Cluster analysis of ME/CFS symptoms in DecodeME reveals two subgroups and a link to onset type

Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating, often infection-triggered illness with no cure and no effective treatment. Marked symptom heterogeneity hampers diagnosis, disease management, and trial design. Using phenotype data from the world's largest ME/CFS cohort, this study aimed to identify groups of patients with similar symptom profiles using cluster analysis, to assess the association between cluster membership and onset type, and to explore genetic associations with cluster membership. Methods: This study included 19,019 DecodeME participants, ages 16 and over, with ME/CFS in the UK, from 2022-2024. We performed a k-modes cluster analysis