Topic

Diagnostics

Domain: Diagnostic Criteria

PEM-relevant research

4 studies in the atlas

Clinical and biological diagnostic approaches and criteria for ME/CFS.

What We Know

The IOM 2015 report established SEID criteria requiring PEM, unrefreshing sleep, and cognitive impairment or orthostatic intolerance. Multiple diagnostic criteria exist (Fukuda, CCC, ICC, IOM) with different sensitivities and specificities.

What We Think

Nanoelectronic immune assays and multi-omics signatures are being explored as potential objective diagnostic tools.

What We Don't Know

There is no validated biological test for ME/CFS. Diagnosis remains clinical. Diagnostic delays of 5+ years are common, particularly in women.

Studies in this Topic

E0 ConsensusPEM ✓Higher confidenceReviewed

Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness

Institute of Medicine Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome·National Academies Press·2015

The US Institute of Medicine reviewed over 9,000 scientific articles to establish new diagnostic criteria for ME/CFS. The report introduced SEID (Systemic Exertion Intolerance Disease) as a proposed name and established that ME/CFS is a serious, chronic, complex systemic disease. New criteria require PEM, unrefreshing sleep, plus cognitive impairment or orthostatic intolerance.

DiagnosticsPost-Exertional Malaise

E0 ConsensusPEM ✓Higher confidenceReviewed

Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management

NICE Guideline Committee·National Institute for Health and Care Excellence (NICE)·2021

The UK's National Institute for Health and Care Excellence updated its ME/CFS guidelines after a comprehensive evidence review. The updated guidelines removed Graded Exercise Therapy (GET) and Cognitive Behavioural Therapy (CBT) as recommended treatments, as evidence showed they were not effective and could be harmful. Pacing and energy management were endorsed.

InterventionsDiagnostics

E1 ReplicatedPEM ✓Moderate confidenceReviewed

Cardiopulmonary exercise testing and post-exertional malaise in ME/CFS: A retrospective analysis

Staci R. Stevens, Christopher R. Snell, Jared N. Stevens et al.·Journal of Translational Medicine·2018·n=51

ME/CFS patients underwent two consecutive days of cardiopulmonary exercise testing (CPET). On the second day, patients showed significantly reduced VO2 max and anaerobic threshold compared to the first day — and compared to healthy and disease controls who recovered normally. This objective impairment matches the subjective PEM experience.

Post-Exertional MalaiseDiagnostics

E2 ModeratePEM ✓PreliminaryReviewed

A nanoelectronics-blood-based diagnostic biomarker for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

Rahim Esfandyarpour, Aref Kashi, Maya Nemat-Gorgani et al.·Proceedings of the National Academy of Sciences (PNAS)·2019·n=40

Stanford researchers developed a nanoelectronics device that detects immune cell changes using a tiny electrical sensor. When salt stress was applied to blood samples, ME/CFS patient samples showed a distinctly different electrical response compared to healthy controls. This 'nano-needle' assay could potentially serve as an objective diagnostic test.

BiomarkersDiagnostics