Medical Criteria – C

Medical Criteria – C

CHRONIC FATIGUE SYNDROME:

• Definition (CDC 2006) – must meet both criteria

1. • New or definite onset of unexplained, clinically evaluated, persistent or relapsing chronic fatigue, not relieved by rest, which results in occupational, educational, social, or personal dysfunction

1. • Concurrent presence of ≥4 of the following symptoms for a minimum of 6 months

• • 1. Impairment of short-term memory or concentration, severe enough to cause significant decline in function
    2. Sore throat
    3. Tender cervical or axillary lymph nodes
    4. Muscle pain
    5. Multi-joint pain with no swelling or redness
    6. New headache
    7. Unrefreshing sleep
    8. Post-exertion malaise lasting >24 h
• Exclusion criteria: Medical conditions that may explain the fatigue, certain psychiatric disorders (Depression with psychotic or melancholic features, schizophrenia, eating disorders), substance abuse, severe obesity (BMI >45)

CAMERON’S CRITERIA FOR CONSERVATIVE MANAGEMENT OF ESOPHAGEAL PERFORATION:

• Disruption contained in mediastinum
• Barium drains back into esophagus
• No signs of sepsis
• Minimal symptoms

COMPLEX REGIONAL PAIN SYNDROMES:

• Clinical diagnosis consistent with the Budapest Criteria:

1. • Continuing regional pain disproportionate to an inciting event
   • Patient must have symptoms in 3 of the 4 categories, and must have signs in 2 of the 4 categories (a sign must be observed at the time of diagnosis):

• • 1. Sensory: hyperesthesia and/or allodynia
    2. Vasomotor: temperature and/or skin colour asymmetry
    3. Sudomotor/edema: edema, sweating changes, and/or sweating asymmetry
    4. Motor/trophic: decreased range of motion, motor dysfunction (weakness, tremor, dystonia) and/ or trophic changes (hair, skin, nail)

1. • Absence of any other diagnosis that would better explain the signs or symptoms

• Bone scintigraphy ≤5 mo of symptom onset may support diagnosis (negative test does not rule it out)
• MRI may help rule out other causes of regional pain if indicated

CONTINUOUS CTG AS A FORM OF EFM FOR FOETAL ASSESSMENT DURING LABOUR:

• Selection Criteria:

• • Randomized and quasi-randomized controlled trials comparing continuous CTG (with and without foetal blood sampling) to a) no foetal monitoring, b) intermittent auscultation, or c) intermittent CTG.

CONDUCT DISORDER:

• Diagnosis criteria
  • Pattern of behaviour that violates rights of others and age-appropriate social norms with ≥3 criteria noted in past 12 months and ≥1 in past 6 months:
    1. Aggression to people and animals: bullying, initiating physical ­fights, use of weapons, forced sex, cruel to people and/or animals, stealing while confronting a person (i.e., armed robbery)
    2. Destruction of property: arson, deliberately destroying others’ property
    3. Deceitfulness or theft: breaking and entering, conning others, stealing nontrivial items without confrontation
    4. Violation of rules: out all night before age 13, often truant from school before age 13, runaway ≥2 times at least overnight or for long periods of time
    5. Disturbance causes clinically signi­ficant impairment in social, academic, or occupational functioning
    6. If ≥18 yrs., criteria not met for ASPD.

COMMUNITY TREATMENT ORDER (CTO):

• Criteria for a physician to issue a CTO
• • Patient with a prior history of hospitalization
  • A community treatment plan for the person has been made
  • Examination by a physician within the previous 72 hrs before entering into the CTO plan
  • Ability of the person subject to the CTO to comply with it
  • Consultation with a rights advisor and consent of the person or the person’s substitute decision maker

CAUSATION:

• Criteria for Causation (Bradford Hill Criteria)

1. • Strength of association: the frequency with which the factor is found in the disease, and the frequency with which it occurs in the absence of disease
   • consistency: is the same relationship seen with diferent populations or study design?
   • Speci­ficity: is the association particular to your intervention and measured outcome?
   • Temporal relationship: did the exposure occur before the onset of the disease?
   • Biological gradient: Finding a dose response relationship between the exposure-outcome
   • Biological plausibility: does the association/causation make biological sense?
   • Coherence: can the relationship be explained/accounted for based on what we know about science, logic, etc.?
   • Experimental evidence: does experimental evidence support the association (e.g., is there improvement?)
   • Analogy: do other established associations provide a model for this type of the relationship?

• Note: Not all criteria must be ful‑lled to establish scienti‑c causation, and the modern practice of EBM emphasizes ‘experimental evidence’ as superior to other criteria for experimental causation review. However, many causation questions in health cannot be answered with experimental methods.

CLINICAL PREDICTION RULE FOR PULMONARY EMBOLISM:

• J Thromb Hemost 2000; 83:416-20
• Wells’ Criteria

CATEGORIZATION OF ARDS ACUTE RESPIRATORY DISTRESS SYNDROME:

• ARDS Categorization as Mild, Moderate or Severe – The Berlin Criteria

• *on ≥5 cm H2O PEEP, #P<0.001 JAMA 2012;307:2526-33

Also read:

1. Criteria in GPNotebook
2. Criteria in NICE
3. Criteria in Statpearls