'Too tired to go to the support group': a health needs assessment of myalgic encephalomyelitis.
BACKGROUND
Myalgic encephalomyelitis (ME) is a mysterious and controversial condition. Debate has centred upon its causation, and the purchasing question-which services to commission for people with ME-has not been addressed.


METHODS
A health needs assessment was made of people with ME in Wakefield, based upon published (including grey) literature, and local informants.


RESULTS
Previous studies have mostly reflected institutional outbreaks; local needs will reflect community, sporadic cases but there is little information about these. The very wide estimates of prevalence (between zero and 57000 for a district the size of Wakefield) indicate a fundamental problem over the validity of the concept of ME. Four sets of health needs emerged from the literature and from local informants: a medical diagnosis, rest, specific treatments and social care. All four are highly debatable.


CONCLUSIONS
There are no proven services or interventions which the health authority should purchase for people with ME. Purchasing, being a blunt tool for service change, is unlikely to improve health care given the disagreements over the condition.
Nuffield Institute for Health, Leeds.
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Sutton
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001510:Bed Rest; D002648:Child; D004679:Encephalomyelitis / Q000191:economics / Q000503:physiopathology / Q000628:therapy; D004739:England / Q000453:epidemiology; D015673:Fatigue Syndrome, Chronic / Q000191:economics / Q000503:physiopathology / Q000628:therapy; D005228:Fatty Acids, Essential / Q000627:therapeutic use; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008041:Linoleic Acids; D008297:Male; D031665:Oenothera biennis; D010938:Plant Oils; D012657:Self-Help Groups; D012947:Social Work; D017965:gamma-Linolenic Acid
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005228:Fatty Acids, Essential; D008041:Linoleic Acids; D010938:Plant Oils; C028498:evening primrose oil; D017965:gamma-Linolenic Acid