Kim, Sung-A, Macfarlane, Gary J, Beasley, Marcus J · Arthritis care & research · 2026 · DOI
This study examined UK Biobank data to understand why many people who meet the clinical criteria for fibromyalgia do not receive a formal diagnosis from a doctor. Researchers found that about 73% of individuals meeting fibromyalgia criteria had not been diagnosed, and identified several factors associated with not receiving a diagnosis—including being male, being older, having shorter pain duration, and reporting less frequent fatigue. The findings suggest that diagnostic bias and stereotypical perceptions of fibromyalgia may delay or prevent people from getting a diagnosis, though this is one cross-sectional study and does not establish why these patterns occur.
This study is relevant to ME/CFS research because fibromyalgia and ME/CFS share overlapping symptom profiles and diagnostic challenges. By analogy, understanding diagnostic barriers in fibromyalgia—such as how male sex, older age, and lower fatigue frequency are associated with missed diagnosis—may illuminate similar biases affecting ME/CFS diagnosis and clinical recognition. However, whether these specific factors apply to ME/CFS requires independent investigation.
This study does not establish causation; it identifies associations observed in a cross-sectional snapshot and cannot determine whether these factors cause diagnostic delay or are merely correlated with it. The findings do not confirm diagnostic bias as a mechanism, nor do they apply directly to ME/CFS without separate evidence. A diagnosis-receiving group studied cross-sectionally cannot reveal why clinicians made or withheld diagnoses.
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
Kim, Sung-A, Macfarlane, Gary J, & Beasley, Marcus J (2026). Factors Associated with Fibromyalgia Diagnosis amongst People Meeting Criteria: Results from UK Biobank.. Arthritis care & research. https://doi.org/10.1002/acr.80131
BibTeX
@article{mecfsatlas-kim-2026-factors-associated,
author = {Kim, Sung-A and Macfarlane, Gary J and Beasley, Marcus J},
title = {Factors Associated with Fibromyalgia Diagnosis amongst People Meeting Criteria: Results from UK Biobank.},
journal = {Arthritis care & research},
year = {2026},
doi = {10.1002/acr.80131},
note = {PubMed: 42559678},
url = {https://www.mecfsatlas.com/evidence/kim-2026-factors-associated},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-08-08. https://www.mecfsatlas.com/evidence/kim-2026-factors-associated
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