Frampton, Daniel, Kerr, Jonathan, Harrison, Tim J et al. · PloS one · 2011 · DOI
Researchers tested whether 44 genes could be used together to diagnose ME/CFS by measuring their activity in blood samples from patients and healthy people. While the combination of genes worked well when tested on the original group, it failed when applied to a new group of patients, correctly identifying only about two-thirds of cases. This suggests that a simple blood test using these genes is not yet ready for diagnosing ME/CFS in everyday medical practice.
This study highlights a critical challenge in developing a blood-based diagnostic test for ME/CFS: findings from one research study may not work reliably in different patient populations. Understanding why gene expression patterns differ between studies helps researchers design better validation strategies and move toward a truly reliable diagnostic tool that could benefit millions of undiagnosed patients.
This study does not prove that gene expression differences between ME/CFS patients and healthy people do not exist, nor does it rule out the possibility that a future combination of genes could serve as a diagnostic marker. It only demonstrates that this particular 44-gene classifier is not robust across different populations and cannot yet be used clinically. The findings do not explain why the genes performed differently in the new population.
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
Frampton, Daniel, Kerr, Jonathan, Harrison, Tim J, & Kellam, Paul (2011). Assessment of a 44 gene classifier for the evaluation of chronic fatigue syndrome from peripheral blood mononuclear cell gene expression.. PloS one. https://doi.org/10.1371/journal.pone.0016872
BibTeX
@article{mecfsatlas-frampton-2011-assessment-gene,
author = {Frampton, Daniel and Kerr, Jonathan and Harrison, Tim J and Kellam, Paul},
title = {Assessment of a 44 gene classifier for the evaluation of chronic fatigue syndrome from peripheral blood mononuclear cell gene expression.},
journal = {PloS one},
year = {2011},
doi = {10.1371/journal.pone.0016872},
note = {PubMed: 21479222},
url = {https://www.mecfsatlas.com/evidence/frampton-2011-assessment-gene},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/frampton-2011-assessment-gene
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