Pheby, Derek F H, Araja, Diana, Berkis, Uldis et al. · Medicina (Kaunas, Lithuania) · 2021 · DOI
This European research report examined whether ME/CFS could be prevented and what money might be saved if prevention programs worked. The researchers found that preventing ME/CFS before it starts is very difficult because the illness seems to result from a mix of genetic factors and environmental exposures that we don't fully understand yet. However, they identified that safer use of certain agricultural chemicals like organophosphates could help, and catching ME/CFS earlier through better doctor training could reduce how severe the illness becomes and lower healthcare costs.
This study is important because it identifies where resources could be most effectively spent to reduce the burden of ME/CFS across Europe. By demonstrating that early diagnosis and secondary prevention hold greater promise than primary prevention, it guides policymakers and health systems toward practical interventions that could improve patient outcomes and reduce the enormous economic costs associated with prolonged illness.
This study does not prove that ME/CFS is completely preventable or identify all causative factors. It also does not establish that primary prevention will never be possible—rather, it reflects current knowledge gaps, meaning future research may uncover modifiable risk factors not yet identified. The findings are based on available evidence and economic models, not on randomized controlled trials of prevention interventions.
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
Pheby, Derek F H, Araja, Diana, Berkis, Uldis, Brenna, Elenka, Cullinan, John, de Korwin, Jean-Dominique, et al. (2021). The Role of Prevention in Reducing the Economic Impact of ME/CFS in Europe: A Report from the Socioeconomics Working Group of the European Network on ME/CFS (EUROMENE).. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina57040388
BibTeX
@article{mecfsatlas-pheby-2021-role-prevention,
author = {Pheby, Derek F H and Araja, Diana and Berkis, Uldis and Brenna, Elenka and Cullinan, John and de Korwin, Jean-Dominique and Gitto, Lara and Hughes, Dyfrig A and Hunter, Rachael M and Trepel, Dominic and Wang-Steverding, Xia},
title = {The Role of Prevention in Reducing the Economic Impact of ME/CFS in Europe: A Report from the Socioeconomics Working Group of the European Network on ME/CFS (EUROMENE).},
journal = {Medicina (Kaunas, Lithuania)},
year = {2021},
doi = {10.3390/medicina57040388},
note = {PubMed: 33923830},
url = {https://www.mecfsatlas.com/evidence/pheby-2021-role-prevention},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/pheby-2021-role-prevention
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