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ME/CFS Atlas is an evidence reference platform, not a medical provider. Content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.

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ME/CFS Evidence Browser — Classified Studies on Myalgic Encephalomyelitis

Evidence browser

Search and filter 6,121 studies by evidence level, diagnostic criteria, PEM status, and research domain. Each entry links to the original source.

Studies sorted by evidence level, then year. Browse by topic instead →

Evidence level (E0–E3) reflects study type and replication, not methodological quality. A weak systematic review still sits at E0. How evidence levels work →

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200 studies

E0 — Consensus629E1 — Replicated319E2 — Moderate2,757E3 — Preliminary2,416

ME/CFS4,010Long COVID208Post-infectious188Overlapping1,031

Required for diagnosis409Not specified / unclear2,191Not required3,521

Post-Exertional Malaise1,040Cognitive Dysfunction1,712Pain1,606Unrefreshing Sleep787Orthostatic Intolerance470

Cytokines812Gene Expression564Metabolomics469Neuroimaging464Autoantibodies454

Infection-Triggered1,158Long COVID Overlap563Pediatric494Severe227

Strong Phenotyping427Sex-Stratified325Severe ME Included115

Systematic Review256Meta-Analysis60RCT299

Peer-reviewed6,064Preprint3Unclear54

161–180 of 200 studies

E3 PreliminaryReviewPEM unclearReview-Narrative

FITNET's Internet-Based Cognitive Behavioural Therapy Is Ineffective and May Impede Natural Recovery in Adolescents with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. A Review.

Ghatineh, Simin, Vink, Mark·Behavioral sciences (Basel, Switzerland)·2017

This review examined a Dutch study called FITNET that claimed internet-based cognitive behavior therapy helped adolescents with ME/CFS recover at high rates. The reviewers found serious problems with how the study was designed and analyzed, including how they defined 'recovery' and that they didn't use objective measurements like activity monitors to confirm their results. The study actually found no meaningful difference between the therapy group and the usual care group at long-term follow-up, suggesting the treatment may not have worked as claimed.

E3 PreliminaryPEM unclear

Caring for people with severe myalgic encephalomyelitis: An interpretative phenomenological analysis of parents' experiences.

Mihelicova, Martina, Siegel, Zachary, Evans, Meredyth et al.·Journal of health psychology·2016

This study listened to parents who care for severely ill ME/CFS patients and asked about their experiences. Researchers found that parents often feel their identity has changed, experience guilt, feel isolated from others, deal with uncertainty about the future, and develop ways to cope with the demands of caregiving. The study provides important insights that could help healthcare providers better support and understand these caregivers.

E3 PreliminaryDiagnosticPEM unclearMethods-Paper

Assessing the Psychometric Properties of an Activity Pacing Questionnaire for Chronic Pain and Fatigue.

Antcliff, Deborah, Campbell, Malcolm, Woby, Steve et al.·Physical therapy·2015

This study tested a questionnaire designed to measure how well people with chronic fatigue and pain pace their activities—meaning how they balance rest and activity throughout the day. Researchers simplified the original 38-question survey down to 26 questions and identified five different ways people try to pace themselves: adjusting activities, keeping activities consistent, gradually increasing activities, planning activities, and accepting limitations. The questionnaire was found to be reliable and useful for measuring pacing strategies.

E3 PreliminaryDiagnosticPEM unclearMethods-Paper

The use of mixed methods in studying a chronic illness.

Jason, Leonard A, Reed, Jordan·Health psychology and behavioral medicine·2015

This paper reviews how researchers can combine qualitative methods (interviews, stories) and quantitative methods (surveys, statistics) to better understand ME/CFS. The authors observed that mixing these two approaches provided richer insights into the disease's epidemiology, how the illness name affects perceptions, and treatment options. However, this is a methodological review article rather than a new research study, so it does not present original findings about ME/CFS itself.

E3 PreliminaryCohortPEM not required

Complete eradication of chronic long standing eczema and keratosis pilaris following treatment with dextroamphetamine sulfate.

Check, J H, Chan, S·Clinical and experimental obstetrics & gynecology·2014

This study describes two patients with ME/CFS who also had long-standing skin conditions (eczema and keratosis pilaris) that improved significantly when treated with dextroamphetamine, a stimulant medication. The authors suggest these skin problems may be related to an underactive nervous system that is also involved in ME/CFS, and that stimulant treatment may help both conditions.

