Cullinan, John, Pheby, Derek F H, Araja, Diana et al. · Medicina (Kaunas, Lithuania) · 2021 · DOI
ME/CFS experts across Europe were asked what they think family doctors know about ME/CFS and how to help them understand it better. The experts reported serious concerns: about 60% of ME/CFS patients go undiagnosed because family doctors lack knowledge about the condition, don't believe it's real, or don't know how to manage it. Most experts agreed that better training for doctors at all levels would help.
This study documents a critical gap in healthcare delivery for ME/CFS patients: family doctors—often the first point of contact—frequently fail to recognize or properly manage the condition. These findings validate patient experiences of diagnostic delays and validate calls for medical education reform, potentially leading to policy changes and improved patient outcomes.
This study does not directly measure actual general practitioner knowledge or diagnostic accuracy—it relies on expert perception rather than assessing GPs themselves. The survey cannot establish causality between GP knowledge gaps and specific patient harms, nor does it prove that education alone would solve the diagnostic and management problems identified.
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
Cullinan, John, Pheby, Derek F H, Araja, Diana, Berkis, Uldis, Brenna, Elenka, de Korwin, Jean-Dominique, et al. (2021). Perceptions of European ME/CFS Experts Concerning Knowledge and Understanding of ME/CFS among Primary Care Physicians in Europe: A Report from the European ME/CFS Research Network (EUROMENE).. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina57030208
BibTeX
@article{mecfsatlas-cullinan-2021-perceptions-european,
author = {Cullinan, John and Pheby, Derek F H and Araja, Diana and Berkis, Uldis and Brenna, Elenka and de Korwin, Jean-Dominique and Gitto, Lara and Hughes, Dyfrig A and Hunter, Rachael M and Trepel, Dominic and Wang-Steverding, Xia},
title = {Perceptions of European ME/CFS Experts Concerning Knowledge and Understanding of ME/CFS among Primary Care Physicians in Europe: A Report from the European ME/CFS Research Network (EUROMENE).},
journal = {Medicina (Kaunas, Lithuania)},
year = {2021},
doi = {10.3390/medicina57030208},
note = {PubMed: 33652747},
url = {https://www.mecfsatlas.com/evidence/cullinan-2021-perceptions-european},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/cullinan-2021-perceptions-european
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