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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 6,205 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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533 studies

E0 — Consensus654E1 — Replicated321E2 — Moderate2,807E3 — Preliminary2,423

ME/CFS4,040Long COVID224Post-infectious190Overlapping1,064

Required for diagnosis417Not specified / unclear2,251Not required3,537

Post-Exertional Malaise1,082Cognitive Dysfunction1,749Pain1,628Unrefreshing Sleep805Orthostatic Intolerance484

Cytokines821Gene Expression573Metabolomics477Neuroimaging472Autoantibodies460

Infection-Triggered1,182Long COVID Overlap604Pediatric496Severe232

Strong Phenotyping445Sex-Stratified330Severe ME Included119

Systematic Review272Meta-Analysis61RCT301

Peer-reviewed6,148Preprint3Unclear54

41–60 of 533 studies

E0 ConsensusReviewPEM unclearReview-Narrative

Pediatric Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Jason, Leonard A, Barker, Kristen, Brown, Abigail·Reviews in health care·2012

This review examines how ME/CFS affects children and teenagers, which can be quite different from how it affects adults. The authors looked at existing research on how common pediatric ME/CFS is, how doctors diagnose it, what treatments are available, and what happens to children over time. They identified important gaps in our understanding and call for better ways to recognize and help young people with this condition.

E0 ConsensusReviewPEM not requiredReview-Narrative

CFS: A Review of Epidemiology and Natural History Studies.

Jason, Leonard A, Porter, Nicole, Brown, Molly et al.·Bulletin of the IACFS/ME·2009

Most ME/CFS research has only studied patients who went to doctors or hospitals, which misses people from minority communities and lower-income backgrounds who may not have access to medical care. This review looks at what we know about how common ME/CFS is, how it develops, and what factors increase the risk of getting it. The authors highlight one study that looked at ME/CFS in a diverse urban community rather than just in clinic patients, which gives a more accurate picture of the illness.

E0 ConsensusReviewPEM not requiredSystematic-Review

A systematic review of chronic fatigue syndrome: don't assume it's depression.

Griffith, James P, Zarrouf, Fahd A·Primary care companion to the Journal of clinical psychiatry·2008

This review examined how ME/CFS is different from depression, since doctors often confuse the two conditions. The researchers looked at hundreds of medical articles to understand what causes ME/CFS, how to properly diagnose it, and how to treat it. They found that ME/CFS is missed in over 80% of people who have it, and is frequently wrongly labeled as depression instead.

E0 ConsensusGuidelinePEM requiredGuideline

Diagnosis and management of chronic fatigue syndrome or myalgic encephalomyelitis (or encephalopathy): summary of NICE guidance.

Baker, R, Shaw, E J·BMJ (Clinical research ed.)·2007

This document summarizes official guidance from NICE (the UK's National Institute for Health and Care Excellence) on how to diagnose and manage ME/CFS. It provides recommendations for healthcare professionals on recognizing the condition, running appropriate tests, and treating patients with practical advice on activity management, rehabilitation, and when to refer patients to specialists.

E0 ConsensusGuidelinePEM unclearGuideline

NICE guidance on managing chronic fatigue syndrome/ME.

Hairon, Nerys, NICE·Nursing times·2007

This document provides official guidance from NICE (the UK's health authority) on how doctors should manage ME/CFS. It offers recommendations for diagnosing the condition, treating symptoms, and supporting patients in their daily lives. The guidance is based on the best evidence available and aims to help healthcare providers give consistent, appropriate care to people with ME/CFS.

E0 ConsensusReviewPEM not requiredSystematic-Review

Chronic fatigue syndrome: a systematic review.

Maquet, D, Demoulin, C, Crielaard, J M·Annales de readaptation et de medecine physique : revue scientifique de la Societe francaise de reeducation fonctionnelle de readaptation et de medecine physique·2006

This review examined all available research about ME/CFS to understand what we know about the condition. Researchers found that ME/CFS affects between 0.2% and 0.7% of people and that despite decades of research into possible causes like infections, immune problems, and hormonal imbalances, we still don't fully understand what causes the illness. Treatment should combine physical rehabilitation with psychological support to address the whole person.

