Canadian criteria and Bell score
This questionnaire reproduces two published instruments: the Canadian Consensus Criteria for ME/CFS by Carruthers and colleagues (2003) and the Bell score (1995) for the severity of the limitation. You can complete it here and see the evaluation immediately.
The evaluation is at the bottom of this page and fills in as soon as you tick the first box.
The result is not a diagnosis. It only states whether the conditions printed on the sheet apply. ME/CFS is a clinical diagnosis made after excluding other possible illnesses that can also cause such complaints. The assessment belongs in the consultation.
Nothing is transmitted while you complete it. The evaluation is calculated by your own browser; unless you expressly press “Send to the clinic”, none of your details leave your device. Alternatively, you can print the result and bring it to your appointment.
Differential diagnoses and comorbidities
ME/CFS is a clinical diagnosis made after excluding other possible illnesses that can also cause such complaints, such as fibromyalgia, severe digestive disorders or Hashimoto’s thyroiditis and others.
Important differential diagnoses of CFS
Rheumatology
- Undifferentiated connective tissue disease/
PMR/ Sjögren’s syndrome - Fibromyalgia*
- Ankylosing spondylitis/
psoriatic arthritis
Endocrinology/
- Hashimoto’s thyroiditis*
- Endometriosis*
Haematology/
- Cancer-related fatigue
Infections
- Chronic hepatitis
- Lyme disease
Gastroenterology
- IBD, coeliac disease
- Irritable bowel syndrome*
- PBC/
PSC
Neurology
- Cervical spinal stenosis/
instability* - Myasthenia gravis
- Multiple sclerosis
*can also occur as a comorbidity of CFS
More common comorbidities of CFS
Immunology
- Immunoglobulin deficiency/
susceptibility to infection - Mast cell activation syndrome
- Severe allergies
Rheumatology
- Fibromyalgia*
- Ehlers–Danlos syndrome
- Sicca symptoms (rule out Sjögren’s syndrome!)
Autonomic dysfunction
- POTS/
resting tachycardia - Orthostatic hypotension
Gastroenterology
- Irritable bowel syndrome
- Food intolerances
Neurology
- Cervical spine instability/
spinal stenosis - Small fibre neuropathies
- Migraine
- Hypersensitivity
Sleep
- Sleep apnoea
- Restless legs syndrome
Endocrinology/
- Hashimoto’s thyroiditis*
- Metabolic syndrome
- Endometriosis*
Where the questionnaire comes from
- Carruthers BM, Kumar Jain A, De Meirleir KL, et al. Myalgic Encephalomyelitis/Chronic Fatigue Syndrom: Clinical Working Case Definition, Diagnostic and Treatment Protocols. Journal of Chronic Fatigue Syndrom 2003;11(1):7-97.
- Bell score 1995. From: The Doctor’s Guide to Chronic Fatigue Syndrome, David S. Bell, MD, p. 122 f. Addison-Wesley Publishing Company, Reading, MA.
- Questionnaire sheet: Charité Fatigue Centrum, https://cfc.charite.de/
Further information on diagnosis and treatment
- Nacul L, Authier J, Scheibenbogen C et al. EUROPEAN ME NETWORK (EUROMENE) Expert Consensus on the Diagnosis, Service Provision and Care of People with ME/CFS in Europe. www.preprints.org/manuscript/202009.0688/v2
- Charité Fatigue Centrum cfc.charite.de
For an appointment in the specialist consultation, please register using the registration form.