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Featured articleMyalgic encephalomyelitis/chronic fatigue syndrome is a featured article; it (or a previous version of it) has been identified as one of the best articles produced by the Wikipedia community. Even so, if you can update or improve it, please do so.
Main Page trophyThis article appeared on Wikipedia's Main Page as Today's featured article on November 25, 2024.
Did You Know Article milestones
DateProcessResult
March 9, 2024Good article nomineeListed
July 25, 2024Peer reviewReviewed
August 25, 2024Featured article candidatePromoted
Did You Know A fact from this article appeared on Wikipedia's Main Page in the "Did you know?" column on April 12, 2024.
The text of the entry was: Did you know ... that some people with severe myalgic encephalomyelitis/chronic fatigue syndrome can lose the ability to speak?
Current status: Featured article

Did you know nomination

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The following is an archived discussion of the DYK nomination of the article below. Please do not modify this page. Subsequent comments should be made on the appropriate discussion page (such as this nomination's talk page, the article's talk page or Wikipedia talk:Did you know), unless there is consensus to re-open the discussion at this page. No further edits should be made to this page.

The result was: promoted by PrimalMustelid talk 16:51, 8 April 2024 (UTC)[reply]

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Improved to Good Article status by Femke (talk), Ward20 (talk), and The Quirky Kitty (talk). Nominated by Femke (talk) at 08:49, 10 March 2024 (UTC). Post-promotion hook changes for this nom will be logged at Template talk:Did you know nominations/Myalgic encephalomyelitis/chronic fatigue syndrome; consider watching this nomination, if it is successful, until the hook appears on the Main Page.[reply]

General: Article is new enough and long enough
Policy: Article is sourced, neutral, and free of copyright problems
Hook: Hook has been verified by provided inline citation
QPQ: Done.

Overall: Overall a good read. NW1223<Howl at me•My hunts> 19:10, 15 March 2024 (UTC)[reply]

Either hook is good. NW1223<Howl at me•My hunts> 19:18, 15 March 2024 (UTC)[reply]

We are in WP:QPQ backlog mode. Double reviews are required.-TonyTheTiger (T / C / WP:FOUR / WP:CHICAGO / WP:WAWARD) 07:03, 17 March 2024 (UTC)[reply]

TonyTheTiger, according to https://qpqtool.toolforge.org/qpq/Femke, Femke has made nine DYK nominations, so she does not need an extra QPQ. TSventon (talk) 14:11, 17 March 2024 (UTC)[reply]
Double QPQ is not required. This nomination is good to go. NW1223<Howl at me•My hunts> 18:12, 17 March 2024 (UTC)[reply]
Yes, the QPQ check tool to the right counts only 9. I don't really trust the QPQ tool that much because it barely counts 40% of my own nominations. But If the nominator feels that they have done less than 20 noms this can go forward or they can do the double. This case is on the honor system.-TonyTheTiger (T / C / WP:FOUR / WP:CHICAGO / WP:WAWARD) 18:48, 17 March 2024 (UTC)[reply]
I don't see an obvious one missing on the list, but will help with the backlog when I've got some time to spare. —Femke 🐦 (talk) 19:03, 17 March 2024 (UTC)[reply]
The tool gives a complete list of the nominations made by Femke since she started editing in 2014. It does not pick up nominations made before 2011, but that is not relevant here. TSventon (talk) 20:11, 17 March 2024 (UTC)[reply]

Reference for duration of PEM

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Currently, the two sentences about PEM potentially lasting for months cite reference 10, a German document. I can't read German, but I translated a paragraph that I think it's referring to for this claim on page 6, and it just cites the IOM report (reference 1 below). So unless there is more relevant information in this German document about this claim, I think the reference should be changed to the IOM report.

The sentences are "This "crash" can last from hours or days to several months." and "PEM can last hours, days, weeks, or months."

1. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness

10. Myalgische Enzephalomyelitis / Chronic Fatigue Syndrome (ME/CFS): Aktueller Kenntnisstand


Also, this is immediately before the second sentence without an additional citation, so I assume it is also in the German document: "but [PEM] can also follow immediately after."

So if the reference above is changed for the second sentence, we'd need to ensure this sentence is still cited correctly. Dimpizzy (talk) 16:45, 9 February 2025 (UTC)[reply]

