Grufferman, S · Reviews of infectious diseases · 1991 · DOI
This paper discusses how scientists should study ME/CFS using epidemiology—a research method that looks at how diseases spread through populations. The authors outline the main problems researchers face when studying ME/CFS, such as unclear diagnostic criteria and limited understanding of the condition, and suggest practical solutions. They emphasize that case-control studies (comparing people who have ME/CFS with similar people who don't) should be a priority for understanding what causes the illness.
This paper provides a comprehensive roadmap for how ME/CFS research should be conducted and identifies critical gaps in scientific knowledge that affect patients' ability to obtain diagnosis and treatment. By highlighting specific methodological challenges and proposing solutions, it has helped guide the research community toward more rigorous investigation of ME/CFS etiology and epidemiology.
This is a methods paper that does not provide data about ME/CFS causes, prevalence, or treatment outcomes. It identifies research needs and problems rather than testing specific hypotheses or providing evidence about disease mechanisms. It does not establish any causal relationships or provide new clinical findings about the condition itself.
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
Grufferman, S (1991). Issues and problems in the conduct of epidemiologic research on chronic fatigue syndrome.. Reviews of infectious diseases. https://doi.org/10.1093/clinids/13.supplement_1.s60
BibTeX
@article{mecfsatlas-grufferman-1991-issues-problems,
author = {Grufferman, S},
title = {Issues and problems in the conduct of epidemiologic research on chronic fatigue syndrome.},
journal = {Reviews of infectious diseases},
year = {1991},
doi = {10.1093/clinids/13.supplement_1.s60},
note = {PubMed: 2020803},
url = {https://www.mecfsatlas.com/evidence/grufferman-1991-issues-problems},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/grufferman-1991-issues-problems
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