Diagnosis and Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

A Systematic Review of the Evidence

CDC has contracted with the Pacific Northwest Evidence-based Practice Center (EPC) to conduct a systematic review of the scientific literature surrounding myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Specifically, the review will explore:

  • Evidence of the benefits and harms of specific treatments for ME/CFS and its symptoms
  • Benefits and harms to the patient of diagnosing ME/CFS
  • Prevalence of non-ME/CFS conditions in people presenting for evaluation of potential ME/CFS.

CDC will use this review to inform development of treatment guidelines for ME/CFS and its symptoms.

Pacific Northwest EPC developed a list of three key questions with input from CDC and stakeholders (key informants). Key informants included patients, caregivers, practicing clinicians, researchers and representatives of relevant professional and consumer organizations.

Key Questions

  1. In patients undergoing evaluation for possible ME/CFS, what is the frequency of non-ME/CFS conditions?
  2. What are the benefits and harms to the patient of diagnosing ME/CFS vs. non-diagnosis?
  3. What are the benefits and harms of therapeutic interventions for patients with ME/CFS, and how do they vary by patient subgroups*?
    • Interventions for treating ME/CFS
    • Interventions for treating symptoms commonly present in people with ME/CFS poor sleep, orthostatic intolerance, pain, fatigue, cognitive problems, depression, multiple chemical sensitivity, gastrointestinal symptoms, urinary symptoms, etc.)

*Subgroups include those defined by age, sex, race/ethnicity, presence of biomarkers, ME/CFS severity (including homebound status) or duration, type of onset (e.g., acute vs. gradual), criteria used to diagnose ME/CFS, and co-morbidities.

The protocol also describes the research team’s approach for conducting the systematic review, including the populations, interventions, comparators and outcomes used to define the key questions; the methods used to identify, select, and abstract data from studies; and methods used to assess the quality of the studies and synthesize the evidence.

The full protocol for the systematic reviewexternal icon is registered with PROSPERO (the International Prospective Register of Systematic Reviews)external icon.