Diagnostic Guidelines
Detailed guidance on the diagnosis of ME can be obtained from:
NICE – ME/CFS: diagnosis and management [NG206] October 2021
This guideline covers children, young people and adults. It includes recommendations on diagnosis, assessment and care planning, safeguarding, access to care and managing ME/CFS and its symptoms.
Doctors with ME: Putting it into Practice: What NICE ME/CFS means for GPs
ME Association: ME/CFS/PVFS: an exploration of the key clinical issues
the ‘purple book’ is updated annually by UK GP Dr Charles Shepherd and neurologist Abhijit Chaudhuri. (Health professionals can contact the MEA for a free copy.)
Myalgic Encephalomyelitis – adult and pediatric: International Consensus Primer for medical practitioners
The 2011 International Consensus Primer covers criteria, pathophysiology, and diagnostic and treatment protocols and is a later development of the widely accepted Canadian criteria: Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners (2005)
Diagnosing and treating Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: – U.S. Clinical coalition v. 2
A 2021 coalition’s clinician’s guide, testing recommendations for suspected ME and treatment recommendations.
Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome: Diagnosis and management in young people: a primer (2017)
Although paediatric ME overlaps with adult ME this paediatric primer was developed to cover the many unique aspects of the diagnosis and management of paediatric ME/CFS.
Physical signs
A number of practitioners are exploring the use of physical examination to identify signs of ME:
- U.S. Clinical Coalition – Testing recommendations for ME/CFS – includes tests to positively support a diagnosis of ME/CFS (rather than ruling out other conditions) e.g. 4-point salivary cortisol test, 10 – 20 minute passive standing test (NASA Lean test), Tilt Table Test
- Other potential tests and biomarkers – The handgrip strength test is one of the promising physical tests under investigation.
