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ME/CFS Atlas — A public knowledge atlas for ME/CFS

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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 6,167 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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517 studies

E0 — Consensus643E1 — Replicated320E2 — Moderate2,782E3 — Preliminary2,422

ME/CFS4,025Long COVID217Post-infectious189Overlapping1,050

Required for diagnosis414Not specified / unclear2,219Not required3,534

Post-Exertional Malaise1,064Cognitive Dysfunction1,735Pain1,620Unrefreshing Sleep799Orthostatic Intolerance478

Cytokines818Gene Expression567Metabolomics473Neuroimaging468Autoantibodies458

Infection-Triggered1,174Long COVID Overlap588Pediatric493Severe231

Strong Phenotyping438Sex-Stratified326Severe ME Included118

Systematic Review265Meta-Analysis60RCT300

Peer-reviewed6,110Preprint3Unclear54

361–380 of 517 studies

E3 PreliminaryCohortPEM not requiredCase-Control

Sympathetic neural hyperalgesia edema syndrome, a frequent cause of pelvic pain in women, mistaken for Lyme disease with chronic fatigue.

Check, J H, Cohen, R·Clinical and experimental obstetrics & gynecology·2011

This study describes a woman who was diagnosed with Lyme disease and treated with antibiotics for chronic fatigue, but her symptoms didn't improve. Doctors then tested her ability to excrete water from her body and found it was impaired, suggesting a problem with her sympathetic nervous system (the part that controls automatic body functions). When she was treated with a stimulant medication instead, she improved significantly.

E3 PreliminaryCohortPEM unclearCross-Sectional

Patients' hopes and expectations of a specialist chronic fatigue syndrome/ME service: a qualitative study.

McDermott, C, Lynch, J, Leydon, G M·Family practice·2011

This study asked 20 newly referred ME/CFS patients what they hoped to gain from visiting a specialist service. Patients most wanted a clear diagnosis, better understanding of their illness, practical guidance on managing it, and hope for the future. Most patients felt uncertain about ME/CFS and wanted more information earlier in their illness journey, rather than waiting to see a specialist.

E3 PreliminaryReviewPEM not requiredReview-Narrative

Fatigue and chronic fatigue in the elderly: definitions, diagnoses, and treatments.

Morelli, Vincent·Clinics in geriatric medicine·2011

This review article helps doctors understand fatigue in older adults by explaining three types: fatigue that comes on recently, fatigue that lasts a long time, and chronic fatigue syndrome. The article discusses how doctors can evaluate fatigue and offers both medication and non-medication treatments like exercise, vitamins, diet changes, and behavioral strategies.

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

The Hebrew version of the FibroFatigue scale: validation of a questionnaire for assessment of fibromyalgia and chronic fatigue syndrome.

Ablin, Jacob N, Odes, Lisa, Neumann, Lily et al.·Rheumatology international·2010

This study tested whether a Hebrew-language questionnaire called the FibroFatigue Scale (FFS) accurately measures symptoms in fibromyalgia patients. Researchers gave 100 patients with fibromyalgia this questionnaire along with other standard symptom-measuring tools, and found that the FFS reliably detected and measured how severe their symptoms were.

E3 PreliminaryCohortPEM unclearCross-Sectional

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in adults: a qualitative study of perspectives from professional practice.

Horton, Simon M C, Poland, Fiona, Kale, Swati et al.·BMC family practice·2010

This study spoke with six healthcare providers who were praised by ME/CFS patients for being helpful and understanding. The researchers asked these doctors and specialists what they thought worked best when treating ME/CFS. The key finding was that patients benefit most from doctors who truly listen, show respect, build trust, and recognize how serious and complex the condition is—rather than those who dismiss or minimize ME/CFS.

E3 PreliminaryCohortPEM not requiredObservational

Making the diagnosis of Chronic Fatigue Syndrome/Myalgic Encephalitis in primary care: a qualitative study.

Chew-Graham, Carolyn, Dowrick, Christopher, Wearden, Alison et al.·BMC family practice·2010

This study asked 22 general practitioners (GPs) about their experiences diagnosing ME/CFS in their clinics. GPs said they find it hard to understand what ME/CFS is, and they typically focus on ruling out other diseases rather than confidently saying a patient has ME/CFS. Many GPs worried that giving someone an ME/CFS diagnosis might actually harm them, and they weren't sure what to do to help these patients once diagnosed.

