Chew-Graham, Carolyn, Dowrick, Christopher, Wearden, Alison et al. · BMC family practice · 2010 · DOI
This study asked 22 general practitioners (GPs) about their experiences diagnosing ME/CFS in their clinics. GPs said they find it hard to understand what ME/CFS is, and they typically focus on ruling out other diseases rather than confidently saying a patient has ME/CFS. Many GPs worried that giving someone an ME/CFS diagnosis might actually harm them, and they weren't sure what to do to help these patients once diagnosed.
Early, accurate diagnosis of ME/CFS in primary care is essential for timely appropriate management and reducing patient suffering from diagnostic delay. This study identifies specific barriers that prevent GPs from confidently diagnosing ME/CFS, which directly impacts access to care and specialist referral—a critical issue since NICE guidelines designate primary care as the first point of contact.
This study does not prove that lack of GP confidence in diagnosis is the primary cause of diagnostic delay for all ME/CFS patients, nor does it measure actual diagnostic delays or patient outcomes. It reflects GPs' reported views rather than their actual diagnostic practices, and findings may not generalize to all healthcare systems or countries outside the UK.
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
Chew-Graham, Carolyn, Dowrick, Christopher, Wearden, Alison, Richardson, Victoria, & Peters, Sarah (2010). Making the diagnosis of Chronic Fatigue Syndrome/Myalgic Encephalitis in primary care: a qualitative study.. BMC family practice. https://doi.org/10.1186/1471-2296-11-16
BibTeX
@article{mecfsatlas-chew-graham-2010-making-diagnosis,
author = {Chew-Graham, Carolyn and Dowrick, Christopher and Wearden, Alison and Richardson, Victoria and Peters, Sarah},
title = {Making the diagnosis of Chronic Fatigue Syndrome/Myalgic Encephalitis in primary care: a qualitative study.},
journal = {BMC family practice},
year = {2010},
doi = {10.1186/1471-2296-11-16},
note = {PubMed: 20178588},
url = {https://www.mecfsatlas.com/evidence/chew-graham-2010-making-diagnosis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/chew-graham-2010-making-diagnosis
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