Engel, Charles C · CNS spectrums · 2006 · DOI
This paper discusses two different ways to approach studying and treating illnesses like ME/CFS that don't have a clear, well-understood cause. One approach focuses on finding the root cause in controlled settings; the other focuses on whether treatments actually work in real-world patient care. The authors argue that for conditions like ME/CFS, the practical approach—focusing on what helps patients in everyday life—may be more useful than searching for a single underlying cause.
This framework offers ME/CFS patients and researchers a way to reduce conflict between different medical disciplines and between doctors and patients by shifting focus from debating causes to implementing evidence-based treatments that work in practice. It validates pragmatic research approaches that measure real-world benefit rather than requiring proof of a single underlying mechanism before treatment is offered.
This paper does not prove that ME/CFS has no biological cause or that biological research is unimportant. It is a methodological perspective piece, not an empirical study with data on ME/CFS patients, so it does not provide evidence about disease mechanisms, treatment efficacy, or patient outcomes in any specific population.
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Primary citation
Engel, Charles C (2006). Explanatory and pragmatic perspectives regarding idiopathic physical symptoms and related syndromes.. CNS spectrums. https://doi.org/10.1017/s1092852900014395
BibTeX
@article{mecfsatlas-engel-2006-explanatory-pragmatic,
author = {Engel, Charles C},
title = {Explanatory and pragmatic perspectives regarding idiopathic physical symptoms and related syndromes.},
journal = {CNS spectrums},
year = {2006},
doi = {10.1017/s1092852900014395},
note = {PubMed: 16575379},
url = {https://www.mecfsatlas.com/evidence/engel-2006-explanatory-pragmatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/engel-2006-explanatory-pragmatic
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