Smith, M E Beth, Nelson, Heidi D, Haney, Elizabeth et al. · Evidence report/technology assessment · 2014 · DOI
This review examined research on how doctors diagnose ME/CFS and which treatments help patients. Researchers looked at 71 studies and found that there is no single agreed-upon way to diagnose ME/CFS, and different diagnostic criteria identify somewhat different groups of patients. Some treatments like counseling and graded exercise showed benefits for fatigue and quality of life, though graded exercise was associated with more reported side effects.
This comprehensive review identifies critical gaps in how ME/CFS is diagnosed and treated, highlighting that no gold-standard diagnostic method exists and treatment evidence remains limited. These findings underscore the need for better diagnostic clarity and more rigorous treatment research to improve care for patients with ME/CFS.
This review does not prove that any current diagnostic method is superior for identifying ME/CFS in patients with diagnostic uncertainty, nor does it establish causation between treatments and outcomes in populations beyond those studied. It also cannot determine the true prevalence or natural history of ME/CFS due to definitional inconsistencies.
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
Smith, M E Beth, Nelson, Heidi D, Haney, Elizabeth, Pappas, Miranda, Daeges, Monica, Wasson, Ngoc, et al. (2014). Diagnosis and Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. Evidence report/technology assessment. https://doi.org/10.23970/AHRQEPCERTA219
BibTeX
@article{mecfsatlas-smith-2014-diagnosis-treatment,
author = {Smith, M E Beth and Nelson, Heidi D and Haney, Elizabeth and Pappas, Miranda and Daeges, Monica and Wasson, Ngoc and McDonagh, Marian},
title = {Diagnosis and Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Evidence report/technology assessment},
year = {2014},
doi = {10.23970/AHRQEPCERTA219},
note = {PubMed: 30313001},
url = {https://www.mecfsatlas.com/evidence/smith-2014-diagnosis-treatment},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/smith-2014-diagnosis-treatment
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