Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME-CFS): good practice statement
Guidance to support the diagnosis and management of ME/CFS in primary care. This was originally published in 2010 and we have partially updated it to insert key recommendations from the NICE Guideline on ME/CFS published in October 2021.
Appendix 3 – Severity rating scale tool
The following guide is drawn from the Canadian Consensus Document. It was designed to assist GPs in assessing severity and duration of symptoms and is to be completed by patients.
Please rank your symptoms in order of severity (1 being the most severe) in the left column. Rate severity of symptoms by putting a check mark in the appropriate box.
0 = Absent, 1 = Mild, 2 = Moderate, 3 = Severe
| Rank | Symptom | 0 | 1 | 2 | 3 |
|---|---|---|---|---|---|
| Post-exertional fatigue: loss of physical and mental stamina, fatigue made worse by physical exertion | |||||
| Long recovery period from exertion: takes more than 24 hours to recover to pre-exertion activity level | |||||
| Fatigue: persistent, marked fatigue that substantially reduces activity level | |||||
| Sleep disturbance: non-restorative sleep, insomnia, hypersomnia | |||||
| Pain: in muscles, joints, headaches | |||||
| Memory disturbance: poor short term memory | |||||
| Confusion and difficulty concentrating | |||||
| Difficulty retrieving words or saying the wrong word | |||||
| Gastrointestinal disturbance: diarrhoea, IBS | |||||
| Recurrent sore throat | |||||
| Recurrent flu-like symptoms | |||||
| Dizziness or weakness upon standing | |||||
| Change in body temperature, erratic body temperature, cold hands and feet | |||||
| Heat/cold intolerance | |||||
| Hot flushes, sweating episodes | |||||
| Marked weight change | |||||
| Breathless with exertion | |||||
| Tender lymph nodes: especially at sides of neck and under arms | |||||
| Sensitive to light, noise, or odours | |||||
| Muscle weakness | |||||
| New sensitivities to food/medications/chemicals | |||||
| Total check marks in column | |||||
| Column Total |
Overall Total Score:
Overall symptom severity:
- mild
- moderate
- severe
(Mild – occurring at rest, moderate – symptoms that occur at rest become severe with effort, unable to work, and severe – often housebound or bed-bound).
Other symptoms:
Aggravators:
Change in symptoms:
How good is your sleep on a scale of 1-5?
(5 = good restorative sleep, 1 = no sleep):
How do you feel today on a scale of 1-10?
(10 = terrific, 1 = totally bedridden):
Contact
Email: Clinical_Priorities@gov.scot
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