Overall the interventions demonstrated mixed results in terms of effectiveness. All conclusions about effectiveness should be considered together with any methodological inadequacies of the studies. Interventions for which there is evidence of effectiveness from RCTs include cognitive behavioural therapy and graded exercise therapy. In some of the included studies, bed or wheelchair restricted patients have been excluded and only one study included young people under 18 years of age, which raises questions about the applicability of findings to all people with CFS/ME.
Further research is needed into (i) how subgroups of patients may respond differently to treatments and (ii) the potential additive or combined effects of treatments where more than one therapy is used. The large number of outcome measures used makes standardisation of outcomes a priority for future research. Future research needs to combine scientific rigour with patient acceptability and good quality research is needed to evaluate the effectiveness of a range of interventions including pacing, ideally in comparison with CBT and GET.