Agarwal, Priya, Friedman, Kenneth J · Healthcare (Basel, Switzerland) · 2025 · DOI
This article is a special essay about ME/CFS that was written by a medical student and selected as the best submission in a scholarship competition. It explains what we currently know about how ME/CFS affects the body and offers practical advice for doctors on how to better care for ME/CFS patients. The essay highlights that ME/CFS is a serious, worldwide health problem affecting millions of people, many of whom haven't been properly diagnosed.
This work addresses a critical gap in healthcare provider education about ME/CFS, a condition affecting 17-24 million people worldwide with over 60% remaining undiagnosed. By combining biological science with practical clinical guidance, it aims to improve diagnostic rates and quality of care for ME/CFS patients who currently lack curative treatments and face significant disability. Educating future healthcare providers through scholarship initiatives like this may substantially improve patient outcomes and reduce diagnostic delays.
This editorial does not present original research data, clinical trials, or new biological discoveries—it is a synthesis and educational piece. It does not prove efficacy of the scholarship program itself in changing clinical practice or patient outcomes, nor does it establish new causal mechanisms of ME/CFS. The article's impact on actual healthcare provider behavior and patient care remains to be demonstrated through future research.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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Primary citation
Agarwal, Priya & Friedman, Kenneth J (2025). Reframing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Biological Basis of Disease and Recommendations for Supporting Patients.. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare13151917
BibTeX
@article{mecfsatlas-agarwal-2025-reframing-myalgic,
author = {Agarwal, Priya and Friedman, Kenneth J},
title = {Reframing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Biological Basis of Disease and Recommendations for Supporting Patients.},
journal = {Healthcare (Basel, Switzerland)},
year = {2025},
doi = {10.3390/healthcare13151917},
note = {PubMed: 40805949},
url = {https://www.mecfsatlas.com/evidence/agarwal-2025-reframing-myalgic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/agarwal-2025-reframing-myalgic
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