Assessment of ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome): A Case Study for Health Care Providers

Publication ID Published Volume
10527 December 31, 2016 12

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Over a million adults in the U.S. are affected by chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME). A debilitating illness, ME/CFS is accompanied by profound fatigue that is not relieved by rest and affects daily activities. Symptoms include postexertional malaise, cognitive problems, unrefreshing sleep, and pain. This course provides tools to teach medical, physician assistant, and nursing students to recognize, diagnose, and manage patients with ME/CFS. The student is expected to view the provider-to-provider video and the PowerPoint slide curriculum, which describe the steps for evaluation. The video depicts two physicians conferring about ME/CFS and addresses the challenges of making a diagnosis. The slide curriculum shows the different ME/CFS symptoms and case definitions and how to apply them using a case study. Medical, physician assistant, and nursing students were recruited to evaluate the course and viewed it either online or in a campus education center. Results showed that students met learning objectives and showed increases from pre- to posttest evaluation in their understanding of the difficulties of diagnosing ME/CFS and managing the illness. In addition to knowledge, student attitudes towards ME/CFS changed, with more empathy towards patients and the awareness that ME/CFS requires frequent communication and reevaluation of patients’ symptoms. Strategies of how to manage ME/CFS for the patient and manage time constraints during visits with ME/CFS patients are discussed.


Brimmer DJ, Jones JF, Boneva R, Campbell C, Lin J-MS, Unger ER. Assessment of ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome): a case study for health care providers. MedEdPORTAL Publications. 2016;12:10527.

Educational Objectives

By the end of this session, learners will be able to:

  1. Identify symptoms common across all myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) case definitions.
  2. Develop steps clinicians should follow to evaluate someone presenting with symptoms of fatigue, pain, and cognitive impairment.
  3. List the factors that make ME/CFS difficult to diagnose.
  4. Describe strategies that physicians can use to manage time constraints during visits with ME/CFS patients.


  • Chronic Fatigue Syndrome, Fatigue Syndrome, Chronic, Myalgic Encephalomyelitis, Case Study, Communication


  1. Bandura A. Social Learning Theory. New York, NY: General Learning Theory Press; 1971.
  2. Brimmer DJ, Campbell C, Bonner K, Lin J-M. News from the CDC: chronic fatigue syndrome (CFS) and standardized patient videos—a novel approach to educating medical students about CFS. Transl Behav Med.2013;3(4):338-339.
  3. Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A; and International Chronic Fatigue Syndrome Study Group. The chronic fatigue syndrome: a comprehensive approach to its definition and study. Ann Intern Med.1994;121(12):953-959.
  4. Institute of Medicine. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. Washington, DC: National Academies Press; 2015.
  5. Jason LA, Benton MC, Valentine L, Johnson A, Torres-Harding S. The economic impact of ME/CFS: individual and societal costs. Dyn Med.2008;7:6.
  6. Jason LA, Richman JA, Rademaker AW, et al. A community-based study of chronic fatigue syndrome. Arch Intern Med. 1999;159(18):2129-2037.
  7. Komaroff AL, Fagioli LR, Doolittle TH, et al. Health status in patients with chronic fatigue syndrome and in general population and disease comparison groups. Am J Med. 1996;101(3):281-290.
  8. Lin J-M, Resch SC, Brimmer DJ, et al. The economic impact of chronic fatigue syndrome in Georgia: direct and indirect costs. Cost Eff Resour Alloc. 2011;9:1.
  9. Nacul LC, Lacerda EM, Campion P, et al. The functional status and well being of people with myalgic encephalomyelitis/chronic fatigue syndrome and their carers. BMC Public Health. 2011;11:402.
  10. Reyes M, Nisenbaum R, Hoaglin DC, et al. Prevalence and incidence of chronic fatigue syndrome in Wichita, Kansas. Arch Intern Med. 2003;163(13):1530-1536.
  11. Reynolds KJ, Vernon SD, Bouchery E, Reeves WC. The economic impact of chronic fatigue syndrome. Cost Eff Resour Alloc.2004;2:4.
  12. Solomon L, Reeves WC. Factors influencing the diagnosis of chronic fatigue syndrome. Arch Intern Med. 2004;164(20):2241-2245.


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