E3 PreliminaryCohortPEM not requiredCross-Sectional

Adolescents and mothers value referral to a specialist service for chronic fatigue syndrome or myalgic encephalopathy (CFS/ME).

Beasant, Lucy, Mills, Nicola, Crawley, Esther·Primary health care research & development·2014

This study asked 13 mothers and 12 teenagers with ME/CFS about their experiences getting help from a specialist ME/CFS service. Most families found it difficult and took a long time to access the specialist clinic, but once they got there, both teenagers and mothers felt it was valuable. The specialist service helped confirm the diagnosis, improved symptom management, and helped communication between doctors and schools.

DiagnosticsInterventions

E3 PreliminaryReviewPEM not requiredReview-Narrative

Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions.

Friedlander, Justin I, Shorter, Barbara, Moldwin, Robert M·BJU international·2012

This review examined how food and beverages affect bladder pain syndrome (IC/BPS) and related conditions like fibromyalgia and chronic fatigue. Nearly 90% of patients report that certain foods make their symptoms worse—especially acidic foods like citrus and tomatoes, caffeine, alcohol, and spicy foods—while some substances like calcium and baking soda may help. The researchers recommend that patients work with their doctors to identify their personal food triggers through careful elimination diets rather than avoiding foods unnecessarily.

E3 PreliminaryReviewPEM unclearReview-Narrative

[Chronic fatigue syndrome and an approach to its treatment].

Akarachkova, E S·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·2010

This is a review article discussing chronic fatigue syndrome (ME/CFS) and treatment approaches. The authors examine what is known about the condition and offer clinical guidance on how to manage it. While not a new research study, it provides a medical perspective on understanding and treating this complex illness.

E3 PreliminaryCohortPEM not requiredObservational

Self within a climate of contention: Experiences of chronic fatigue syndrome.

Travers, Michele Kerry, Lawler, Jocalyn·Social science & medicine (1982)·2008

This study explored how people with ME/CFS experience their illness and how they cope with it, based on interviews with 19 Australian adults (including 3 who recovered). Researchers found that people with ME/CFS often feel their sense of self is damaged by the illness, and they use two main strategies to manage this: protecting themselves (the Guardian Response) and rebuilding their lives with new meaning (the Reconstructing Response). The study shows that living with ME/CFS involves an ongoing struggle as people balance these coping strategies depending on how severe their symptoms are at any given time.

E3 PreliminaryBehavioralPEM not requiredObservational

Clinical observation on the effects of Bo's abdominal acupuncture in 40 cases of chronic fatigue syndrome.

Huang, Yong, Liao, Xiao-ming, Li, Xiao-xi et al.·Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan·2008

This study looked at whether a traditional Chinese acupuncture technique called Bo's abdominal acupuncture could help 40 people with chronic fatigue syndrome. Patients received acupuncture treatments once daily for 2 weeks, and researchers measured their symptoms and fatigue levels before and after treatment. The results showed that patients reported improvements in fatigue, loss of appetite, sleep problems, memory issues, diarrhea, and general pain.

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

The thoughts and methods for clinical research on acupuncture treatment of chronic fatigue syndrome.

Yao, Renmin·Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan·2007

This paper presents acupuncture treatment guidelines for chronic fatigue syndrome (ME/CFS), focusing on how acupuncture might restore balance to the body's energy systems according to traditional Chinese medicine. The authors discuss important considerations like which patients are most suitable for treatment, which acupuncture points to use, and how to measure whether the treatment is working.

E3 PreliminaryCohortPEM not requiredCase-Control

Successful use of a primary care practice-specialty collaboration in the care of an adolescent with chronic fatigue syndrome.

Kuo, Dennis Z, Cheng, Tina L, Rowe, Peter C·Pediatrics·2007

This case report describes how one teenager with ME/CFS improved significantly when their regular doctor and a specialized ME/CFS expert worked together as a team, even though they lived in different cities. By staying in regular contact through phone calls and emails and clearly dividing responsibilities, the two doctors were able to manage the teen's symptoms more effectively. The study suggests that this type of teamwork between primary care doctors and specialists can help young people with ME/CFS get better care.

E3 PreliminaryReviewPEM not requiredReview-Narrative

[On the important role of Siguan points in treatment of chronic fatigue syndrome].

Wang, Jing-jing, Meng, Hong, Cui, Cheng-bin et al.·Zhongguo zhen jiu = Chinese acupuncture & moxibustion·2006

This study examined whether a traditional Chinese medicine acupuncture technique called Siguan points might help treat chronic fatigue syndrome (ME/CFS). The researchers reviewed existing literature on this acupuncture method and concluded that using Siguan points as the main treatment approach showed promise for improving ME/CFS symptoms.

