Richardson, Alice M, Lewis, Don P, Kita, Badia et al. · Journal of translational medicine · 2018 · DOI
This study tested a new way to measure ME/CFS severity by combining how long patients can stand with how difficult standing feels to them. Researchers found that this combined measurement (called weighted standing time) was significantly different between ME/CFS patients and healthy people, and it also related to differences in certain inflammation markers in the blood. This suggests that a simple standing test could help doctors diagnose ME/CFS and track how severe a patient's symptoms are.
ME/CFS currently lacks objective biomarkers for diagnosis and severity assessment, making clinical management challenging. A simple, validated standing test could provide clinicians with a practical tool to confirm diagnosis and monitor disease progression, potentially improving treatment selection and patient outcomes. Identifying associated inflammatory markers (activin B) may also open avenues for mechanistic understanding and targeted interventions.
This study does not establish that weighted standing time is a direct cause of symptom severity or pathological changes—it only shows correlation. The finding of elevated activin B does not prove this cytokine causes orthostatic intolerance; further research is needed to determine causality. The small sample size and single-cohort design mean these findings require validation in larger, geographically diverse populations before clinical implementation.
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
Richardson, Alice M, Lewis, Don P, Kita, Badia, Ludlow, Helen, Groome, Nigel P, Hedger, Mark P, et al. (2018). Weighting of orthostatic intolerance time measurements with standing difficulty score stratifies ME/CFS symptom severity and analyte detection.. Journal of translational medicine. https://doi.org/10.1186/s12967-018-1473-z
BibTeX
@article{mecfsatlas-richardson-2018-weighting-orthostatic,
author = {Richardson, Alice M and Lewis, Don P and Kita, Badia and Ludlow, Helen and Groome, Nigel P and Hedger, Mark P and de Kretser, David M and Lidbury, Brett A},
title = {Weighting of orthostatic intolerance time measurements with standing difficulty score stratifies ME/CFS symptom severity and analyte detection.},
journal = {Journal of translational medicine},
year = {2018},
doi = {10.1186/s12967-018-1473-z},
note = {PubMed: 29650052},
url = {https://www.mecfsatlas.com/evidence/richardson-2018-weighting-orthostatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/richardson-2018-weighting-orthostatic
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