1. Sign our petition calling on Cochrane to withdraw their review of Exercise Therapy for CFS here.
    Dismiss Notice
  2. Guest, the 'News in Brief' for the week beginning 27th November 2023 is here.
    Dismiss Notice
  3. Welcome! To read the Core Purpose and Values of our forum, click here.
    Dismiss Notice

Review Biomarkers for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): a systematic review, 2023, Maksoud et al

Discussion in 'ME/CFS research' started by Wyva, May 24, 2023.

  1. Wyva

    Wyva Senior Member (Voting Rights)

    Budapest, Hungary

    Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a multifaceted condition that affects most body systems. There is currently no known diagnostic biomarker; instead, diagnosis is dependent on application of symptom-based case criteria following exclusion of any other potential medical conditions. While there are some studies that report potential biomarkers for ME/CFS, their efficacy has not been validated. The aim of this systematic review is to collate and appraise literature pertaining to a potential biomarker(s) which may effectively differentiate ME/CFS patients from healthy controls.

    This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane review guidelines. PubMed, Embase and Scopus were systematically searched for articles containing “biomarker” and “ME/CFS” keywords in the abstract or title and if they included the following criteria: (1) were observational studies published between December 1994 and April 2022; (2) involved adult human participants; (3) full text is available in English (4) original research; (5) diagnosis of ME/CFS patients made according to the Fukuda criteria (1994), Canadian Consensus Criteria (2003), International Consensus Criteria (2011) or Institute of Medicine Criteria (2015); (6) study investigated potential biomarkers of ME/CFS compared to healthy controls. Quality and Bias were assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Case Control Studies.

    A total of 101 publications were included in this systematic review. Potential biomarkers ranged from genetic/epigenetic (19.8%), immunological (29.7%), metabolomics/mitochondrial/microbiome (14.85%), endovascular/circulatory (17.82%), neurological (7.92%), ion channel (8.91%) and physical dysfunction biomarkers (8.91%). Most of the potential biomarkers reported were blood-based (79.2%). Use of lymphocytes as a model to investigate ME/CFS pathology was prominent among immune-based biomarkers. Most biomarkers had secondary (43.56%) or tertiary (54.47%) selectivity, which is the ability for the biomarker to identify a disease-causing agent, and a moderate (59.40%) to complex (39.60%) ease-of-detection, including the requirement of specialised equipment.

    All potential ME/CFS biomarkers differed in efficiency, quality, and translatability as a diagnostic marker. Reproducibility of findings between the included publications were limited, however, several studies validated the involvement of immune dysfunction in the pathology of ME/CFS and the use of lymphocytes as a model to investigate the pathomechanism of illness. The heterogeneity shown across many of the included studies highlights the need for multidisciplinary research and uniform protocols in ME/CFS biomarker research.

    Open access: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-023-02893-9
    Michelle, EzzieD, RedFox and 16 others like this.
  2. ME/CFS Skeptic

    ME/CFS Skeptic Senior Member (Voting Rights)

    " AUC, sensitivity, specifcity, and accuracy were reported in only some of the studies (n=35, 34.65%). Due to the limited number of studies that included these values, an average was not calculated."
    Michelle, RedFox, Milo and 6 others like this.
  3. Adrian

    Adrian Administrator Staff Member

    That feels a bit simplistic. things like accuracy (F1 would be better) are measures of a classifiers performance and when looking at that they should be looking at what the comparison is. A biomarker that picks out ME vs not ill is potentially very different from a biomarker that picks out ME from other patients (MS, Lupus, RA, .....).

    It feels like any systematic review would review performance in terms of what the assessment test is really checking. The danger is a bio marker would pick out ill vs not ill rather than ME.
    Tilly, Michelle, Sean and 6 others like this.

Share This Page