Nelson, Maximillian J, Buckley, Jonathan D, Thomson, Rebecca L et al. · Journal of translational medicine · 2019 · DOI
Researchers tested whether a simple exercise test could help diagnose ME/CFS. They had patients and healthy people exercise on a stationary bike on two consecutive days and measured how their performance changed. ME/CFS patients showed a larger drop in exercise capacity on the second day compared to healthy people, suggesting this difference might be a useful diagnostic tool.
ME/CFS lacks objective diagnostic biomarkers, making diagnosis difficult and often delayed. This study identifies a potential objective measurement—the specific pattern of decline in exercise capacity over consecutive days—that could assist clinicians in confirming ME/CFS diagnosis and reducing diagnostic uncertainty for patients.
This small pilot study does not establish that 2-day CPET decline is a definitive diagnostic test; larger, prospective validation studies are needed before clinical implementation. The findings do not explain the biological mechanism causing this exercise decline, nor do they determine whether this pattern is specific to ME/CFS or might occur in other conditions. The cross-sectional design cannot establish whether the decline is a cause or consequence of ME/CFS.
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
Nelson, Maximillian J, Buckley, Jonathan D, Thomson, Rebecca L, Clark, Daniel, Kwiatek, Richard, & Davison, Kade (2019). Diagnostic sensitivity of 2-day cardiopulmonary exercise testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. Journal of translational medicine. https://doi.org/10.1186/s12967-019-1836-0
BibTeX
@article{mecfsatlas-nelson-2019-diagnostic-sensitivity,
author = {Nelson, Maximillian J and Buckley, Jonathan D and Thomson, Rebecca L and Clark, Daniel and Kwiatek, Richard and Davison, Kade},
title = {Diagnostic sensitivity of 2-day cardiopulmonary exercise testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Journal of translational medicine},
year = {2019},
doi = {10.1186/s12967-019-1836-0},
note = {PubMed: 30871578},
url = {https://www.mecfsatlas.com/evidence/nelson-2019-diagnostic-sensitivity},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/nelson-2019-diagnostic-sensitivity
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