Nacul, Luis, Authier, François Jérôme, Scheibenbogen, Carmen et al. · Medicina (Kaunas, Lithuania) · 2021 · DOI
This study brings together ME/CFS experts from 22 European countries to agree on how to diagnose the illness and provide better care for patients. The researchers and healthcare professionals worked together with people who have ME/CFS to create recommendations that can help doctors recognize and treat the condition more consistently across Europe. Their goal was to improve diagnosis and healthcare services for ME/CFS patients everywhere.
ME/CFS diagnosis and care remain highly variable across Europe, leading to delayed diagnoses and inconsistent treatment approaches. This expert consensus provides a unified framework to improve diagnostic accuracy and standardize healthcare delivery, potentially reducing patient suffering and healthcare costs. Harmonized European guidelines create a foundation for more equitable access to appropriate care.
This consensus document does not prove the efficacy of specific treatments through randomized controlled trials, nor does it establish causation of ME/CFS. The recommendations reflect expert opinion and existing evidence rather than new primary research data, and their real-world effectiveness depends on implementation and adoption by healthcare systems.
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
Nacul, Luis, Authier, François Jérôme, Scheibenbogen, Carmen, Lorusso, Lorenzo, Helland, Ingrid Bergliot, Martin, Jose Alegre, et al. (2021). European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE): Expert Consensus on the Diagnosis, Service Provision, and Care of People with ME/CFS in Europe.. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina57050510
BibTeX
@article{mecfsatlas-nacul-2021-european-network,
author = {Nacul, Luis and Authier, François Jérôme and Scheibenbogen, Carmen and Lorusso, Lorenzo and Helland, Ingrid Bergliot and Martin, Jose Alegre and Sirbu, Carmen Adella and Mengshoel, Anne Marit and Polo, Olli and Behrends, Uta and Nielsen, Henrik and Grabowski, Patricia and Sekulic, Slobodan and Sepulveda, Nuno and Estévez-López, Fernando and Zalewski, Pawel and Pheby, Derek F H and Castro-Marrero, Jesus and Sakkas, Giorgos K and Capelli, Enrica and Brundsdlund, Ivan and Cullinan, John and Krumina, Angelika and Bergquist, Jonas and Murovska, Modra and Vermuelen, Ruud C W and Lacerda, Eliana M},
title = {European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE): Expert Consensus on the Diagnosis, Service Provision, and Care of People with ME/CFS in Europe.},
journal = {Medicina (Kaunas, Lithuania)},
year = {2021},
doi = {10.3390/medicina57050510},
note = {PubMed: 34069603},
url = {https://www.mecfsatlas.com/evidence/nacul-2021-european-network},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/nacul-2021-european-network
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