Tian, Hao, Brimmer, Dana J, Lin, Jin-Mann S et al. · Journal of medical Internet research · 2009 · DOI
This study looked at how many people visited the CDC's ME/CFS website over 18 months and what information they searched for. The website received millions of visits from around the world, showing that many people are looking for reliable information about ME/CFS. The researchers found that a public awareness campaign successfully brought more visitors to the site, and that people were more interested in professional medical information after the campaign ended.
This study demonstrates that the internet is a critical resource for ME/CFS patients and healthcare providers seeking information, and reveals how public health campaigns can be optimized to reach target audiences. Understanding website usage patterns helps public health agencies improve their outreach and ensures that accurate, evidence-based ME/CFS information reaches those who need it most.
This study does not establish whether website visitors actually improved their understanding of ME/CFS or changed their clinical behavior. Web traffic alone cannot demonstrate the quality of health outcomes, diagnostic accuracy, or whether the information reached the patients most in need of it. The study is observational and cannot prove causation between campaign activities and changes in visitor behavior.
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
Tian, Hao, Brimmer, Dana J, Lin, Jin-Mann S, Tumpey, Abbigail J, & Reeves, William C (2009). Web usage data as a means of evaluating public health messaging and outreach.. Journal of medical Internet research. https://doi.org/10.2196/jmir.1278
BibTeX
@article{mecfsatlas-tian-2009-web-usage,
author = {Tian, Hao and Brimmer, Dana J and Lin, Jin-Mann S and Tumpey, Abbigail J and Reeves, William C},
title = {Web usage data as a means of evaluating public health messaging and outreach.},
journal = {Journal of medical Internet research},
year = {2009},
doi = {10.2196/jmir.1278},
note = {PubMed: 20026451},
url = {https://www.mecfsatlas.com/evidence/tian-2009-web-usage},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/tian-2009-web-usage
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