title: Defining recovery in chronic fatigue syndrome: a critical review.
abstract: OBJECTIVE
  In chronic fatigue syndrome (CFS), the lack of consensus on how recovery should be defined or interpreted has generated controversy and confusion. The purpose of this paper was to systematically review, compare, and evaluate the definitions of recovery reported in the CFS literature and to make recommendations about the scope of recovery assessments.
  
  
  METHODS
  A search was done using the MEDLINE, PubMed, PsycINFO, CINAHL, and Cochrane databases for peer review papers that contained the search terms "chronic fatigue syndrome" and "recovery," "reversal," "remission," and/or "treatment response."
  
  
  RESULTS
  From the 22 extracted studies, recovery was operationally defined by reference with one or more of these domains: (1) pre-morbid functioning; (2) both fatigue and function; (3) fatigue (or related symptoms) alone; (4) function alone; and/or (5) brief global assessment. Almost all of the studies measuring recovery in CFS did so differently. The brief global assessment was the most common outcome measure used to define recovery. Estimates of recovery ranged from 0 to 66 % in intervention studies and 2.6 to 62 % in naturalistic studies.
  
  
  CONCLUSIONS
  Given that the term "recovery" was often based on limited assessments and less than full restoration of health, other more precise and accurate labels (e.g., clinically significant improvement) may be more appropriate and informative. In keeping with common understandings of the term recovery, we recommend a consistent definition that captures a broad-based return to health with assessments of both fatigue and function as well as the patient's perceptions of his/her recovery status.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stony Brook University, Putnam Hall/South Campus, Stony Brook, NY, 11794-8790, USA, Jenna.Adamowicz@stonybrook.edu.
authors.forename: Jenna L
authors.initials: JL
authors.lastname: Adamowicz
authors.forename: Indre
authors.initials: I
authors.lastname: Caikauskaite
authors.forename: Fred
authors.initials: F
authors.lastname: Friedberg
mesh_terms: D032921:Consensus; D005221:Fatigue / Q000145:classification; D015673:Fatigue Syndrome, Chronic / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011788:Quality of Life