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Diagnostic biomarker
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===Two-day cardiopulmonary exercise test=== ''{{main article| page_name =Two-day cardiopulmonary exercise test}}'' The [[two-day cardiopulmonary exercise test]] or 2-day CPET is an accepted, reliable test for [[post-exertional malaise]] (PEM), one of the cardinal symptoms that distinguishes between individuals with and without ME/CFS.<ref name="Davenport, 2011" /> Obstacles for use: The 2-day CPET "carries substantial risk for these patients as it may worsen their condition."<ref name="IOM2015MECFS" /> A single day CPET is a common test used as a cardiac stress test and therefore the equipment is widely available at medical centers, however, medical personnel would need to be educated on how to interpret a 2-day CPET test for ME/CFS diagnosis.
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