E3 PreliminaryCohortPEM unclearCross-Sectional

A discourse analytic study of ME/CFS (Chronic Fatigue Syndrome) sufferers' experiences of interactions with doctors.

Guise, Jennie, McVittie, Chris, McKinlay, Andy·Journal of health psychology·2010

This study looked at how ME/CFS patients describe their experiences when talking to doctors. Researchers analyzed conversations from an online support group and found that patients often feel their doctors don't listen to them or take their condition seriously. Interestingly, patients were careful about how they complained, trying to focus on practical issues rather than seeming like they were just complaining.

E3 PreliminaryReviewPEM not requiredReview-Narrative

[The chronic asthenia syndrome: a clinical approach].

Young, Pablo, Finn, Bárbara C, Bruetman, Julio et al.·Medicina·2010

Fatigue is one of the most common reasons people visit doctors, affecting about 30% of patients. This article explains how doctors should think about different types of fatigue—including chronic fatigue syndrome (ME/CFS), which affects 0.2–0.7% of people. The authors emphasize that finding and treating the underlying cause is the best approach, though about 20% of patients never get a clear diagnosis.

E3 PreliminaryReviewPEM unclearReview-Narrative

Fibromyalgia: pathogenetic, diagnostic and therapeutic concerns.

Podolecki, Tomasz, Podolecki, Andrzej, Hrycek, Antoni·Polskie Archiwum Medycyny Wewnetrznej·2009

Fibromyalgia is a condition causing widespread muscle and joint pain that affects many people worldwide. This review examines what we know about fibromyalgia's causes, how doctors diagnose it, and how it can be treated. The authors note that fibromyalgia likely results from multiple factors involving the nervous system, brain chemistry, and immune function, and that treatment typically involves antidepressants, therapy, and other approaches.

Pain and SensitizationDiagnostics

E3 PreliminaryReviewPEM not requiredReview-Narrative

[Functional somatic syndromes from the view of cultural anthropology].

Nakagami, Ayako, Tsujiuchi, Takuya·Nihon rinsho. Japanese journal of clinical medicine·2009

This study explains how culture and society shape the way people experience and describe illnesses like ME/CFS. The authors point out that doctors and patients often understand illness differently—doctors focus on what they can measure (disease), while patients focus on how the illness affects their daily life (illness). Understanding these different viewpoints can help doctors and patients communicate better and work together.

E3 PreliminaryReviewPEM unclearReview-Narrative

[Changes on definition and diagnostic criteria of the chronic fatigue syndrome].

Qin, You, Pang, Feng-Shun, Cai, Bei-Yuan·Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine·2009

This article reviews how the definition and diagnostic criteria for ME/CFS have changed over time. The authors examine the evolution of how doctors identify and classify this condition using different diagnostic frameworks. Understanding these changes helps patients and doctors communicate more clearly about the disease.

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

Bayesian biomarker identification based on marker-expression proteomics data.

Bhattacharjee, M, Botting, C H, Sillanpää, M J·Genomics·2008

This study developed statistical methods to find biological markers (biomarkers) that could help identify and diagnose ME/CFS. The researchers used blood protein measurements and genetic information from ME/CFS patients to find which markers are most closely linked to the disease. Finding these biomarkers is important because ME/CFS is currently hard to diagnose and measure, and having reliable biological tests could change that.

E3 PreliminaryReviewPEM not requiredReview-Narrative

[Sub-health state and chronic fatigue syndrome].

Wang, Tian-Fang, Xue, Xiao-Lin·Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine·2008

This study clarifies that 'sub-health'—a state of feeling unwell that falls short of diagnosed disease—is different from ME/CFS. The authors explain what fatigue, chronic fatigue, and ME/CFS actually are, and discuss how doctors can tell them apart using established diagnostic criteria. Understanding these differences helps ensure people with ME/CFS receive appropriate diagnosis and care.

