Improving Diagnostic Accuracy of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Through a Point-of-Care Clinical Algorithm, 2026, Seltzer et al

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Improving Diagnostic Accuracy of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Through a Point-of-Care Clinical Algorithm

Spoiler: Authors

Seltzer, Jaime; Grach, Stephanie L.; Eggers, Scott D.; Redetzke, Melissa M.; Mau, Katie J.; Chon, Tony Y.; Ganesh, Ravindra

Abstract

Despite the increasing prevalence and median severity of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), medical education on the disease is scant, leading to a diagnostic crisis in which the majority of people with ME/CFS are undiagnosed.

We created a care process algorithm in AskMayoExpert accessible to all Mayo Clinic medical providers as a source for information on diagnosis and management of ME/CFS.

To evaluate whether the algorithm was associated with improved diagnostic accuracy, we compared concordance before versus after the algorithm was introduced, where concordance was defined as agreement between an appropriately coded referral to Mayo Clinic’s Chronic Fatigue Specialty Clinic and the specialty clinic with an expert diagnosis of ME/CFS.

Referrals to the Chronic Fatigue Specialty Clinic increased overall and were more likely to show concordance between specialist diagnosis and referral after the introduction of the ME/CFS AskMayoExpert algorithm.

Particularly in diseases that are prevalent and poorly understood, a point-of-care clinical tool may offer just-in-time opportunities to improve diagnosis and management.

Web | DOI | International Journal of Environmental Research and Public Health

 

[ahimsa]

I used the automated tool to create this thread, hope it looks okay!

I thought it was worth adding this part of the paper which is listed before the abstract:

Highlights

Public health relevance—How does this work relate to a public health issue?

• ME/CFS is a common, debilitating disease affecting millions in the United States.
• Prevalence has increased by several orders of magnitude due to COVID-19, yet the majority of patients remain undiagnosed.

Public health significance—Why is this work of significance to public health?

• Accessible, point-of-care clinical tools can significantly improve diagnostic accuracy and decrease diagnostic delay.
• Point-of-care tools require minimal resources yet may achieve measurable improvements in clinical practice, suggesting that educational gaps drive poor diagnostic outcomes, and that targeted knowledge delivery at the point of care can efficiently address public health-scale diagnostic crises.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?

• Point-of-care clinical decision support tools improve diagnosis and management of complex chronic conditions where medical education is inadequate; healthcare systems should prioritize developing and implementing such resources for poorly understood, prevalent diseases.
• Involving people with lived experience as co-creators of clinical tools and educational resources is essential for developing effective interventions, particularly for complex chronic conditions where clinical expertise alone may not capture critical diagnostic and management insights.