Myalgic encephalomyelitis/chronic fatigue syndrome

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I've listed this article for peer review because I'd like one (or two) additional reviewers before I nominate at FAC. Is the article sufficiently understandable to a broad audience? Is there still some awkward prose?

Thanks, —Femke 🐦 (talk) 07:32, 16 June 2024 (UTC)[reply]

RoySmith

• You state (in the lead) "ME/CFS affected roughly one in every 150 people" and then "Doctors may be unfamiliar with ME/CFS, as it is often not covered in medical school". The obvious question is "How can med schools not teach about something that affects 1 in 150 of the population?" Either one of those statements is wrong, or there's a glaring gap in medical education. Either way, it deserves some discussion.

  I'm not sure how to expand on this. The cited source bases their statement on a single 2013 study, which found 6% of medical schools in the US teach ME/CFS fully (so both theoretically, practically & research). I have weakened the sentence accordingly (not covered --> not fully covered). In the UK, the 2022 interim delivery plan noted the same gap. NICE has a short discussion in their guideline evidence doc (p.18), which follows the doctor-patient relationships section in the themes discussed (i.e. patients sometimes teaching HCPs). My guess is that limited teaching comes from limited research, which I have discussed in detail. —Femke 🐦 (talk) 19:00, 19 June 2024 (UTC)[reply]

• I'm reading this mostly to answer your "Is the article sufficiently understandable to a broad audience?" question. To give some context, I'm not a doctor, but have a better than average grounding in medicine and human physiology. So far, Im finding this easy reading. Every time I come upon some technical term that I expect most people would not understand ("orthostatic intolerance", "postural orthostatic tachycardia syndrome", "Orthostatic hypotension" you've provided both an in-line explanation and a link to an article for more details. So all good there.
  • "hypersensitivities to touch, light, sound, and smells" you've got a link, but this might also benefit from an in-line explanation of "hypersensitivities"
    • I've removed the link, as the Wikipedia article doesn't seem to cover the same topic. Gave some more info. —Femke 🐦 (talk) 19:00, 19 June 2024 (UTC)[reply]
  • "NASA 10-minute lean test.[12]", I'd provide an in-line description here.
    • Done. —Femke 🐦 (talk) 19:00, 19 June 2024 (UTC)[reply]

Overall, as you get further into the article, particularly the "Diagnosis" and "Management" sections, it gets more technical, but I think that's fine; anybody who gets that far is likely to have a stronger technical background.

• As far as the prose goes, there are a few odd phrases. I'll list them as I see them.
  • "They cannot be caused by a different illness", I'm not sure what you're trying to say here.
    • Removed as it's about diagnosis, so doesn't really fit there. —Femke 🐦 (talk) 18:06, 19 June 2024 (UTC)[reply]
  • "cleaning their teeth" -> "brushing their teeth", or if you wanted to sound a bit more clinical, "oral hygiene".
    • Done. —Femke 🐦 (talk) 18:06, 19 June 2024 (UTC)[reply]
  • "Rest does not ease the fatigue much." -> "Rest provides limited relief from fatigue". Your version sounds too informal.
    • Done. —Femke 🐦 (talk) 18:06, 19 June 2024 (UTC)[reply]
  • "bedbound" -> I was going to suggest changing that to "bedridden", but I see that both terms do exist with slightly different meanings so I'm not sure what to suggest there.
    • Hah, I wasn't aware there was a difference. Benbound is what the sources consistently use, so I'll stick with that one. —Femke 🐦 (talk) 18:06, 19 June 2024 (UTC)[reply]
  • "cannot independently care for themselves." -> "for themselves" kind of implies "independently"
    • Done. —Femke 🐦 (talk) 18:06, 19 June 2024 (UTC)[reply]
  • "People with ME/CFS have decreased quality of life according to the SF-36 questionnaire" -> "... indicate a decreased qualify of life when evaluated using the sF-36 questionnaire"
    • I don't quite understand your suggestion.
  • "Less than 50% of people with ME/CFS are employed" -> I would have used "fewer" instead of "less", but I think you might find multiple opinions on that
    • Done. —Femke 🐦 (talk) 18:06, 19 June 2024 (UTC)[reply]
  • "Bacterial infections such as Q-fever are another potential trigger." -> "Bacterial infections" is plural, so I think you want "... are other potential triggers".
    • Done. —Femke 🐦 (talk) 18:06, 19 June 2024 (UTC)[reply]

• "a full blood count, a HIV test, red blood cell sedimentation rate (ESR), C-reactive protein, blood glucose and thyroid-stimulating hormone." WP:SEAOFBLUE
  • Removed links to two most obvious ones. —Femke 🐦 (talk) 18:06, 19 June 2024 (UTC)[reply]

Well, that's what I see in a first pass. Overall, quite good. RoySmith (talk) 18:27, 18 June 2024 (UTC)[reply]

Draken Bowser

What a massive undertaking, I could hardly imagine another disease article more difficult to get to FA-standard, but I digress..

• They are able to do much less than before they became ill - a bit colloquial, could we use "everyday function" or "daily activities"?

  I would like to avoid even light jargon in the first paragraph. I think both of your options make it more difficult to understand.

• This "crash" can last less than a day to several months - repetitive, already covered by the preceding sentence.

  I've clarified the previous sentence to differentiate between onset and duration. —Femke 🐦 (talk) 07:15, 30 June 2024 (UTC)[reply]

• The cause or causes - repetitive, I sorta get what you might be hinting at, but that will fly over the head of the uninitiated anyways.

  Done. NHS uses singular, so went for that. —Femke 🐦 (talk) 07:15, 30 June 2024 (UTC)[reply]

• Treatment is aimed at relieving symptoms, as no therapies or medications are approved to treat the condition - I'd rearrange this to first say that there is no treatment and then mentioning symptom relief.

• Done. —Femke 🐦 (talk) 07:15, 30 June 2024 (UTC)[reply]

• Pacing one's activities - I'd prefer "of" or some such solution. It's not a clear cut case of "addressing the reader directly" though.

  Done. —Femke 🐦 (talk) 19:52, 3 July 2024 (UTC)[reply]

• ME/CFS affected roughly one in every 150 people - given the uncertainties including the various diagnostic criteria used over the years, why are we attempting an estimate? Also, since I'm no statistician what's the rationale behind using the "pooled percentage" number?

  I asked my resident statician at home whether I should use the pooled prevalence or the meta-analysis. I'd chosen the meta-analysis as this was the number the authors of that paper highlighted. He indicated he had no idea what the authors had done because they didn't explain it sufficiently. Either way, I think you're right we shouldn't highlight a single number that falls somewhere in between the prevalance rates of the different definitions, but show the wide range explicitly. Changed to 2 to 9 out of 1000 people, as natural frequencies are best for ease of understanding.

Regards. Draken Bowser (talk) 09:22, 29 June 2024 (UTC)[reply]

Thanks Draken Bowser for your comments. This is probably the most difficult article I've worked on so far, but I do relish the challenge :). I'd be happy to hear more. Hope to nominate before the end of the months, and keen to hear opinions on whether it's ready. —Femke 🐦 (talk) 19:52, 3 July 2024 (UTC)[reply]