Establishing a consensus on ME/CFS exclusionary illnesses

Leonard A. Jason*, Suvetha Ravichandran, Ben Z. Katz, Benjamin H. Natelson, Hector Fabio Bonilla

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: The diagnosis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is generally reached based on meeting the criteria of a case definition and eliminating other conditions that could be causing the patient’s symptoms. Investigators in the ME/CFS field are currently confronted with 139 medical exclusionary conditions listed among the various ME/CFS case definitions. There is a need to standardize the illnesses/diagnoses that should be excluded. Methods: Exclusionary conditions were listed for several prominent ME/CFS case definitions. From this list, symptoms were also identified as exclusionary by several physicians with experience in diagnosing ME/CFS. Input was also solicited from representatives from the patient community for a consensus list of exclusionary comorbid conditions. Results: Once overlapping illnesses were eliminated, a consensus was reached on a briefer set of exclusionary conditions. The final set of exclusionary conditions is divided into 14 categories with 53 specific examples. Conclusions: It is important for ME/CFS researchers to select uniform medical conditions to exclude from their studies so that samples across different studies are consistent and generate generalizable ME/CFS findings. This list can be applied to ME/CFS case definitions in order to enhance the reproducibility of identifying patients with ME/CFS for research studies.

Original languageEnglish (US)
Pages (from-to)1-13
Number of pages13
JournalFatigue: Biomedicine, Health and Behavior
Issue number1
StatePublished - 2023


  • Exclusionary
  • Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
  • case definitions
  • comorbidity
  • criterion variance

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health
  • Behavioral Neuroscience


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