Gleason, Kristen D, Stoothoff, Jamie, McClellan, Damani et al. · International journal of behavioral medicine · 2018 · DOI
This study looked for the best way to measure the 'substantial reduction in functioning' that is required for ME/CFS diagnosis. Researchers used a standard health survey (SF-36) with young adults (ages 18-29) who had ME/CFS and compared them to people without the condition. They found that specific cutoff scores on four areas of the survey—physical functioning, general health, role physical (ability to work), and social functioning—could accurately identify who has ME/CFS.
ME/CFS diagnosis requires documenting 'substantial reduction in functioning,' but clinicians and researchers lacked consensus on how to measure this objectively. This study provides specific, evidence-based numerical thresholds that could standardize diagnosis and improve consistency across clinical and research settings, potentially reducing diagnostic delays and improving access to care for young adults with ME/CFS.
This study does not prove these cutoff scores work equally well in adolescents, middle-aged, or older adults with ME/CFS. The cross-sectional design cannot establish whether the SF-36 score changes cause functional impairment or merely reflect it. The findings also do not validate whether these specific thresholds distinguish ME/CFS from other chronic illnesses that also reduce functioning.
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
Gleason, Kristen D, Stoothoff, Jamie, McClellan, Damani, McManimen, Stephanie, Thorpe, Taylor, Katz, Ben Z, et al. (2018). Operationalizing Substantial Reduction in Functioning Among Young Adults with Chronic Fatigue Syndrome.. International journal of behavioral medicine. https://doi.org/10.1007/s12529-018-9732-1
BibTeX
@article{mecfsatlas-gleason-2018-operationalizing-substantial,
author = {Gleason, Kristen D and Stoothoff, Jamie and McClellan, Damani and McManimen, Stephanie and Thorpe, Taylor and Katz, Ben Z and Jason, Leonard A},
title = {Operationalizing Substantial Reduction in Functioning Among Young Adults with Chronic Fatigue Syndrome.},
journal = {International journal of behavioral medicine},
year = {2018},
doi = {10.1007/s12529-018-9732-1},
note = {PubMed: 29872989},
url = {https://www.mecfsatlas.com/evidence/gleason-2018-operationalizing-substantial},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/gleason-2018-operationalizing-substantial
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