E0 ConsensusReviewPEM not requiredReview-Narrative

Chronic fatigue syndrome: the need for subtypes.

Jason, Leonard A, Corradi, Karina, Torres-Harding, Susan et al.·Neuropsychology review·2005

ME/CFS is a complex condition that affects people in different ways, and researchers found that treating it as one single disease may not be helpful. This review shows that patients with ME/CFS have different combinations of symptoms, different levels of disability, and different biological markers (measurable signs in the body), suggesting the condition should be divided into subtypes. Just like how different patients with diabetes or heart disease need different treatment approaches, ME/CFS patients might benefit from being grouped into categories so doctors can provide more targeted care.

E0 ConsensusGuidelinePEM unclearGuideline

Chronic fatigue syndrome. Clinical practice guidelines--2002.

Working Group of the Royal Australasian College of Physicians·The Medical journal of Australia·2002

These guidelines were created by Australian medical experts in 2002 to help doctors recognize, diagnose, and treat ME/CFS (a condition also called chronic fatigue syndrome). The guidelines set standards for how patients should be evaluated and managed, based on the best medical knowledge available at that time. They aim to improve the quality of care patients receive and reduce confusion about how to properly approach this illness.

E0 ConsensusGuidelinePEM unclearGuideline

Chronic fatigue syndrome: a step towards agreement.

Clark, Christopher, Buchwald, Dedra, MacIntyre, Anne et al.·Lancet (London, England)·2002

This 2002 guideline paper from leading ME/CFS researchers brought together different international perspectives on how to define and diagnose chronic fatigue syndrome, aiming to reduce confusion among doctors. The authors reviewed existing diagnostic criteria and clinical approaches to help create more consistent standards for identifying the condition. This work was an important step toward getting doctors and researchers to agree on what ME/CFS actually is.

E0 ConsensusReviewPEM not requiredReview-Narrative

Chronic fatigue syndrome and fibromyalgia: clinical assessment and treatment.

Friedberg, F, Jason, L A·Journal of clinical psychology·2001

This review examines how ME/CFS and fibromyalgia are similar conditions that doctors don't fully understand yet. The authors looked at research on what causes these illnesses, how to diagnose them (including checking for depression and anxiety), and what treatments work—including medications, alternative therapies, and talking with a therapist. The study suggests that mental health professionals can play an important role in helping patients manage their symptoms.

E0 ConsensusReviewPEM not requiredSystematic-Review

A review of the evidence for overlap among unexplained clinical conditions.

Aaron, L A, Buchwald, D·Annals of internal medicine·2001

This review examined eight unexplained illnesses—including ME/CFS, fibromyalgia, and irritable bowel syndrome—and found they share many similarities in symptoms (like fatigue and pain), how they affect daily life, and how they respond to laboratory tests. The researchers discovered that many patients have more than one of these conditions at the same time, suggesting they may be related or overlap in important ways.

E0 ConsensusReviewPEM unclearSystematic-Review

Defining and managing chronic fatigue syndrome.

Mulrow, C D, Ramirez, G, Cornell, J E et al.·Evidence report/technology assessment (Summary)·2001

This 2001 review examined the medical literature on chronic fatigue syndrome to summarize what was known about how to define and manage the condition. The authors looked at existing research to identify consistent diagnostic criteria and treatment approaches. The goal was to create a clear picture of CFS based on the best available evidence at that time.

E0 ConsensusReviewPEM not requiredReview-Narrative

Functional somatic syndromes: one or many?

