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.
- In patients undergoing evaluation for possible ME/CFS, what is the frequency of non-ME/CFS conditions?
- What are the benefits and harms to the patient of diagnosing ME/CFS vs. non-diagnosis?
- 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.