{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T22:07:29Z","timestamp":1766182049735,"version":"build-2065373602"},"reference-count":53,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia, Portugal","doi-asserted-by":"publisher","award":["SFRH\/BD\/149758\/2019","UIDB\/00006\/2020","081_596653860","HR22-00741","PPN\/ULM\/2020\/1\/00069\/U\/00001"],"award-info":[{"award-number":["SFRH\/BD\/149758\/2019","UIDB\/00006\/2020","081_596653860","HR22-00741","PPN\/ULM\/2020\/1\/00069\/U\/00001"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Fundacion la Caixa, Spain","award":["SFRH\/BD\/149758\/2019","UIDB\/00006\/2020","081_596653860","HR22-00741","PPN\/ULM\/2020\/1\/00069\/U\/00001"],"award-info":[{"award-number":["SFRH\/BD\/149758\/2019","UIDB\/00006\/2020","081_596653860","HR22-00741","PPN\/ULM\/2020\/1\/00069\/U\/00001"]}]},{"DOI":"10.13039\/501100014434","name":"Polish National Agency for Academic Exchange, Poland","doi-asserted-by":"publisher","award":["SFRH\/BD\/149758\/2019","UIDB\/00006\/2020","081_596653860","HR22-00741","PPN\/ULM\/2020\/1\/00069\/U\/00001"],"award-info":[{"award-number":["SFRH\/BD\/149758\/2019","UIDB\/00006\/2020","081_596653860","HR22-00741","PPN\/ULM\/2020\/1\/00069\/U\/00001"]}],"id":[{"id":"10.13039\/501100014434","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Misdiagnosis of myalgic encephalomyelitis\/chronic fatigue syndrome (ME\/CFS) can occur when different case definitions are used by clinicians (relative misdiagnosis) or when failing the genuine diagnosis of another disease (misdiagnosis in a strict sense). This problem translates to a recurrent difficulty in reproducing research findings. To tackle this problem, we simulated data from case-control studies under misdiagnosis in a strict sense. We then estimated the power to detect a genuine association between a potential causal factor and ME\/CFS. A minimum power of 80% was obtained for studies with more than 500 individuals per study group. When the simulation study was extended to the situation where the potential causal factor could not be determined perfectly (e.g., seropositive\/seronegative in serological association studies), the minimum power of 80% could only be achieved in studies with more than 1000 individuals per group. In conclusion, current ME\/CFS studies have suboptimal power under the assumption of misdiagnosis. This power can be improved by increasing the overall sample size using multi-centric studies, reporting the excluded illnesses and their exclusion criteria, or focusing on a homogeneous cohort of ME\/CFS patients with a specific pathological mechanism where the chance of misdiagnosis is reduced.<\/jats:p>","DOI":"10.3390\/diagnostics13030531","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T04:27:02Z","timestamp":1675225622000},"page":"531","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of Misdiagnosis in Case-Control Studies of Myalgic Encephalomyelitis\/Chronic Fatigue Syndrome"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4389-1483","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Malato","sequence":"first","affiliation":[{"name":"Instituto de Medicina Molecular Jo\u00e3o Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal"},{"name":"CEAUL\u2014Centro de Estat\u00edstica e Aplica\u00e7\u00f5es da Universidade de Lisboa, 1749-016 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6935-8500","authenticated-orcid":false,"given":"Lu\u00eds","family":"Gra\u00e7a","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Molecular Jo\u00e3o Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8542-1706","authenticated-orcid":false,"given":"Nuno","family":"Sep\u00falveda","sequence":"additional","affiliation":[{"name":"CEAUL\u2014Centro de Estat\u00edstica e Aplica\u00e7\u00f5es da Universidade de Lisboa, 1749-016 Lisboa, Portugal"},{"name":"Faculty of Mathematics and Information Science, Warsaw University of Technology, 00-662 Warszawa, Poland"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"953","DOI":"10.7326\/0003-4819-121-12-199412150-00009","article-title":"The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study","volume":"121","author":"Fukuda","year":"1994","journal-title":"Ann. 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