My research concentrates on the epidemiology and treatment of CFS/ME. I lead research on recovery in paediatric CFS/ME trying to answer questions including: "How likely is my child to recover?", "How should we define recovery in paediatric CFS/ME?" "What is the minimum clinically important difference that we should use in trials". We work closely with the Bath specialist CFS/ME service (which I lead) to recruit participants to these studies.
My team also analyses data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to investigate the prevalence of and risk factors for CFS/ME at ages 13, 15 and 18. Simon Collin now runs the CFS/ME National Outcomes Database, which collects assessment and outcome data from 26 adult and 4 paediatric teams across England. This is the largest CFS/ME disease register in the world, with assessment data on more than 7000 adults and 1500 children with CFS/ME. It provides the infrastructure for a variety of projects in children and adults. In addition to epidemiological studies we conduct qualitative studies and systematic reviews.
We have recently completed follow up in two trials: SMILE - a randomised controlled trial comparing specialist medical care with specialist medical care plus the Lightning Process (an alternative intervention); and a feasibility randomised controlled trial evaluating an early intervention to prevent CFS/ME in adults (PI Dr O'Dowd).
Dr Esther Crawley, is a Reader in Child Health at the University of Bristol and a Consultant Paediatrician with a special interest in CFS/ME. She is the clinical lead for Bath specialist CFS/ME service for children based at the Royal National Hospital for Rheumatic Diseases in Bath which currently provides assessment and treatment for over 200 children and young people each year.
Dr Crawley completed her medical training in Oxford, and then worked in Birmingham and Liverpool before doing her PhD at University College London and Great Ormond Street Hospital. Esther then moved to Bristol and Bath and set up the paediatric CFS/ME service. She is a medical advisor to the Association of young people with ME and the Kent and Sussex ME Society and was Chair of the British Association for CFS/ME (BACME, 2007-2010). She set up the Royal College of Paediatrics and Child Health special interest group for CFS/ME, was on the guideline development group for the NICE guidelines published in August 2007 and the MRC CFS/ME expert working group (2009-2010).
Our research has led to some important papers for children with CFS/ME including: the first paper describing CFS/ME in primary school children, and the first paper to describe different phenotypes of paediatric CFS/ME. We also recently showed that 1% of secondary school children missed one day a week because of CFS/ME. In most cases, it is neither diagnosed or treated.
My priority for teaching over the last 7 years has been to provide training nationally for both clinicians and education professionals in the diagnosis, management and recent research findings in paediatric CFS/ME. I developed the department of health training package for the diagnosis and management of CFS/ME (2004) which I delivered to all CFS/ME services. I then developed basic and advanced workshops for health professionals as well as a separate package for teachers/tutors/attendance officers which I have delivered to >70 groups of clinicians/schools/commissioners (2008-11). I take teaching seriously and I am joint element lead for Child Health in the Community Orientated Medical Practice (COMP 1) unit of the clinical medical undergraduate degree (260 students).
My main research interests are: The Epidemiology of CFS/ME in children - Children who miss school have been screened each term for fatigue, Analysis is underway to determine: the prevalence and incidence of CFS/ME in secondary schools; whether children who are identified by screening are different to those referred for rehabilitation by health services. Memory and concentration problems in children with CFS/ME - The first part of this study demonstrated significant problems in memory and attention in children with CFS/ME. Children are now being examined 6 months after treatment started, to see whether their memory and concentration problems change with treatment. Anxiety in children with CFS/ME - This research compares anxiety in children with CFS/ME with best friend controls. Predictors of disease severity and outcome in children with CFS/ME - The CFS/ME service provides assessment and treatment for over 150 children a year.
View complete publications list in the University of Bristol publications system
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