Collin, Simon M, Bakken, Inger J, Nazareth, Irwin et al. · BMC family practice · 2017 · DOI
This study looked at doctor visits, tests, prescriptions, and referrals for people diagnosed with ME/CFS compared to similar people without the condition. Researchers found that people who were later diagnosed with ME/CFS visited their doctors much more frequently—both years before they received their diagnosis and for at least 10 years afterward. This suggests that people with ME/CFS have ongoing, significant health needs that require more medical care than the general population.
This study quantifies the substantial and sustained healthcare burden experienced by ME/CFS patients, demonstrating that elevated medical need exists years before formal diagnosis—suggesting either prolonged diagnostic delay or genuine disease precursors. These findings highlight the real-world impact of ME/CFS on healthcare systems and support the need for earlier recognition and intervention strategies.
This study does not prove that elevated healthcare use causes ME/CFS or that the symptoms recorded in the decade before diagnosis were ME/CFS itself; it simply documents that healthcare use was higher in this group. The study cannot establish whether the diagnostic spike in the index year reflects true disease onset, accumulated symptoms finally meeting diagnostic criteria, or diagnostic labeling of pre-existing illness. Correlation between pre-diagnosis healthcare use and later diagnosis does not explain the mechanisms driving either the symptoms or the diagnostic delay.
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
Collin, Simon M, Bakken, Inger J, Nazareth, Irwin, Crawley, Esther, & White, Peter D (2017). Health care resource use by patients before and after a diagnosis of chronic fatigue syndrome (CFS/ME): a clinical practice research datalink study.. BMC family practice. https://doi.org/10.1186/s12875-017-0635-z
BibTeX
@article{mecfsatlas-collin-2017-health-care,
author = {Collin, Simon M and Bakken, Inger J and Nazareth, Irwin and Crawley, Esther and White, Peter D},
title = {Health care resource use by patients before and after a diagnosis of chronic fatigue syndrome (CFS/ME): a clinical practice research datalink study.},
journal = {BMC family practice},
year = {2017},
doi = {10.1186/s12875-017-0635-z},
note = {PubMed: 28476151},
url = {https://www.mecfsatlas.com/evidence/collin-2017-health-care},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/collin-2017-health-care
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