Systematic Review of the Epidemiological Burden of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Across Europe: Current Evidence and  EUROMENE Research Recommendations for Epidemiology

Abstract

This review aimed at determining the prevalence and incidence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in Europe. We conducted a  primary search in Scopus, PubMed and Web of Science for publications between 1994  and 15 June 2019 (PROSPERO: CRD42017078688). Additionally, we performed a  backward-(reference lists) and forward-(citations) search of the works included  in this review. Grey literature was addressed by contacting all members of the  European Network on ME/CFS (EUROMENE). Independent reviewers searched, screened  and selected studies, extracted data and evaluated the methodological and  reporting quality. For prevalence, two studies in adults and one study in  adolescents were included. Prevalence ranged from 0.1% to 2.2%. Two studies also  included incidence estimates. In conclusion, studies on the prevalence and  incidence of ME/CFS in Europe were scarce. Our findings point to the pressing  need for well-designed and statistically powered epidemiological studies. To  overcome the shortcomings of the current state-of-the-art, EUROMENE recommends  that future research is better conducted in the community, reviewing the clinical  history of potential cases, obtaining additional objective information (when  needed) and using adequate ME/CFS case definitions; namely, the Centers for  Disease Control & Prevention-1994, Canadian Consensus Criteria, or Institute of  Medicine criteria.