0.904
	G 3	1	5	69	24	0	100	419	3.17	0.96	p
	All	1	5	67	27	1	100	584	3.22	0.88	0.412
Immuno-modulatory drugs – numbers	All	3	2	31	11	4		51	3.22	0.68
Antiviral drugs – numbers	All	0	3	39	14	4		60	3.32	0.58
Physio-therapist	G 1	0	10	59	28	3	100	71	3.24	0.58	F
	G 2	5	16	53	24	3	100	152	3.05	0.50	0.167
	G 3	4	15	56	23	2	100	560	3.04	0.49	p
	All	3	15	56	24	2	100	783	3.06	0.50	0.846
Minerals Mag-nesium Iodine Selenium	G 1	0	2	72	22	5	100	64	3.30	0.66	F
	G 2	0	1	75	22	2	100	138	3.25	0.84	2.030
	G 3	0	1	72	26	1	100	503	3.27	0.77	p
	All	0	1	73	25	1	100	705	3.27	0.78	0.132
Antibiotics	G 1	7	4	64	11	14	100	28	3.21	0.99	F
	G 2	3	9	69	14	6	100	35	3.11	0.76	0.331
	G 3	2	7	63	20	8	100	183	3.23	0.78	p
	All	3	7	64	18	8	100	246	3.22	0.80	0.719
Nevro Chiro-practor	G 1	0	0	66	28	7	100	29	3.41	0.63	F
	G 2	4	16	51	27	1	100	73	3.05	0.81	3.235
	G 3	2	9	68	20	1	100	260	3.10	0.64	p
	All	2	10	64	22	2	100	362	3.11	0.68	0.041
D vitamins fatty acids Omega3 Q10	G 1	0	0	77	19	3	100	88	3.26	0.51	F
	G 2	0	0	82	17	1	100	188	3.19	0.42	0.731
	G 3	0	0	79	20	1	100	620	3.22	0.46	p
	All	0	0	79	19	2	100	896	3.22	0.45	0.482
Qigong	G 1	6	6	50	31	6	100	16	3.25	0.93	F
	G 2	6	3	72	19	0	100	32	3.03	0.69	1.284
	G 3	3	18	62	16	1	100	110	2.95	0.70	p
	All	4	14	63	18	1	100	158	2.99	0.73	0.280
Acupuncture	G 1	0	0	80	20	0	100	40	3.20	0.41	F
	G 2	1	1	79	19	0	100	75	3.15	0.48	1.244
	G 3	1	8	72	18	0	100	279	3.08	0.57	p
	All	1	6	74	18	0	100	394	3.10	0.54	0.289
Nutrition with antioxi-dants	G 1	0	0	84	16	0	100	25	3.16	0.37	F
	G 2	0	0	84	14	2	100	44	3.18	0.45	0.070
	G 3	1	2	77	19	2	100	178	3.20	0.51	p
	All	0	1	79	18	2	100	247	3.19	0.49	0.932
Rehab centre	G 1	14	16	43	23	5	100	44	2.89	1.06	F
	G 2	16	22	45	15	3	100	109	2.67	1.00	5.108
	G 3	20	30	35	14	1	100	425	2.45	0.99	p
	All	19	28	38	15	2	100	578	2.53	1.00	0.006
Homeopathy	G 1	0	0	84	16	0	100	19	3.16	0.37	F
	G 2	3	9	75	13	0	100	32	2.97	0.59	1.558
	G 3	2	1	81	15	2	100	133	3.14	0.51	p
	All	2	2	80	15	1	100	184	3.11	0.52	0.213
Training to cope with ME	G 1	2	6	69	19	4	100	48	3.17	0.69	F
	G 2	2	17	60	19	3	100	114	3.04	0.73	9.720
	G 3	6	22	60	12	0	100	451	2.79	0.74	p
	All	5	19	60	14	1	100	613	2.87	0.75	0.000
Graded exercise training	G 1	23	31	35	12	0	100	26	2.35	0.46	F
	G 2	30	48	20	2	2	100	61	1.98	0.59	4.244
	G 3	35	46	13	6	0	100	245	1.90	0.69	p
	All	33	45	16	6	0	100	332	1.95	0.66	0.015
Psychiatrist Psychologist	G 1	0	11	79	9	0	100	53	2.98	0.98	F
	G 2	4	7	79	10	1	100	114	2.97	0.85	3.280
	G 3	7	15	71	6	1	100	417	2.80	0.85	p
	All	5	13	73	7	1	100	584	2.85	0.86	0.039
Cognitive therapy and graded exercise training	G 1	12	35	29	18	6	100	17	2.71	1.10	F
	G 2	20	52	20	8	0	100	50	2.16	0.84	4.574
	G 3	28	44	23	5	0	100	217	2.05	0.86	p
	All	26	45	23	6	1	100	284	2.11	0.88	0.011
Lightning Process	G 1	21	21	43	7	7	100	14	2.57	1.16	F
	G 2	37	21	37	5	0	100	19	2.11	0.99	1.892
	G 3	40	25	31	3	1	100	72	2.00	0.98	p
	All	37	24	33	4	2	100	105	2.10	1.01	0.156

* Diagnostic groups:

G 1 Respondents with fatigue and possibly fulfilling Oxford and/or Fukuda criteria.

G 2 Respondents fulfilling Fukuda, IOM/ NICE and/or CCC criteria, but not DSQ-PEM nor ICC criteria.

G 3 Respondents fulfilling CCC & DSQ-PEM criteria and/or ICC criteria.