Observational studyBMJ open2021
Symptom heterogeneity and patient subgroup classification among US patients with post-treatment Lyme disease: an observational study.
Observational study in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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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.
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Who cites it
13 citing papers in PubMed, 14 citations in OpenAlex.
- Post-Treatment Lyme Disease Syndrome in Six European Countries Using Data from the Burden of Lyme Disease (BOLD) Study.Pathogens (Basel, Switzerland) · 2026Article
- Characterization ofMicroorganisms · 2026Article
- Patient roadmap and economic burden of chronic tick-borne illness and post-treatment Lyme disease syndrome in Ireland, and public health issues arising.Frontiers in public health · 2026Article
- Diagnostic and Therapeutic Challenges in Lyme Disease and Co-Infections: Unraveling Neuropsychiatric and Neurological Complexities-A Comprehensive Case Series Analysis.Integrative medicine (Encinitas, Calif.) · 2025Article
- Understanding the Perspectives, Experiences, Beliefs, and Knowledge of Health Care Practitioners on the Diagnosis and Treatment of Lyme Disease in Canada.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2025Article
- Aberrant T-cell phenotypes in a cohort of patients with post-treatment Lyme disease.Frontiers in immunology · 2025Article
- Protocol for a longitudinal cohort study of Lyme disease with physical, mental and immunological assessment.BMJ open · 2023Article
- Posttreatment Lyme disease syndrome and myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review and comparison of pathogenesis.Chronic diseases and translational medicine · 2023Review
- Lyme disease and the pursuit of a clinical cure.Frontiers in medicine · 2023Review
- Superior efficacy of combination antibiotic therapy versus monotherapy in a mouse model of Lyme disease.Frontiers in microbiology · 2023Article
- A multimodal neuroimaging study of brain abnormalities and clinical correlates in post treatment Lyme disease.PloS one · 2022Article
- Article
- Recent Progress in Lyme Disease and Remaining Challenges.Frontiers in medicine · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo identify underlying subgroups with distinct symptom profiles, and to characterise and compare these subgroups across a range of demographic, clinical and psychosocial factors, within a heterogeneous group of patients with well-defined post-treatment Lyme disease (PTLD).
designA clinical case series of patents.
settingParticipants were recruited from a single-site, Lyme disease referral clinic patient population and were evaluated by physical exam, clinical laboratory testing and standardised questionnaires.
participantsTwo hundred and twelve participants met study criteria for PTLD, with medical record-confirmed prior Lyme disease as well as current symptoms and functional impact.
resultsExploratory factor analysis classified 30 self-reported symptoms into 6 factors: 'Fatigue Cognitive', 'Ocular Disequilibrium', 'Infection-Type', 'Mood-Related', 'Musculoskeletal Pain' and 'Neurologic'. A final latent profile analysis was conducted using 'Fatigue Cognitive', 'Musculoskeletal Pain' and 'Mood-Related' factor-based scores, which produced three emergent symptom profiles, and participants were classified into corresponding subgroups with 59.0%, 18.9% and 22.2% of the sample, respectively. Compared with the other two groups, subgroup 1 had similarly low levels across all factors relative to the sample as a whole, and reported lower rates of disability (1.6% vs 10.0%, 12.8%; q=0.126, 0.035) and higher self-efficacy (median: 7.5 vs 6.0, 5.3; q=0.068,<0.001). Subgroup 2 had the highest 'Musculoskeletal Pain' factor-based scores (q≤0.001). Subgroup 3 was characterised overall by higher symptom factor-based scores, and reported higher depression (q≤0.001).
conclusionsThis analysis identified six symptom factors and three potentially clinically relevant subgroups among patients with well-characterised PTLD. We found that these subgroups were differentiated not only by symptom phenotype, but also by a range of other factors. This may serve as an initial step towards engaging with the symptom heterogeneity that has long been observed among patients with this condition.
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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.