Bates, D W, Buchwald, D, Lee, J et al. · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 1994 · DOI
This study tested whether three different sets of diagnostic criteria for ME/CFS identified the same patients. Researchers looked at 805 patients at two clinics and found that about 55-61% met each of the three definitions, though different patients sometimes qualified under different criteria. The study suggests that using broader, more flexible definitions might better capture people with ME/CFS.
Diagnostic criteria directly affect which patients receive diagnoses, access treatment, and participate in research. This study shows that the choice of criteria significantly impacts who gets identified as having ME/CFS, highlighting the need for consensus on the most appropriate definition—a foundational issue for consistent patient care and research validity.
This study does not determine which case definition is most accurate or biologically valid. It does not identify the underlying cause of ME/CFS or explain why different criteria capture different patient populations. The findings do not establish that more inclusive definitions are clinically superior, only that they identify more patients.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Bates, D W, Buchwald, D, Lee, J, Kith, P, Doolittle, T H, Umali, P, et al. (1994). A comparison of case definitions of chronic fatigue syndrome.. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. https://doi.org/10.1093/clinids/18.supplement_1.s11
BibTeX
@article{mecfsatlas-bates-1994-comparison-case,
author = {Bates, D W and Buchwald, D and Lee, J and Kith, P and Doolittle, T H and Umali, P and Komaroff, A L},
title = {A comparison of case definitions of chronic fatigue syndrome.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
year = {1994},
doi = {10.1093/clinids/18.supplement_1.s11},
note = {PubMed: 8148436},
url = {https://www.mecfsatlas.com/evidence/bates-1994-comparison-case},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/bates-1994-comparison-case
Contribute
Private, reviewed by a human. Not a public comment thread.