Digital monitoring for integrated progression assessment of myalgic encephalomyelitis / chronic fatigue syndrome

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic condition with unclear etiology and a lack of diagnostic and progression biomarkers. Despite numerous studies investigating various biomedical aspects of ME/CFS, questions about recovery, reversibility, and progression remain unclear. At the same time, recent studies indicate biomarker patterns characteristic of severity classes, but given the fluctuating nature and the fact that most markers do not leave the normal range or no normal range is defined, diagnostic and prognostic capabilities are limited and have fewer chances for integration into the healthcare system. A digital assistant that follows patients at different stages and is integrated into the functional areas of the healthcare system could fill the gap. The proposed study will develop a digitally integrated assistance solution based on digital phenotyping, connecting digital biomarkers with the best possible set of serum biomarkers. The results will be ready for integration into symptom checker applications and, using the relevant ontology approach, in artificial intelligence systems. An important enabler of the digital assistant and digital health is coaching to improve patient self-management skills.

Outcomes

• Original scientific articles published, submitted or accepted for publication in the Q1 or Q2 quartile publications included in Web of Science Core Collection or SCOPUS databases - 1;
• Original scientific articles, published, submitted or accepted for publication in the scientific publications or conference symposia, included in Web of Science Core Collection or SCOPUS databases, for social, human and art sciences included in ERIH PLUS database - 2;
• Scientific databases and datasets developed within the project and prepared according to FAIR principles - 1;
• Other new product or technology, software copyrights (including methods, prototypes, treatment and diagnostic methods not to be commercialised, etc.) - 2;
• Project proposal submitted in an international call for research and development projects (competition abroad or submitted by an international consortium) - 1;
• Project proposal submitted in a Latvian call for research and development projects - 2;
• Doctoral thesis defended within the thematic focus of the project -1.

Project-related activities

• Ethics Approval Obtained and Data Management Plan Published (Q2 2025)
  In May 2025, the project received approval from the Rīga Stradiņš University Ethics Committee for the implementation of all planned research activities. In parallel, the project Data Management Plan was published in the Zenodo repository, ensuring compliance with the principles of Open Science.
• Development of the ME/CFS Monitoring Dashboard (MEPANEL) (Q3 2025)
  Within the project, a web-based prototype, MEPANEL, was developed for patient monitoring. The platform enables the administration of questionnaires, functional tests, self-assessment instruments, and other digital monitoring tools. It was used to evaluate usability and the acceptability of monitoring tasks and served as the foundation for subsequent mobile application development.
• Continued Patient Engagement and Refinement of the Monitoring Methodology (Q4 2025)
  Patient engagement and the refinement of monitoring instruments continued throughout the project. In the first phase, the collection of data on health status, fatigue, quality of life, and well-being was initiated using internationally validated and widely recognised questionnaire instruments. The data support the development of digital monitoring approaches and methodologies for assessing disease progression in ME/CFS.
• International Project ENCOURAGE-ME Approved (Q1 2026)
  The project team contributed to the development of the international project ENCOURAGE-ME (Engaging Coaching Outreach for Resilience in the Age of Chronic Fatigue: Education, Management and Empowerment for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome), which was approved under the European Partnership Transforming Health and Care Systems (THCS) call. The project commenced in 2026 in collaboration with partners from Canada, France, the Czech Republic, and Italy.
  Read more about the ENCOURAGE-ME project 
• Development of the MEMONITOR Mobile Application for ME/CFS Monitoring (Q2 2026)
  Building on the results of MEPANEL pilot testing and user feedback, the MEMONITOR mobile application was developed for people living with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The application enables remote monitoring of patient health status and the collection of research data. The application was delivered in project month 18 and is currently undergoing technical testing.

Major International Scientific Conference

• Participation in the 25th International Conference on Integrated Care (ICIC25), Lisbon, Portugal (14–16 May 2025)
  The International Foundation for Integrated Care conference is one of the leading international scientific forums in the field of integrated care. Contributions to the scientific programme are selected through a peer-review process, demonstrating the international relevance and scientific quality of the presented research. The following project results were presented and published in the International Journal of Integrated Care:
  • Arāja, D., Berķis, U., Krūmiņa, A., Murovska, M. Empowering ME/CFS Patients: A Predictive Model Using Digital Biomarkers and Integrated Care
  • Arāja, D., Krūmiņa, A., Murovska, M., Berķis, U. Transforming Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Care with Data-Driven Key Performance Indicators (KPIs): Insights and Impacts

Other conferences

• Additional dissemination activity. At the 10th Latvian Physicians' Congress, Rīga, Latvia, the project's lead researcher, Prof. Angelika Krūmiņa, participated in the scientific and practical session Current Issues in Infectious Diseases, presenting The Role of Infections in the Development of Fatigue Syndrome. Participation in one of Latvia's leading professional medical forums contributed to increasing awareness of the project's research topic and further strengthened the visibility of the project's scientific expertise within the healthcare community (12 June 2025)
• Participation in the 18th Annual Scientific Baltic Business Management Conference (ASBBMC), Rīga, Latvia. Arāja, D., Berķis, U., Krūmiņa, A., Murovska, M. presented Digital Monitoring of Disease as a Human-Centered Approach to Sustainable Health Systems (Rīga, Latvia, 27 May 2025)
  Conference abstracts
• Participation in the RSU 10th International Multidisciplinary Research Conference Society. Health. Welfare, Rīga, Latvia. Arāja, D., Nora-Krūkle, Z., Krūmiņa, A., Murovska, M., Berķis, U. presented Advancing Prevention for Under-Recognised Diseases: Myalgic Encephalomyelitis / Chronic Fatigue Syndrome and Fibromyalgia in Focus (26–28 March 2025) 
  Conference abstracts
• Participation in the RSU International Research Conference on Medical and Health Care Sciences Knowledge for Use in Practice, Rīga, Latvia. Arāja, D., Berķis, U., Nora-Krūkle, Z., Krūmiņa, A., Murovska, M. presented Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) and Long COVID: Shared Challenges and Opportunities in Chronic Disease Management (26–28 March 2025)
  Conference abstracts
• Participation in the 4th International Conference Nutrition and Health. Arāja, D., Murovska, M., Krūmiņa, A., Berķis, U. presented Nutrition Interventions for the Treatment of Myalgic Encephalomyelitis / Chronic Fatigue Syndrome: A Scoping Review (5–6 December 2024)
  Conference abstracts

Publications

• Araja, D., Murovska, M., Krumina, A., Eory, A., Berkis, U. Digital Approaches for Managing Brain Fog in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Interventions, Monitoring, and Future Directions. Life (Basel), 16(4), 571. (1 April 2026)
• Murovska, M., Krumina, A., Araja, D., Kujawski, S., Zalewski, P., Nora-Krukle, Z., Berkis, U. Myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia: overlap, differences, and emerging insights. Journal of Translational Medicine, 24(1), 425. (20 February 2026)

Project Research Team

• Uldis Berķis, Project Manager
• Modra Murovska,
• Angelika Krūmiņa