As the IOM report edges on 10 years, and the iQWiG report is only 2 years, that is the one preferred for WP:MEDRS reasons. The reason we use the more recent citations, even when they cite older work, is that a newer source makes clear that this is still accepted knowledge.
You're correct that all text preceding a citation should be covered by that citation, which can be more than one sentence. —Femke 🐦 (talk) 20:29, 9 February 2025 (UTC)[reply]
That makes sense, thanks for pointing me to that policy. Dimpizzy (talk) 20:33, 9 February 2025 (UTC)[reply]
@Femke Would it maybe be better to use this review which is also from 2023 and also cites the IOM report, because it is in English, considering this is an English Wikipedia page? Or is the iQWiG a more reputable source?
"The US Committee on the Diagnostic Criteria for ME/CFS describes PEM as having an immediate onset or occurring within 30 h, but it is outlined that PEM may also develop hours or days after the trigger has ceased (Locher and IOM, 2015). Moreover, the committee describes an unpredictable duration of PEM as it may last for hours, days, weeks, and even months. In accord, a survey demonstrated a large variability in reported onset and duration of PEM, and most of the respondents reported that they sometimes experienced an immediate onset and sometimes a delayed onset (Holtzman et al., 2019). The delay ranged from 1 h to a week, and the duration could last from 1 day to several months. Similar results have been reported by others (Chu et al., 2018; Stussman et al., 2020). Thus, the onset and duration of PEM have no definite pattern and seem to vary both within and between patients."
  1. Vøllestad, N. K., & Mengshoel, A. M. (2023). Post-exertional malaise in daily life and experimental exercise models in patients with myalgic encephalomyelitis/chronic fatigue syndrome. Frontiers in physiology, 14, 1257557. https://doi.org/10.3389/fphys.2023.1257557
The reason I'm asking is because this is the second time I've wanted to look at the evidence for a claim that came from this report (immediate PEM before, and months long duration this time), and I open an enormous PDF in a language I don't understand, and have no idea which part to try to translate to find the relevant details.
Dimpizzy (talk) 03:29, 10 February 2025 (UTC)[reply]
IQWiG is sort of the German NICE, so a top source. We typically avoid Frontiers Media journals, as they don't have a good reputation for fact checking. The best way to translate I've found is to copy-paste in a large language model like ChatGPT. If you copy-paste into DeepL, it struggles with the PDF formatting (the random enters).
The official guideline on using non-English sources is that it's fine as long as it's higher quality than equivalent English-language sourcing. I've used this on purpose, as I saw some pushback against NICE's 2021 clinical guidelines and wanted to make sure NICE wasn't an "oddity" in how they describe GET/CBT for instance. —Femke 🐦 (talk) 08:31, 10 February 2025 (UTC)[reply]
Okay, again makes sense, thank you! Dimpizzy (talk) 12:39, 10 February 2025 (UTC)[reply]

Sentences on long covid?

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Takeheed, could you explain what was confusing about the long covid sentence before? The new sentence is confusing to me. How can people be affected by criteria (rather than symptoms). It seems to make the overlap more speculative as well. —Femke 🐦 (talk) 17:43, 10 March 2025 (UTC)[reply]

Yes. And it's still confusing, because it's improper grammer. It also has/had a hanging modifier.
"... Before the COVID-19 pandemic, ME/CFS affected two to nine out of every 1,000 people,"
2 to 9 out of 1,000 people is not an accurate statistical modifier. It's like saying, 1 to 5 out of every 10, which would mean 2 separate polls are being taken within 10. And if they were, they should be sourced.
"... depending on the definition. "
What definition? ME or CFS? No definition has been defined in the paragraph for reference. Nor has the disease multiple definitions that relate to this paragraph.
"However, many people fit ME/CFS diagnostic criteria after contracting long COVID."
What does this mean when nothing is countering the statement for their to be a "however".
I'm can't babysit this topic to correct it. ME/CFSs validity is already highly questioned, and has a lot of stigma behind it. I don't see adding to its confusion--which is what this paragraph does--as helping it. Clear, concise information is all that is needed and should be written. Takeheed (talk) 01:39, 13 March 2025 (UTC)[reply]
I should also note that the position of the covid/long covid information is out of place, and that may be a contributor to its messiness. I suggest keeping the effects of the disease and the statistics in separate paragraphs or sections all together. Takeheed (talk) 01:47, 13 March 2025 (UTC)[reply]
I agree that the stable version was clearer than the new version, and more faithful to the sources. The new version introduced doubt the sources don’t. Innisfree987 (talk) 04:13, 13 March 2025 (UTC)[reply]

MCAS co-occurs with CFS?

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@Femke Can you please provide the data supporting the statement that MCAS co-occurs with CFS? And that it interacts with and worsens it? I don't see it in any reference. There is abundant misinformation about MCAS online, and I hope this article is not feeding it. Thank you. ScienceFlyer (talk) 16:53, 4 April 2025 (UTC)[reply]

