The 20 Years Ago Today Series III: the Most Influential Researchers of the Last 20 Years

Who's made the most difference in the chronic fatigue syndrome research field? A measure called the 'H-index' attempts to determine the impact a researcher has had on a field based on how often his/her work is cited by others. Researchers publishing 'seminal' papers in highly read journals will do the best. The index does not measure who's measures who's work is read and cited the most by other researchers. The higher the score the bigger the impact.

The index is not perfect; flaws have been pointed out but it does give us a good sense of who's had the most impact in the CFS research field. One thing to note, early important papers can wrack up a lot of points if they become standards for the field.

To get the H-index for researchers studying chronic fatigue syndrome, each researchers name and the phrase 'chronic fatigue syndrome' was entered in the Google citations search boxes

The Top Five - the Old Guard

The work of the top five most influential CFS researchers all dates back at least to the early 1990's. Each of these authors, with the exception of Dr. Reeves, published early studies which have been cited hundreds of times by other researchers and their work has played a major role in determining how CFS is perceived inside the research community. Two of them played major roles in instituting the chokehold CBT/GET has on treatment studies.

Dr. Reeves is the odd man out; he didn't start published regularly until the late 1990's, but his publication of several seminal papers during the 2,000's cemented his grip on the top five. Only one researcher with a predominantly pathophysiological approach to ME/CFS, Dr. Natelson, was in the top five.

Simon Wessely - H-index 62

Simon Wessely may say he's retired but he's still very active with 6 papers published on chronic fatigue syndrome in the last year and a half. If the Google citation index is anywhere near accurate Simon Wessely has been the force that many people have thought him to be; his papers have been regularly cited in major journals for many years and his H-index is 50% higher than the next researcher.

Wessely's most cited paper, Cognitive Behavioral Therapy for CFS (1998) (377 times) is just ahead of his 1998 book Chronic Fatigue and its Syndromes (cited 366 times). Wessely's appeal, however, is not entirely based on his behavioral orientation; four of his top six cited documents are on subjects like neuroendocrine responses, low dose hydrocortisone, prognosis and prevalence.

Dr. Benjamin Natelson - H-index 41

The leader of one of most productive NIH sponsored CFS research groups in the 1990's, Dr. Natelson has investigated many aspects of ME/CFS. His most cited papers are on information processing, neuropsychological impairments, cognitive functioning and brain MRI's. Natelson believes everyone - and he literally means everyone with a chronic illness (and he may go further than that) would benefit from CBT, but he's forged a career looking at the physiological side, in particular, the central nervous system side of ME/CFS. His work suggests that CFS and FM may be very different and after 25 years of research he remains quite active; he's currently engaged in studies that could break up ME/CFS into patients with and without depression and is working on a follow-up to his spinal fluid magnetic spectroscopy studies.

Dr. Dedra Buchwald - University of Washington, Seattle - H-index - 39

Dr. Buchwald ran the NIH funded CFS Research Center in Seattle in the 1990's. (The fact the two of the top three researchers in the field ran NIH funded research centers speaks of the centers productivity -and the corresponding loss when they were shut down in the early 2,000's). A proponent of CBT, Buchwald also believes that biological abnormalities are present in the disorder. Dr. Buchwald has become more and more focused over time on identifying conditions that are co-morbid with CFS. Buchwald's most cited paper, a 2003 Review of Chronic Fatigue Syndrome, clearly made an impression as it's rare to have a relatively recent paper with so many citations (except see Dr. Reeves, below).

William Reeves - former CDC CFS Chief Investigator - H-Index - 39

Reeves came to CFS later than the top 3 investigators and published less but clearly made his mark while he was there. Perhaps the most influential researcher during his time Reeves top six papers all were published from 2003-2010. His most cited paper identified problems with the Fukuda Definition; his 2005 follow-up paper on the 'Empirical Definition' estranged the CDC from much of the research community but his next most cited paper, a 2003 prevalence paper, suggested that CFS was a "major health problem' and a 2004 paper on indicated ME/CFS cost the economy billions of dollars in losses.

