Wang, Wei, Russell, Alyce, Yan, Yuxiang et al. · The EPMA journal · 2014 · DOI
This study looked at how to identify people in the early stages of health problems before they develop into serious diseases. The researchers created a simple 25-question survey to measure 'suboptimal health'—a state where people feel unwell with fatigue and other complaints but don't have a clear diagnosis. They tested this survey with over 3,400 people in China and found that answers to the survey were connected to blood pressure, blood sugar, and cholesterol levels.
ME/CFS patients often struggle with a lack of objective diagnostic tests and may be categorized as having 'suboptimal health' before receiving a diagnosis. This study proposes a systematic approach to identify and monitor people with unexplained fatigue and symptom clusters, which could help researchers better understand the early stages of conditions like ME/CFS and potentially enable earlier intervention.
This study does not prove that the SHSQ-25 survey can predict who will develop ME/CFS or other chronic diseases, nor does it establish causation between suboptimal health status and disease onset. The cross-sectional design captures only a single time point and cannot demonstrate whether the observed correlations with cardiometabolic factors precede or follow the development of fatigue symptoms.
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
Wang, Wei, Russell, Alyce, Yan, Yuxiang, & Global Health Epidemiology Reference Group (GHERG) (2014). Traditional Chinese medicine and new concepts of predictive, preventive and personalized medicine in diagnosis and treatment of suboptimal health.. The EPMA journal. https://doi.org/10.1186/1878-5085-5-4
BibTeX
@article{mecfsatlas-wang-2014-traditional-chinese,
author = {Wang, Wei and Russell, Alyce and Yan, Yuxiang and Global Health Epidemiology Reference Group (GHERG)},
title = {Traditional Chinese medicine and new concepts of predictive, preventive and personalized medicine in diagnosis and treatment of suboptimal health.},
journal = {The EPMA journal},
year = {2014},
doi = {10.1186/1878-5085-5-4},
note = {PubMed: 24521056},
url = {https://www.mecfsatlas.com/evidence/wang-2014-traditional-chinese},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/wang-2014-traditional-chinese
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