Conroy, Karl E, Islam, Mohammed F, Jason, Leonard A · Disability and rehabilitation · 2023 · DOI
This study looked at how doctors diagnose ME/CFS by analyzing symptoms reported by over 2,300 patients from around the world. Researchers used statistical methods to identify which symptoms tend to occur together, then compared their findings to three existing diagnostic guidelines. They found that the symptoms cluster into seven main groups, with post-exertional malaise (worsening after activity), cognitive problems, and sleep issues being particularly important.
ME/CFS currently lacks a universally accepted diagnostic definition, which delays diagnosis, prevents patients from accessing treatment and disability benefits, and complicates research. This study provides empirical evidence to replace consensus-based criteria, potentially standardizing diagnosis and improving access to care and recognition for disabled patients.
This study does not prove that any specific case definition is correct or that the identified symptom clusters directly cause ME/CFS. Factor analysis shows which symptoms correlate with each other, not whether they are independent, causally related, or sufficient for diagnosis. The findings also do not explain the biological mechanisms underlying these symptom clusters.
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
Conroy, Karl E, Islam, Mohammed F, & Jason, Leonard A (2023). Evaluating case diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): toward an empirical case definition.. Disability and rehabilitation. https://doi.org/10.1080/09638288.2022.2043462
BibTeX
@article{mecfsatlas-conroy-2023-evaluating-case,
author = {Conroy, Karl E and Islam, Mohammed F and Jason, Leonard A},
title = {Evaluating case diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): toward an empirical case definition.},
journal = {Disability and rehabilitation},
year = {2023},
doi = {10.1080/09638288.2022.2043462},
note = {PubMed: 35236205},
url = {https://www.mecfsatlas.com/evidence/conroy-2023-evaluating-case},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/conroy-2023-evaluating-case
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