Unger, Elizabeth R, Lin, Jin-Mann S, Tian, Hao et al. · American journal of epidemiology · 2017 · DOI
Researchers created a large study called MCAM to better understand ME/CFS by collecting standardized health information from patients across seven U.S. clinics. They also enrolled healthy people and patients with similar illnesses for comparison. The study tracked patients over time, collected samples for future research, and documented how doctors were treating ME/CFS patients, aiming to identify different types of ME/CFS and find tests that could help diagnosis.
This study addresses a critical gap in ME/CFS research by systematically collecting standardized clinical data across multiple expert clinics, enabling researchers to understand disease heterogeneity and identify potential biomarkers. For patients, this work provides a foundation for developing better diagnostic tools, understanding disease subtypes, and validating outcome measures that could improve clinical care and future treatment research.
This methods paper does not present clinical findings or prove any treatments work. It does not establish what causes ME/CFS, confirm any biomarkers as diagnostic, or demonstrate differences between subgroups. The study's reliance on expert clinician diagnosis rather than standardized diagnostic criteria may affect generalizability, and long-term outcomes data were not yet available at publication.
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
Unger, Elizabeth R, Lin, Jin-Mann S, Tian, Hao, Natelson, Benjamin H, Lange, Gudrun, Vu, Diana, et al. (2017). Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM): Design and Implementation of a Prospective/Retrospective Rolling Cohort Study.. American journal of epidemiology. https://doi.org/10.1093/aje/kwx029
BibTeX
@article{mecfsatlas-unger-2017-multi-site,
author = {Unger, Elizabeth R and Lin, Jin-Mann S and Tian, Hao and Natelson, Benjamin H and Lange, Gudrun and Vu, Diana and Blate, Michelle and Klimas, Nancy G and Balbin, Elizabeth G and Bateman, Lucinda and Allen, Ali and Lapp, Charles W and Springs, Wendy and Kogelnik, Andreas M and Phan, Catrina C and Danver, Joan and Podell, Richard N and Fitzpatrick, Trisha and Peterson, Daniel L and Gottschalk, C Gunnar and Rajeevan, Mangalathu S and MCAM Study Group},
title = {Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM): Design and Implementation of a Prospective/Retrospective Rolling Cohort Study.},
journal = {American journal of epidemiology},
year = {2017},
doi = {10.1093/aje/kwx029},
note = {PubMed: 28338983},
url = {https://www.mecfsatlas.com/evidence/unger-2017-multi-site},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/unger-2017-multi-site
Contribute
Private, reviewed by a human. Not a public comment thread.