E3 PreliminaryReviewPEM unclearReview-Narrative

[Contentious diseases--a medico-social phenomenon from an insurance medicine perspective].

Regenauer, A·Versicherungsmedizin·2008

This article examines a group of conditions—including ME/CFS, fibromyalgia, and others—that are difficult to diagnose with standard medical tests and have become controversial in healthcare and insurance systems. The author explores why these illnesses are questioned by insurers, what they have in common, and why cases are increasing in Western societies. The paper aims to help insurance companies better understand these conditions rather than dismiss them as imaginary.

E3 PreliminaryPEM not required

Obstructions for quality care experienced by patients with chronic fatigue syndrome (CFS)--a case study.

Gilje, Ann Marit, Söderlund, Atle, Malterud, Kirsti·Patient education and counseling·2008

This study asked 12 ME/CFS patients about their experiences with doctors and healthcare. Patients reported that doctors often didn't believe them, didn't listen carefully, or treated them dismissively. Many felt that doctors blamed their symptoms on psychological causes or didn't take them seriously, which was sometimes as painful as the illness itself.

E3 PreliminaryDiagnosticPEM not requiredMethods-Paper

A train-the-trainer education and promotion program: chronic fatigue syndrome--a diagnostic and management challenge.

Brimmer, Dana J, McCleary, K Kimberly, Lupton, Teresa A et al.·BMC medical education·2008

This study tested whether training primary care doctors about ME/CFS could help more patients get diagnosed and treated. Researchers trained 79 doctors and nurse practitioners to recognize and manage ME/CFS, and these trained providers then taught over 2,000 other healthcare workers. The training improved doctors' knowledge and confidence in diagnosing ME/CFS, showing that education programs can help address the problem of missed diagnoses.

E3 PreliminaryReviewPEM unclearReview-Narrative

[History of chronic fatigue syndrome].

Hashimoto, Nobuya·Nihon rinsho. Japanese journal of clinical medicine·2007

This article reviews the history of ME/CFS, showing that conditions with similar symptoms have existed for hundreds of years under different names like neurasthenia and myalgic encephalomyelitis. A major outbreak at Lake Tahoe in the 1980s brought modern attention to the disease, but doctors realized that not all patients with CFS symptoms actually had evidence of EBV infection, suggesting the disease is more complex than a simple viral cause. The authors explain how understanding this history can help develop better diagnostic guidelines for the condition.

E3 PreliminaryReviewPEM unclearReview-Narrative

Myalgic encephalomyelitis: a review with emphasis on key findings in biomedical research.

Hooper, M·Journal of clinical pathology·2007

This review examines what scientific research has discovered about ME/CFS, a complex illness that affects multiple body systems and causes long-lasting tiredness, pain, and other symptoms. The authors discuss not only the medical findings but also how disagreements and differing opinions among doctors and scientists have affected research and care for ME/CFS patients. They emphasize that these broader debates have real consequences for patients seeking answers and proper treatment.

E3 PreliminaryPEM not required

[Chronic fatigue syndrome in a 15-year-old girl].

Díaz-Caneja Greciano, A, Rodríguez Sosa, J T, Aguilera Albesa, S et al.·Anales de pediatria (Barcelona, Spain : 2003)·2007

This report describes a 15-year-old girl diagnosed with ME/CFS (chronic fatigue syndrome), a condition that causes severe tiredness and lack of energy without an obvious physical cause. The doctors emphasize that ME/CFS should be considered when young people have chronic fatigue along with other symptoms but medical tests don't reveal why. Treatment focused on rehabilitation with cognitive behavioral therapy (talking therapy to address thoughts and behaviors) combined with a gradual, structured increase in activity levels.

E3 PreliminaryReviewPEM not requiredReview-Narrative

[Chronic fatigue syndrome].

Maoz, Daniel, Shoenfeld, Yehuda·Harefuah·2006

ME/CFS is a serious illness that causes extreme tiredness and other symptoms that interfere with daily life. Doctors often fail to diagnose it correctly, and we still don't fully understand what causes it. This review suggests that ME/CFS likely results from multiple different factors working together, and that two treatments—cognitive behavioral therapy and graded exercise therapy—might help some patients.

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Or browse by topic

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.