@article{6d138c906c394dc7bb9ddd11f83b46a2,
title = "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management",
abstract = "Despite myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) affecting millions of people worldwide, many clinicians lack the knowledge to appropriately diagnose or manage ME/CFS. Unfortunately, clinical guidance has been scarce, obsolete, or potentially harmful. Consequently, up to 91% of patients in the United States remain undiagnosed, and those diagnosed often receive inappropriate treatment. These problems are of increasing importance because after acute COVID-19, a significant percentage of people remain ill for many months with an illness similar to ME/CFS. In 2015, the US National Academy of Medicine published new evidence-based clinical diagnostic criteria that have been adopted by the US Centers for Disease Control and Prevention. Furthermore, the United States and other governments as well as major health care organizations have recently withdrawn graded exercise and cognitive-behavioral therapy as the treatment of choice for patients with ME/CFS. Recently, 21 clinicians specializing in ME/CFS convened to discuss best clinical practices for adults affected by ME/CFS. This article summarizes their top recommendations for generalist and specialist health care providers based on recent scientific progress and decades of clinical experience. There are many steps that clinicians can take to improve the health, function, and quality of life of those with ME/CFS, including those in whom ME/CFS develops after COVID-19. Patients with a lingering illness that follows acute COVID-19 who do not fully meet criteria for ME/CFS may also benefit from these approaches.",
author = "Lucinda Bateman and Bested, {Alison C.} and Bonilla, {Hector F.} and Chheda, {Bela V.} and Lily Chu and Curtin, {Jennifer M.} and Dempsey, {Tania T.} and Dimmock, {Mary E.} and Dowell, {Theresa G.} and Donna Felsenstein and Kaufman, {David L.} and Klimas, {Nancy G.} and Komaroff, {Anthony L.} and Lapp, {Charles W.} and Levine, {Susan M.} and Montoya, {Jose G.} and Natelson, {Benjamin H.} and Peterson, {Daniel L.} and Podell, {Richard N.} and Rey, {Irma R.} and Ruhoy, {Ilene S.} and Vera-Nunez, {Maria A.} and Yellman, {Brayden P.}",
note = "Funding Information: Grant Support: This project was supported by funding from Open Medicine Foundation for travel and hotel costs for the 2018 and 2019 meetings of the ME/CFS Clinician Coalition. Funding Information: Grant Support: This project was supported by funding from Open Medicine Foundation for travel and hotel costs for the 2018 and 2019 meetings of the ME/CFS Clinician Coalition.Potential Competing Interests: Dr Felsenstein reports personal fees from Once Here Foundation, during the conduct of the study. Dr Lapp reports personal fees from AIM Immunotech, personal fees from Pfizer, and personal fees from Eli Lilly, outside the submitted work. Dr Komaroff reports personal fees from Serimmune, Inc., outside the submitted work. Dr Peterson reports a grant from AIM Immunotech, outside the submitted work.Peter C. Rowe, MD, Director, Children's Center Chronic Fatigue Clinic, and Professor of Pediatrics at the Johns Hopkins University School of Medicine, provided helpful insights on sections related to orthostatic intolerance. Bateman Horne Center provided valuable support for the annual US ME/CFS Clinician Coalition meetings, during which the information in this article was discussed. Publisher Copyright: {\textcopyright} 2021 The Authors",
year = "2021",
month = nov,
doi = "10.1016/j.mayocp.2021.07.004",
language = "English",
volume = "96",
pages = "2861--2878",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "11",
}