Wessely, S, Nimnuan, C, Sharpe, M·Lancet (London, England)·1999

This study looked at several long-term illnesses that cause many physical symptoms but don't show obvious damage on standard medical tests, including ME/CFS and irritable bowel syndrome. The researchers found that these conditions have much more in common with each other than previously thought—they affect similar types of patients, cause overlapping symptoms, and respond to treatment in similar ways. Rather than treating each condition as completely separate, the authors suggest doctors and researchers should think of them as related conditions on a spectrum.

E0 ConsensusReviewPEM not requiredReview-Narrative

Review of juvenile primary fibromyalgia and chronic fatigue syndrome.

Breau, L M, McGrath, P J, Ju, L H·Journal of developmental and behavioral pediatrics : JDBP·1999

This review examined research on fibromyalgia and chronic fatigue syndrome (ME/CFS) in children. The authors found that these conditions in young people may work differently than they do in adults, and that they might be more closely related to each other than previously thought. The review suggests that these illnesses are likely caused by biological and genetic factors rather than psychological problems.

E0 ConsensusReviewPEM unclearReview-Narrative

Chronic fatigue syndrome in children and adolescents: a review.

Jordan, K M, Landis, D A, Downey, M C et al.·The Journal of adolescent health : official publication of the Society for Adolescent Medicine·1998

This review examined what was known about ME/CFS (chronic fatigue syndrome) specifically in children and teenagers. The authors looked at existing research to understand how the illness affects young people, how doctors recognize it, and what happens to patients over time. This study helps explain what ME/CFS looks like in younger patients, which is often different from how it appears in adults.

E0 ConsensusReviewPEM not requiredEditorial

Chronic fatigue and chronic fatigue syndrome: shifting boundaries and attributions.

Lloyd, A R·The American journal of medicine·1998

This review examines how fatigue is defined and diagnosed, and how different definitions lead to very different estimates of how many people have chronic fatigue syndrome. The authors look at how doctors and researchers measure fatigue using patient reports, and explore whether fatigue that follows infections is a real medical condition. The study highlights that without clear, consistent definitions, it's difficult to understand the true scope of the problem.

E0 ConsensusReviewPEM not requiredReview-Narrative

Epidemiologic advances in chronic fatigue syndrome.

Levine, P H·Journal of psychiatric research·1997

This review summarized what researchers knew about ME/CFS in 1997, including how common it is, who gets it, and what affects recovery. The study found that about 200 out of every 100,000 people have ME/CFS, and that women are more likely to develop it than men. The review also noted that people with sudden-onset ME/CFS tend to recover better than those whose symptoms start gradually.

E0 ConsensusReviewPEM not requiredReview-Narrative

Fibromyalgia and chronic fatigue syndrome: similarities and differences.

Buchwald, D·Rheumatic diseases clinics of North America·1996

This review compared ME/CFS and fibromyalgia (FM), two conditions that cause fatigue, muscle pain, and sleep problems. The researchers found that these two illnesses are very similar in their symptoms and how they affect people's lives, even though doctors use different criteria to diagnose them. Some patients have both conditions at the same time, which makes their suffering worse.

SleepDiagnostics

E0 ConsensusReviewPEM unclearReview-Narrative

The epidemiology of chronic fatigue syndrome.

Wessely, S·Epidemiologic reviews·1995

This review examined what we know about how common ME/CFS is, who develops it, and how it varies across different populations and regions. The researchers looked at existing research to understand the overall patterns of this illness in society. This helps doctors and patients understand whether ME/CFS is rare or relatively common, and whether certain groups are more likely to be affected.

E0 ConsensusReviewPEM not requiredEditorial

Fibromyalgia, chronic fatigue, and myofascial pain syndromes.

Goldenberg, D L·Current opinion in rheumatology·1992

This review examined research published on fibromyalgia and chronic fatigue syndrome, looking at what treatments work best and how these conditions are diagnosed. Researchers found that while many studies have been done, no single treatment has proven highly effective for either condition, and the way doctors diagnose chronic fatigue syndrome needs to be improved and made more consistent.

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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.