The updated sentences are given below, and the changes have been highlighted in bold typeface.
Characteristics of RCTs meeting the inclusion criteria
From the PubMed and Cochran databases, a total of 513 articles were initially identified, and 56 articles ultimately met the inclusion criteria for this study (Fig. 1). Fifty-one RCTs (91.1%) were conducted for adult patients, while 5 RCTs (8.9%) were conducted for the adolescent population (Table 1). The majority of RCTs were conducted in 3 countries: the UK (n = 16), the Netherlands (n = 14), and the USA (n = 9). Regarding interventions, 29 RCTs (51.8%) conducted nonpharmacological interventions, 25 RCTs (44.6%) conducted pharmacological interventions and 2 RCTs conducted a combination of pharmacological and nonpharmacological interventions (Tables 2 and 3).
Characteristics of participants and case definitions for inclusion criteria
In 56 RCTs, a total of 6956 participants (1713 males and 5243 females, 6499 adults with a mean age of 40.2 ± 4.0 years and 457 adolescents with a mean age of 15.5 ± 0.3 years) were enrolled. Fifty-five RCTs (98.2%) adapted at least one of the following CFS case definitions: CDC 1994 (Fukuda) criteria (42 RCTs), Oxford 1991 (Sharpe) criteria (13 RCTs), CDC 1988 (Holmes) criteria (3 RCTs), Lloyd 1988 criteria (2 RCTs), and Schluederberg 1992 (2 RCTs).
Main outcome measurement
A total of 31 primary measurement tools were used to assess the main outcome in 56 RCTs. The Checklist Individual Strength (CIS) was the most frequently used (35.7%), and others included the 36-item Short Form health survey (SF-36, 32.1%), Sickness Impact Profile (SIP, 14.3%), Chalder Fatigue Scale (14.3%), Visual Analogue Scale (VAS, 10.7%) and Clinical Global Impression (CGI, 8.9%). There were 29 RCTs that used multiple primary measurements (Table 1).
RCTs with nonpharmacological interventions
There were 29 RCTs in the nonpharmacological category (26 for adults, 3 for adolescents) with 19 kinds of interventions, mainly CBT (n = 12), exercise (n = 6), and self-care (n = 5). The mean treatment period was 18.5 ± 8.9 weeks (17.1 ± 7.1 weeks for adults, 30.7 ± 15.1 weeks for adolescents). Of the 12 CBT subcategories, 6 RCTs showed statistical effectiveness of CBT compared to the control [41, 44, 46, 49, 50, 52]. In addition, 4 RCTs of graded-exercise-related therapies [46, 53, 55, 56] and 3 RCTs of integrative, consumer-driven rehabilitation [64], acupuncture [65] and abdominal tuina [67] showed a significantly effect of the intervention compared to the control (Table 3).