ArticleBMC medicine2009
Chronic fatigue syndrome: identifying zebras amongst the horses.
Article in BMC medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Efficacy and Acceptance of Cognitive Behavioral Therapy in Adults with Chronic Fatigue Syndrome: A Meta-analysis.International journal of behavioral medicine · 2024Pooled it
- A randomized controlled trial of qigong exercise on fatigue symptoms, functioning, and telomerase activity in persons with chronic fatigue or chronic fatigue syndrome.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2012Trial
- ME/CFS and the emotional toll of persistent disbelief: from epistemic to affective injustice.Medicine, health care, and philosophy · 2026Article
- Recovery from chronic fatigue syndrome: a reflexive thematic analysis of experiences of people before, during and after treatment.International journal of qualitative studies on health and well-being · 2025Article
- [Fatigue in chronic physical diseases].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2024Review
- Sleep Disorders and Fatigue among Patients with MS: The Role of Depression, Stress, and Anxiety.Neurology research international · 2024Article
- Response to the report published by the UK House of Commons All-Party Parliamentary Group on Chronic Fatigue Syndrome/Myalgic Encephalitis (CFS/ME): implications for cardiometabolic risk.Cardiovascular endocrinology & metabolism · 2022Article
- How peptic ulcer disease could potentially lead to the lifelong, debilitating effects of chronic fatigue syndrome: an insight.Scientific reports · 2021Article
- Striking the balance with epistemic injustice in healthcare: the case of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.Medicine, health care, and philosophy · 2020Article
- Stressful Events in the Onset of Chronic Fatigue Syndrome.Revista espanola de salud publica · 2016Observational
- Clinical and evoked pain, personality traits, and emotional states: can familial confounding explain the associations?Journal of psychosomatic research · 2015Article
- How should functional somatic syndromes be diagnosed?International journal of behavioral medicine · 2013Article
- Effects of qigong exercise on fatigue, anxiety, and depressive symptoms of patients with chronic fatigue syndrome-like illness: a randomized controlled trial.Evidence-based complementary and alternative medicine : eCAM · 2013Article
- Comparison of chronic fatigue syndrome/myalgic encephalopathy with other disorders: an observational study.JRSM short reports · 2012Article
- Alternative diagnoses to chronic fatigue syndrome in referrals to a specialist service: service evaluation survey.JRSM short reports · 2012Article
- Determinants of fatigue and stress.BMC research notes · 2011Article
- Chronic fatigue syndrome in the media: a content analysis of newspaper articles.JRSM short reports · 2011Article
- Review
- The 'cognitive behavioural model' of chronic fatigue syndrome: Critique of a flawed model.Health psychology openArticle
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There are currently no investigative tools or physical signs that can confirm or refute the presence of chronic fatigue syndrome (CFS). As a result, clinicians must decide how long to keep looking for alternative explanations for fatigue before settling on a diagnosis of CFS. Too little investigation risks serious or easily treatable causes of fatigue being overlooked, whilst too many increases the risk of iatrogenic harm and reduces the opportunity for early focused treatment. A paper by Jones et al published this month in BMC Medicine may help clinicians in deciding how to undertake such investigations. Their results suggest that if clinicians look for common psychiatric and medical conditions in those complaining of prolonged fatigue, the rate of detection will be higher than previously estimated. The most common co-morbid condition identified was depression, suggesting a simple mental state examination remains the most productive single investigation in any new person presenting with unexplained fatigue. Currently, most diagnostic criteria advice CFS should not be diagnosed when an active medical or psychiatric condition which may explain the fatigue is identified. We discuss a number of recent prospective studies that have provided valuable insights into the aetiology of chronic fatigue and describe a model for understanding chronic fatigue which may be equally relevant regardless of whether or not an apparent medical cause for fatigue can be identified. See the associated research paper by Jones et al: http://www.biomedcentral.com/1741-7015/7/57.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.