Meta-analysis investigating post-exertional malaise between patients and controls

J Health Psychol. Nov-Dec 2020;25(13-14):2053-2071. doi: 10.1177/1359105318784161. Epub 2018 Jul 5.


Post-exertional malaise is either required or included in many previously proposed case definitions of myalgic encephalomyelitis/chronic fatigue syndrome. A meta-analysis of odds ratios (ORs; association between patient status and post-exertional malaise status) and a number of potential moderators (i.e. study-level characteristics) of effect size were conducted. Post-exertional malaise was found to be 10.4 times more likely to be associated with a myalgic encephalomyelitis/chronic fatigue syndrome diagnosis than with control status. Significant moderators of effect size included patient recruitment strategy and control selection. These findings suggest that post-exertional malaise should be considered a cardinal symptom of myalgic encephalomyelitis/chronic fatigue syndrome.

Keywords: assessment; chronic fatigue syndrome; meta-analysis; myalgic encephalomyelitis; symptoms.

Publication types

  • Research Support, N.I.H., Extramural