I don't know about co-occurance with the old CFS, but the source for co-occurance with ME/CFS is as given. To quote "The CCC and ICC recognise numerous comorbidities that are often diagnosed with ME/CFS. These include (..) Immunological disorders such as MCAS, chronic infection. —Femke 🐦 (talk) 17:07, 4 April 2025 (UTC)[reply]
@ScienceFlyer, I’m confused about what question you’d like answered: the claim is clearly sourced in the entry to the BMJ Best Practice review, page 19, which Femke quoted in reply to you. Innisfree987 (talk) 22:11, 4 April 2025 (UTC)[reply]
I'm asking for the data supporting the three unsubstantiated claims that MCAS co-occurs with CFS, interacts with it, and worsens it. Why is MCAS (a rare condition) even mentioned in this article? And I cannot read BMJ Best Practice because it is paywalled. There must be a better source, if it exists at all.
Interestingly, there is data (source 1, source 2) and expert consensus that people with unexplained symptoms (including chronic fatigue) are being misdiagnosed with MCAS.
Let's improve the article by removing the three claims about MCAS, or by citing a better source. Thank you.ScienceFlyer (talk) 23:02, 4 April 2025 (UTC)[reply]
That sentence is also cited to a high-quality review (Mayo Clinic Proceedings). The relevant guidance there advises, under “Management Approach”:
“Treat Comorbidities. Treatment of comorbidities can positively affect a patient’s quality of life and severity of symptoms. Common comorbidities (Supplemental Table 3) include fibromyalgia, mast cell activation syndrome, postural orthostatic tachycardia syndrome, Ehlers-Danlos syndrome, sleep apnea, irritable bowel syndrome, and secondary depression/anxiety.”
Innisfree987 (talk) 23:50, 4 April 2025 (UTC)[reply]
The Bateman-2021 review has a number of fringe authors, and frankly I don't think it's a good idea to use it as a source. The Bateman-2021 review references a handout having many of the same authors, and in both references, it places "multiple chemical sensitivities" directly adjacent to it. Multiple chemical sensitivity is not a real condition. The claim in the Bateman-2021 supplement stating that MCAS and MCS are "Conditions Which Commonly Co-exist with ME/CFS" is simply false.
To summarize: There is no data supporting the three unsubstantiated claims that MCAS co-occurs with CFS, interacts with it, and worsens it. And the only references are from people who legitimize a pseudoscientific diagnosis and make false claims. And of course anyone who is a proponent of non-specific (and discredited) diagnostic criteria for MCAS is not reliable as well. ScienceFlyer (talk) 00:12, 5 April 2025 (UTC)[reply]
It sounds to me like we have BMJ and Mayo Clinic Proceedings that regard these as legitimate findings against a WP editor’s personal view that they’re fringe. Innisfree987 (talk) 00:18, 5 April 2025 (UTC)[reply]
Again, no data to support the three claims. ScienceFlyer (talk) 00:24, 5 April 2025 (UTC)[reply]
? We have two highly regarded review articles verifying it. Innisfree987 (talk) 00:27, 5 April 2025 (UTC)[reply]
While MCAS is rare, I think that is why it is mentioned. It's odd that two rare (ME isn't rare, but a lot of research has been done on the assumption that it is) coexist frequently, especially if we don't have a solid explanation for this. IntentionallyDense (Contribs) 03:11, 5 April 2025 (UTC)[reply]
ScienceFlyer, your asserting without support that folks are fringe, and using the outdated term for ME/CFS, which was associated with a more "vague" symptom description and might be perceived as belittling. Can you use the standard term?
You're asking us to delve into non-MEDRS primary sourcing. Normally, that practice is a bit frowned upon by some, as we should trust MEDRS sourcing. The first primary source I found however does support the claim, but only for post-covid ME/CFS. This source came out after the other two I believe, so it's not the origin of the claim. —Femke 🐦 (talk) 06:32, 5 April 2025 (UTC)[reply]
Femke you may correct me on this, but assuming that the MCAS statement was in the article at the time of the FA review, I would find it hard to believe that no one would have questioned this then if there was anything to question here. IntentionallyDense (Contribs) 20:02, 5 April 2025 (UTC)[reply]
Yes, this sentence was in the article at the time of the FA review. Of course, a FA review doesn't capture everything, but it does imply some form of consensus. —Femke 🐦 (talk) 08:41, 6 April 2025 (UTC)[reply]
While yes, FA review doesn't always catch every issue, people are pretty strict with MEDRS at a FA level and I'd be surprised that no one would have questioned things if there was a fringe claim with fringe sources. IntentionallyDense (Contribs) 17:58, 6 April 2025 (UTC)[reply]
Note that calling people fringe without evidence comes close to a BLP vio. —Femke 🐦 (talk) 06:33, 5 April 2025 (UTC)[reply]

NPOV?

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Surely I cant be the only one who feels like this article is profoundly not neutral in that it feels argumentative and written from a position of a very biased CFS/ME patient/parent? Like I'm a doc and I do believe CFS could sometimes be caused by actual non-psychiatric illnesses but when the article about it feels this "ideological" it just really doesnt help the CFS sufferers' case! 5.44.170.181 (talk) 05:48, 25 April 2025 (UTC)[reply]

There's been quite a dramatic change in how medical authorities see the disesase in the last 10-15 years. So, as somebody who may have learned about ME/CFS in medical school some time ago, this may seem non-neutral, but I do believe it's a good reflection of the highest-quality sources out there. The article relies strongly on NICE, IOM, IQWIG and similar sources. Is there anything in particular you feel is not neutral? —Femke 🐦 (talk) 07:12, 25 April 2025 (UTC)[reply]
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