A Quick and Practical Approach to Secure a Chronic Fatigue Syndrome Diagnosis: The Novel Functional Limitation Index
Chronic Fatigue Syndrome (CFS) is a serious, clinical, long-term condition with an unclear etiology and a difficult diagnosis. Our aim is to propose an objective physiological parameter (Functional Limitation Index, FLI) that describes the degree of functional impairment to support clinical suspicio...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/22/7157 |
| _version_ | 1797458842099908608 |
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| author | Juan Antonio Corbalán Gisela Feltes Daniela Silva Eduardo Gómez-Utrero Iván J. Núñez-Gil |
| author_facet | Juan Antonio Corbalán Gisela Feltes Daniela Silva Eduardo Gómez-Utrero Iván J. Núñez-Gil |
| author_sort | Juan Antonio Corbalán |
| collection | DOAJ |
| description | Chronic Fatigue Syndrome (CFS) is a serious, clinical, long-term condition with an unclear etiology and a difficult diagnosis. Our aim is to propose an objective physiological parameter (Functional Limitation Index, FLI) that describes the degree of functional impairment to support clinical suspicion. Materials and Methods: We consecutively included all CFS patients who consulted in the Exercise Physiology Department at our hospital, a dedicated referral unit for CFS, from 2009 to 2022. For comparison purposes, we included two control groups. Thus, three cohorts were included: the CFS group (patients with a previous definitive diagnosis), healthy voluntaries and a sportspeople/trained cohort (amateur athletes). All patients underwent a body composition test, spirometry, basal ECG in supine and standing positions and double peak effort ergospirometry with criteria of maximality. Results: The CFS+ group comprised 183 patients (85% female, mean age 46.2 years) and the CFS− included 161 cases (25.5% female, mean age 41.2 years); there were 93 patients in the healthy and 68 in the trained cohort. The CFS+ presented a lower functional class and scored worse in all of the performance parameters. The FLI was significantly higher in CFS+ (2.7 vs. 1.2; <i>p</i> < 0.001). The FLI displayed a good discrimination power (AUC = 0.94, <i>p</i> < 0.001), with a higher AUC than all of the other spirometric variables recorded. The best dichotomic overall FLI cutoff would be 1.66 with good specificity and sensitivity (S = 0.874, E = 0.864, Youden Index = 0.738). Conclusions: The Functional Limitation Index (FLI) could provide an easy and accurate diagnosis of this condition in both genders in a one-day assessment. |
| first_indexed | 2024-03-09T16:42:57Z |
| format | Article |
| id | doaj.art-5b5447837e0e4519ad2314ebead7dcdc |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T16:42:57Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5b5447837e0e4519ad2314ebead7dcdc2023-11-24T14:49:41ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011222715710.3390/jcm12227157A Quick and Practical Approach to Secure a Chronic Fatigue Syndrome Diagnosis: The Novel Functional Limitation IndexJuan Antonio Corbalán0Gisela Feltes1Daniela Silva2Eduardo Gómez-Utrero3Iván J. Núñez-Gil4Exercise Physiology Department, Vithas Arturo Soria Hospital, 28043 Madrid, SpainCardiology Department, Vithas Arturo Soria Hospital, 28043 Madrid, SpainGeriatric Department, Vithas International Arturo Soria Hospital, 28043 Madrid, SpainNeurophysiology Department, Vithas International Arturo Soria Hospital, 28043 Madrid, SpainCardiology Department, Vithas Arturo Soria Hospital, 28043 Madrid, SpainChronic Fatigue Syndrome (CFS) is a serious, clinical, long-term condition with an unclear etiology and a difficult diagnosis. Our aim is to propose an objective physiological parameter (Functional Limitation Index, FLI) that describes the degree of functional impairment to support clinical suspicion. Materials and Methods: We consecutively included all CFS patients who consulted in the Exercise Physiology Department at our hospital, a dedicated referral unit for CFS, from 2009 to 2022. For comparison purposes, we included two control groups. Thus, three cohorts were included: the CFS group (patients with a previous definitive diagnosis), healthy voluntaries and a sportspeople/trained cohort (amateur athletes). All patients underwent a body composition test, spirometry, basal ECG in supine and standing positions and double peak effort ergospirometry with criteria of maximality. Results: The CFS+ group comprised 183 patients (85% female, mean age 46.2 years) and the CFS− included 161 cases (25.5% female, mean age 41.2 years); there were 93 patients in the healthy and 68 in the trained cohort. The CFS+ presented a lower functional class and scored worse in all of the performance parameters. The FLI was significantly higher in CFS+ (2.7 vs. 1.2; <i>p</i> < 0.001). The FLI displayed a good discrimination power (AUC = 0.94, <i>p</i> < 0.001), with a higher AUC than all of the other spirometric variables recorded. The best dichotomic overall FLI cutoff would be 1.66 with good specificity and sensitivity (S = 0.874, E = 0.864, Youden Index = 0.738). Conclusions: The Functional Limitation Index (FLI) could provide an easy and accurate diagnosis of this condition in both genders in a one-day assessment.https://www.mdpi.com/2077-0383/12/22/7157Chronic Fatigue Syndromeprognosisdiagnosisergospirometryfunctional impairmentdyspnea |
| spellingShingle | Juan Antonio Corbalán Gisela Feltes Daniela Silva Eduardo Gómez-Utrero Iván J. Núñez-Gil A Quick and Practical Approach to Secure a Chronic Fatigue Syndrome Diagnosis: The Novel Functional Limitation Index Journal of Clinical Medicine Chronic Fatigue Syndrome prognosis diagnosis ergospirometry functional impairment dyspnea |
| title | A Quick and Practical Approach to Secure a Chronic Fatigue Syndrome Diagnosis: The Novel Functional Limitation Index |
| title_full | A Quick and Practical Approach to Secure a Chronic Fatigue Syndrome Diagnosis: The Novel Functional Limitation Index |
| title_fullStr | A Quick and Practical Approach to Secure a Chronic Fatigue Syndrome Diagnosis: The Novel Functional Limitation Index |
| title_full_unstemmed | A Quick and Practical Approach to Secure a Chronic Fatigue Syndrome Diagnosis: The Novel Functional Limitation Index |
| title_short | A Quick and Practical Approach to Secure a Chronic Fatigue Syndrome Diagnosis: The Novel Functional Limitation Index |
| title_sort | quick and practical approach to secure a chronic fatigue syndrome diagnosis the novel functional limitation index |
| topic | Chronic Fatigue Syndrome prognosis diagnosis ergospirometry functional impairment dyspnea |
| url | https://www.mdpi.com/2077-0383/12/22/7157 |
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