Joyce, J, Rabe-Hesketh, S, Wessely, S · JAMA · 1998 · DOI
This study examined how researchers write review articles about ME/CFS and found that what gets included depends heavily on the author's background and where they're from. Scientists with laboratory training tend to focus on lab-based research, while psychiatrists tend to focus on psychiatric research. Authors also tend to cite papers from their own country much more often than papers from other countries.
This study exposes a critical bias in how ME/CFS research is synthesized and presented to the field. If review articles—which shape clinical understanding and research priorities—systematically emphasize certain types of evidence based on author background rather than scientific merit, this could distort the direction of ME/CFS research and influence how patients are understood and treated.
This study does not prove that citation preferences are inappropriate or that authors are deliberately biased. It also does not establish that excluding certain literature types produces worse reviews, only that selection patterns are non-random. The findings describe association, not causation, and apply only to reviews published through March 1996.
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
Joyce, J, Rabe-Hesketh, S, & Wessely, S (1998). Reviewing the reviews: the example of chronic fatigue syndrome.. JAMA. https://doi.org/10.1001/jama.280.3.264
BibTeX
@article{mecfsatlas-joyce-1998-reviewing-reviews,
author = {Joyce, J and Rabe-Hesketh, S and Wessely, S},
title = {Reviewing the reviews: the example of chronic fatigue syndrome.},
journal = {JAMA},
year = {1998},
doi = {10.1001/jama.280.3.264},
note = {PubMed: 9676676},
url = {https://www.mecfsatlas.com/evidence/joyce-1998-reviewing-reviews},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/joyce-1998-reviewing-reviews
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