Crawley, E, Collin, S M, White, P D et al. · QJM : monthly journal of the Association of Physicians · 2013 · DOI
This study tracked over 800 people with ME/CFS who received care at NHS specialist services in England for 8-20 months. Patients showed meaningful improvements in fatigue, physical function, anxiety, depression, and pain. The study found that patients who started with more severe fatigue, disability, or pain tended to have less improvement, suggesting baseline severity is an important predictor of how well someone will improve with specialist care.
This is one of the few real-world studies measuring outcomes in NHS ME/CFS specialist services, providing evidence that patients can expect clinically meaningful improvements from specialist care. Understanding which baseline factors predict poor outcomes helps clinicians identify patients who may need more intensive or modified interventions.
This study does not establish causation or identify which specific treatments drove the improvements observed. The lack of a control group means we cannot determine whether improvements resulted from NHS care, natural disease progression, or other factors. The 49% loss to follow-up and absence of data on individual treatment protocols limit generalizability of findings.
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
Crawley, E, Collin, S M, White, P D, Rimes, K, Sterne, J A C, May, M T, et al. (2013). Treatment outcome in adults with chronic fatigue syndrome: a prospective study in England based on the CFS/ME National Outcomes Database.. QJM : monthly journal of the Association of Physicians. https://doi.org/10.1093/qjmed/hct061
BibTeX
@article{mecfsatlas-crawley-2013-treatment-outcome,
author = {Crawley, E and Collin, S M and White, P D and Rimes, K and Sterne, J A C and May, M T and CFS/ME National Outcomes Database},
title = {Treatment outcome in adults with chronic fatigue syndrome: a prospective study in England based on the CFS/ME National Outcomes Database.},
journal = {QJM : monthly journal of the Association of Physicians},
year = {2013},
doi = {10.1093/qjmed/hct061},
note = {PubMed: 23538643},
url = {https://www.mecfsatlas.com/evidence/crawley-2013-treatment-outcome},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/crawley-2013-treatment-outcome
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