Gus Bleijenberg - H-index 39

One of the most active CBT researchers, Bleigenberg's 2001 CBT Trial in Lancet has been cited over 330 times but it's his 1994 "Dimensional Assessment of CFS' paper examining the behavioral, cognitive, emotional and social aspects of CFS which has drawn the most attention. (It's the six most cited CFS paper of all time (440 times). ) Other than that his most cited papers have been on fluoxetine, prognosis of CFS abd the measurement of fatigue. His 2005 CBT study was a big hit garnering 120 citations in 7 years. Bleijenberg has reportedly retired.

The Top Fifteen

Things even out a bit after the top five. Of the next ten, three focus on behavioral issues while 7 are focused on pathophysiological issues.

Next comes Dr. Komaroff of Harvard (37) who has examined many different areas of ME/CFS: CBT specialist Chalder (and originator of the Chalder Fatigue Scale); the immunologist Dr. Nancy Klimas (33); Dr. White with his behavioral focus (32); psychiatrist Dr. Michael Sharpe; former head of NIH CFS Research, Dr. Stephen Straus (32); immunologist Mary Fletcher (32); psychoneuroimmunologist Dr Maes (31); epidemiologist Dr. Leonard Jason (28) and then Dr. Andrew Lloyd (28).

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Someone has been busy with their calculator. Really interesting work, thank you, and I think it does give a good measure of who has been most influential in the field.
Just a pity it does not mention "who's right" - SW we know was not (despite his volume of papers) - surely influence in ME/CFS - the disease itself - lies with all the researchers finding all the pathologies and advancing understanding of the disease, not a tally of/dependant on how many papers published or quoted.
I think one reason the psych lobby (I can't bring myself to call them researchers) "score" so high is that they cite each other like crazy. It becomes very circular and self-referential. And they certainly do not cite studies showing biological abnormalities, which refute their pet theories.

Good scientific papers will cite studies whose results conflict with the author's thesis, and discuss possible explanations for the disparity. Good scientists, when forming a hypothesis, try to find out that fits all the facts (or at least they mention and try to explain the outliers). What bugs me most about the psych model proponents is that they practice junk science. Anything that doesn't fit their theory --and that's a huge body of knowledge-- they simply ignore and don't mention. They have no respect for the scientific process. Add to that the fact that they have received most of the research funding and it's no wonder their papers are cited most.

But being highly cited is not the same thing as advancing the state of knowledge. Ultimately it will be the researchers who unravel the mystery of this disease who are influential. The obstructionists with their junk science, if they are remembered at all, will be quoted as examples of the quaint and backward, the way today we look at those who said that educating women would cause their uteruses to shrink. Unfortunately, in the meantime they use their influence to do a lot of damage.
I quite agree ixchelkali. Well said.
I think that's a very good point...much more money has been spent on physiological research in the US I would guess that no single subject has gotten more research than CBT...on the other hand the biological studies are spread all over the place...a bit on the HPA axis here, a bit on natural killer cells here - the body of work most of the fields of research is quite low...

I would also guess that CBT researchers have been pretty good at getting published in high attention Journals as well - that makes a big difference.

I don't know why that piece came out in italics...that's kind of weird..

I think one reason the psych lobby (I can't bring myself to call them researchers) "score" so high is that they cite each other like crazy. It becomes very circular and self-referential. And they certainly do not cite studies showing biological abnormalities, which refute their pet theories.
Thanks for this Cort. Its a very interesting read.

I think everyone knew who'd had that most influence on the field and this proves it.
I am interested in what scientists do for ME, since that's the disease I suffer from. CFS is not a disease.

Some scientists with a significant impact on our understanding of ME are: Baraniuk, Chia, Hyde, Kuratsune, Suhadolnik.

I would not call Gijs (not: Gus) Bleijenberg a scientist.