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Factors Affecting The Characterization Of Post-Exertional Malaise Derived From Patient Input

Friday 11 September 2020


From the Journal of Health Disparities Research and Practice:



Factors affecting the characterization of Post-Exertional Malaise derived from patient input

Carly S. Holtzman, DePaul University
Claire Fisher, DePaul University
Shaun Bhatia, DePaul University
Leonard A. Jason, DePaul University
September 3, 2020
All items in Digital Scholarship@UNLV are protected by original copyright, with all rights reserved, unless otherwise indicated.


post-exertional malaise; myalgic encephalomyelitis; chronic fatigue syndrome; participatory research; patient advocacy


Diagnosis | Immune System Diseases | Medicine and Health Sciences


The National Institutes of Health/Center for Disease Control and Prevention (NIH/CDC) Common Data Elements (CDE) established a post-exertional malaise (PEM) workgroup with the task of describing PEM and recommending a standardized way of assessing it in patients with myalgic encephalomyelitis and chronic fatigue syndrome (ME/CFS). As a stigmatized group, patients with ME/CFS are in need of instruments which can properly describe their symptomatic experiences, which can help reduce the disparity between illness seriousness and appropriate attention from healthcare. The current study explored attitudes and preferences among 115 patients with ME/CFS who participated in the creation of a patient-driven instrument to measure PEM, the key symptom of the illness. Themes that emerged from the qualitative analyses of patient feedback focused on how their illness was experienced; their access to care; problems with physicians, researchers, and research methods; and expressions of gratitude for the collaborative process. Domains that were most important to the patient community were identified in the effort to create a comprehensive measure of PEM. Benefits of community-based action research are discussed.

Recommended Citation

Holtzman, Carly S.; Fisher, Claire; Bhatia, Shaun; and Jason, Leonard A. (2020) "Factors Affecting the Characterization of Post-Exertional Malaise Derived from Patient Input," Journal of Health Disparities Research and Practice: Vol. 13 : Iss. 2 , Article 5.
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