Johnston, Samantha C, Brenu, Ekua W, Hardcastle, Sharni L et al. · Health and quality of life outcomes · 2014 · DOI
This study compared two different sets of criteria used to diagnose ME/CFS and looked at how severely the disease affected patients who met each definition. Researchers found that patients meeting the stricter International Consensus Criteria (ICC) definition had worse physical functioning, more pain, and greater disability than those who only met the older CDC criteria. This suggests that the ICC criteria identify a more severely affected group of patients within the broader ME/CFS population.
Diagnostic criteria directly affect which patients receive an ME/CFS diagnosis and access to care. Understanding whether different criteria identify distinct patient subgroups with different severity levels helps clinicians better characterize disease presentations and may inform more precise patient stratification in future research and clinical practice.
This pilot study does not prove that ICC criteria are superior or preferable to CDC criteria—it only shows they identify groups with different severity profiles. The small sample size and lack of biological marker measurements limit generalizability. The study cannot establish whether ICC patients are inherently different or whether the stricter criteria simply select for more severe cases within the same disease spectrum.
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
Johnston, Samantha C, Brenu, Ekua W, Hardcastle, Sharni L, Huth, Teilah K, Staines, Donald R, & Marshall-Gradisnik, Sonya M (2014). A comparison of health status in patients meeting alternative definitions for chronic fatigue syndrome/myalgic encephalomyelitis.. Health and quality of life outcomes. https://doi.org/10.1186/1477-7525-12-64
BibTeX
@article{mecfsatlas-johnston-2014-comparison-health,
author = {Johnston, Samantha C and Brenu, Ekua W and Hardcastle, Sharni L and Huth, Teilah K and Staines, Donald R and Marshall-Gradisnik, Sonya M},
title = {A comparison of health status in patients meeting alternative definitions for chronic fatigue syndrome/myalgic encephalomyelitis.},
journal = {Health and quality of life outcomes},
year = {2014},
doi = {10.1186/1477-7525-12-64},
note = {PubMed: 24886213},
url = {https://www.mecfsatlas.com/evidence/johnston-2014-comparison-health},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/johnston-2014-comparison-health
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