E3 PreliminaryReviewPEM unclearReview-Narrative

The debate: myalgic encephalomyelitis and chronic fatigue syndrome.

Shepherd, Charles·British journal of nursing (Mark Allen Publishing)·2006

This article discusses the ongoing disagreement among doctors and researchers about ME/CFS, including what causes it and how to treat it. The author explains that while we still don't fully understand what causes the illness, we are learning more about the factors that may trigger or worsen it. Good news: doctors now have treatments available that can help reduce symptoms and improve quality of life for patients, rather than simply accepting the illness as untreatable.

E3 PreliminaryCohortPEM not requiredCase-Control

Acupuncture in the treatment of post viral fatigue syndrome--a case report.

Mears, Tim·Acupuncture in medicine : journal of the British Medical Acupuncture Society·2005

This report describes one patient with post-viral fatigue (chronic fatigue syndrome) who received electroacupuncture treatment. The patient reported improvements in her symptoms and was able to return to work, though she was not cured. Because this is a single case and has not been replicated in other patients, we cannot yet determine whether electroacupuncture would help others with similar conditions.

E3 PreliminaryBehavioralPEM unclear

Ayurvedic treatment of chronic fatigue syndrome--a case report.

Vinjamury, Sivarama Prasad, Singh, Betsy B·Alternative therapies in health and medicine·2005

This case report describes one patient with chronic fatigue syndrome (ME/CFS) who received treatment using Ayurveda, a traditional medicine system from India. The authors documented whether Ayurvedic treatments helped reduce the patient's fatigue and other symptoms. While the patient showed some improvement, this is just one person's experience and cannot tell us whether this approach works for most people with ME/CFS.

E3 PreliminaryCommentaryPEM unclearEditorial

Supporting people with severe myalgic encephalomyelitis.

Crowhurst, Greg·Nursing standard (Royal College of Nursing (Great Britain) : 1987)·2005

This article helps nurses better understand ME/CFS, a serious condition that is often misunderstood by healthcare providers. The author describes the main symptoms people experience and discusses how healthcare services can support patients. The article emphasizes that ME/CFS is a real physical illness that needs more research to help doctors and nurses care for people with it properly.

E3 PreliminaryMechanismPEM not requiredObservational

The effect of granisetron, a 5-HT3 receptor antagonist, in the treatment of chronic fatigue syndrome patients--a pilot study.

The, G K H, Prins, J, Bleijenberg, G et al.·The Netherlands journal of medicine·2003

Researchers tested whether a medication called granisetron, which affects a brain chemical involved in nausea and other functions, might help ME/CFS patients feel less fatigued. Five women with ME/CFS took the medication for one month and reported significant improvements in how tired they felt and how much they could do. However, this was a very small study without a comparison group, so much more research is needed to confirm these results.

E3 PreliminaryReviewPEM unclearReview-Narrative

An overview of chronic fatigue syndrome.

Jackson, Elizabeth·Nursing standard (Royal College of Nursing (Great Britain) : 1987)·2003

This article reviews what we know about ME/CFS, including the symptoms people commonly experience and how they can be treated. The author describes a new model of patient care that was tested in the community, which combines several different therapeutic approaches to help manage the condition.

E3 PreliminaryReviewPEM unclearReview-Narrative

Atypical depression spectrum disorder - neurobiology and treatment.

Murck, Harald·Acta neuropsychiatrica·2003

This article explores a type of depression with unusual symptoms—like eating more and sleeping more instead of less—that is often overlooked in standard depression assessments. The author suggests this pattern of depression shares biological similarities with chronic fatigue syndrome, fibromyalgia, and other related conditions, and that all of these may involve a common problem with how the body regulates stress hormones. Different medications may work better for this type of depression than those typically used for other forms.

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PEM Immune Neuro Metabolic Biomarkers Severe ME Long COVID Cognitive

Curated Collections

Thematic groupings by clinical question or research area.

Neuroinflammation Evidence

PET imaging and other studies providing evidence for brain inflammation in ME/CFS.

Metabolism & Mitochondria

Metabolomics and mitochondrial function studies revealing energy metabolism disruption.

Biomarkers

Studies identifying potential biological markers for ME/CFS diagnosis and stratification.

PEM-Specific Research

Studies specifically examining post-exertional malaise, the hallmark symptom of ME/CFS.