SynthesisBMJ open2014
Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review.
Synthesis in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 130 papers, 6 of them syntheses 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
130 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Comparative effectiveness of non-pharmacological traditional Chinese medicine therapies for chronic fatigue syndrome: a systematic review and network meta-analysis.Frontiers in medicine · 2026Pooled it
- Cognitive behavioural therapy for the treatment of chronic fatigue syndrome in adults - a meta-analysis.Frontiers in psychiatry · 2025Pooled it
- Biomarkers for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a systematic review.BMC medicine · 2023Pooled it
- Is there a role for traditional and complementary medicines in managing chronic fatigue? a systematic review of randomized controlled trials.Frontiers in pharmacology · 2023Pooled it
- Systematic review and meta-analysis of the prevalence of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).Journal of translational medicine · 2020Pooled it
- Efficacy of acupuncture-based traditional Chinese medicine therapies for chronic fatigue syndrome: a systematic review and meta-analysis.Frontiers in neurologyPooled it
- Open-label study with the monoamine stabilizer (-)-OSU6162 in myalgic encephalomyelitis/chronic fatigue syndrome.Brain and behavior · 2021Trial
- Low-Dose Ionizing Radiation and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Review of Recent Evidence and Future Research Directions Toward the Elucidation of a Metabolic, Immunologic, and Signaling Cascade.International journal of molecular sciences · 2026Review
- Australian registry reports poor health and wellbeing in people living with ME/CFS.Journal of translational medicine · 2026Article
- Chronic fatigue syndrome in nursing practice: a concept analysis.BMC nursing · 2026Article
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome diagnostic reporting in the 2021-2023 National Health Interview Survey.BMC public health · 2026Article
- Overcoming barriers in myalgic encephalomyelitis/chronic fatigue syndrome research: the CureME participatory model.Frontiers in human neuroscience · 2026Article
- Chronic stress and cognitive dysfunction in myalgic encephalomyelitis/chronic fatigue syndrome: HPA axis dysregulation and hippocampal plasticity.Frontiers in neuroscience · 2026Review
- Information exchange or discussion? A qualitative study on cross-sectoral collaboration between social security service and healthcare service for patients with chronic fatigue.BMC health services research · 2025Article
- Circulating FGF-21 as a Disease-Modifying Factor Associated with Distinct Symptoms and Cognitive Profiles in Myalgic Encephalomyelitis and Fibromyalgia.International journal of molecular sciences · 2025Article
- The Psychological Benefits of Forest Bathing in Individuals with Fibromyalgia and Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Pilot Study.Healthcare (Basel, Switzerland) · 2025Article
- Assessment of the Gut Microbiome in Patients with Coexisting Irritable Bowel Syndrome and Chronic Fatigue Syndrome.Nutrients · 2025Article
- Neurodevelopment Genes Encoding Olduvai Domains Link Myalgic Encephalomyelitis to Neuropsychiatric Disorders.Diagnostics (Basel, Switzerland) · 2025Article
- Medication use and symptomology in North American women with myalgic encephalomyelitis/chronic fatigue syndrome.Frontiers in medicine · 2025Article
- Fatigue, interoplastic and nociplastic distress in myalgic encephalomyelitis/chronic fatigue syndrome, Gulf War Illness, and chronic idiopathic fatigue.Frontiers in neuroscience · 2025Article
70 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and explore how the validity of case definitions can be evaluated in the absence of a reference standard.
designSystematic review.
settingInternational.
participantsA literature search, updated as of November 2013, led to the identification of 20 case definitions and inclusion of 38 validation studies. PRIMARY AND SECONDARY OUTCOME MEASURE: Validation studies were assessed for risk of bias and categorised according to three validation models: (1) independent application of several case definitions on the same population, (2) sequential application of different case definitions on patients diagnosed with CFS/ME with one set of diagnostic criteria or (3) comparison of prevalence estimates from different case definitions applied on different populations.
resultsA total of 38 studies contributed data of sufficient quality and consistency for evaluation of validity, with CDC-1994/Fukuda as the most frequently applied case definition. No study rigorously assessed the reproducibility or feasibility of case definitions. Validation studies were small with methodological weaknesses and inconsistent results. No empirical data indicated that any case definition specifically identified patients with a neuroimmunological condition.
conclusionsClassification of patients according to severity and symptom patterns, aiming to predict prognosis or effectiveness of therapy, seems useful. Development of further case definitions of CFS/ME should be given a low priority. Consistency in research can be achieved by applying diagnostic criteria that have been subjected to systematic evaluation.
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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.