Objective: To acknowledge the clinical syndrome chronic fatigue syndrome (CFS) and outline the diagnostic criteria and reasonable management.
Outcomes: Attempt at containment of treatment cost and improvement of the quality of care of patients with CFS.
Evidence: Delphi-type commentary from 20 expert clinicians and appropriate organisations. Limited literature survey.
Values: To clarify the reasonable management of CFS amid conflicting clinical opinion on a condition of concern to patients, funders and doctors. An adaptation of an existing guideline was sent to organisations and individuals for comment. Comments received were included in this guideline where possible. BENEFITS, HARMS AND COSTS. To acknowledge a clinical syndrome with a reasonable approach to management considering the cost implications. No cost analysis was done.
Recommendations: To recommend the following: (i) diagnostic criteria for CFS; (ii) potential differential diagnoses and possible investigations; and (iii) management protocol.
Validation: The draft guidelines were subjected to external review by individual doctors who are acknowledged CFS treaters, doctor groups and the patient support group. There were major disputes about the content, with the responses falling into two groups: those who do not believe CFS is a distinguishable illness, and those who do.
Developer and funding: The Committee for Science and Education, Medical Association of South Africa. ENDORSEMENTS: Medical Association of South Africa and national health care organisations (see list at the end of the document).