Our Outcomes, and the Honest Version of the Data
We measure client outcomes with two instruments: the SF-36 Health Survey, used in clinical research worldwide, and our own Nervous System Health Assessment. This page shows what that data says, how we collect it, and where it is thin. We report observed outcomes in a self-selected coaching population, not a controlled trial.
The Numbers at a Glance
Two complementary instruments, kept separate on purpose. The Nervous System Health Assessment (NSHA) gives us scale and repeated within-person tracking. The SF-36 gives us an external, internationally validated yardstick that we do not control.
Who this data describes
Ages 9 to 86 (median 40). Illness duration from 1 month to 69 years (median 4 years). Conditions include CFS/ME, long COVID, post-viral fatigue, fibromyalgia, POTS, and dysautonomia.
Severity at intake
Share of clients at each activity level on their first assessment (n=1,752 with activity data). 34.9% arrive housebound or worse.
The most common symptoms at intake
Share of 2,393 clients reporting each symptom on their first assessment. The average person reports 13.2 symptoms at once, from a list of 282 we track.
Nervous System Health Assessment (NSHA): within-person change
Our proprietary assessment maps cognitive capabilities (7 sub-domains), physical capabilities (7 sub-domains), symptom load, polarization patterns, and activity levels. 817 clients completed 2 or more assessments, giving within-person before-and-after data over a median tracking period of 123 days (about 4 months). We compare each client's first assessment with their most recent one.
"Improved" counts any measurable positive change from a client's first assessment to their most recent. We show the average magnitude alongside each rate so the numbers are not read as all-or-nothing.
SF-36 Health Survey: within-person change
The SF-36 is a standardized health survey widely used in clinical research. We score it with the standard RAND-36 method: eight domains, each on a 0 to 100 scale where higher is better. Each client is compared with their own baseline, and change is shown in points. Of the 829 clients who completed a baseline survey, 178 have a counted baseline and follow-up, a median of 5.8 months apart. Their average change across all eight domains was +21.7 points.
Where clients start: SF-36 baseline scores
Score out of 100 at baseline, where higher is better (n=178 paired clients). Role Limitation (Physical) at 4.2 of 100 means near-total inability to carry out normal daily roles.
| SF-36 Domain | Baseline | Follow-up | Change (95% CI) | % With a Higher Score |
|---|---|---|---|---|
| Physical Functioning | 45.6 | 68.0 | +22.4 (±3.4) | 82% |
| Role Limitation (Physical) | 4.2 | 26.6 | +22.4 (±5.3) | 44% |
| Role Limitation (Emotional) | 20.9 | 53.7 | +32.9 (±6.8) | 54% |
| Energy / Fatigue | 23.6 | 43.8 | +20.2 (±3.1) | 79% |
| Emotional Wellbeing | 48.3 | 64.9 | +16.6 (±2.8) | 76% |
| Social Functioning | 34.6 | 61.2 | +26.6 (±3.7) | 82% |
| Pain | 57.9 | 70.2 | +12.2 (±3.8) | 55% |
| General Health | 29.6 | 50.1 | +20.5 (±4.0) | 76% |
| Average Change (All 8 Domains) | +21.7 | |||
Scores run from 0 to 100, and higher means better health in every domain, including pain (a higher pain score means less pain). Change is each client's follow-up score minus their own baseline, averaged across clients, with its 95% confidence interval. % With a Higher Score is the share of clients whose score went up. Every domain includes 178 clients except social functioning (177). Change is calculated before rounding, so a few rows differ by 0.1 from the rounded baseline and follow-up columns. The pairing rule: each client's follow-up is their latest Survey 2 that has a Survey 1 at least 30 days before it, and their baseline is the most recent Survey 1 at least 30 days before that follow-up. Staff and test submissions are excluded.
By time between surveys. Average change across all eight domains was larger among clients with more time between their baseline and follow-up. Each row is a different group of clients, and those groups may differ in ways beyond time, so read this as an observed pattern.
| Months Between Surveys | Clients (n) | Average Change (All 8 Domains) |
|---|---|---|
| 0 to 6 | 100 | +17.7 |
| 6 to 12 | 47 | +25.0 |
| 12+ | 31 | +29.7 |
By domain. The table below shows the same three groups across all eight SF-36 domains, with each cell showing the average change in points from baseline to follow-up. Average change was positive in every domain for every group, and because each column is a different group of clients, the same caveat applies.
| SF-36 Domain | 0 to 6 Months (n = 100) | 6 to 12 Months (n = 47) | 12+ Months (n = 31) |
|---|---|---|---|
| Physical Functioning | +17.5 | +23.1 | +36.9 |
| Role Limitation (Physical) | +17.8 | +31.2 | +24.2 |
| Role Limitation (Emotional) | +28.8 | +36.2 | +40.9 |
| Energy / Fatigue | +17.9 | +22.2 | +24.5 |
| Emotional Well-being | +13.3 | +19.1 | +23.3 |
| Social Functioning | +23.1 | +30.3 | +32.3 |
| Pain | +8.6 | +15.4 | +19.0 |
| General Health | +14.5 | +22.5 | +36.6 |
Download the data (CSV). Baseline, follow-up and change for every domain and group. SF-36 data as of September 16, 2026.
Average Change by Baseline Need
We split the 178 paired clients into thirds by their average baseline score. Average change across all eight domains was +24.4 points for the highest-need third (n = 59), +23.0 for the moderate third (n = 60), and +17.8 for the milder third (n = 59). Part of this gap is likely regression to the mean: clients who start near the floor tend to score higher when measured again, whatever happens in between. We present it as an observed pattern worth studying.
What This Data Can and Cannot Say
- These are aggregate, observed outcomes, not controlled trial results. There is no control group and no randomization.
- The population is self-selected. Clients who complete a follow-up survey may differ from those who do not, which can bias results upward.
- SF-36 follow-up completion is 21.5% so far (178 of the 829 clients with a baseline survey; 25.4% among clients whose baseline was at least 12 months ago).
- Some subgroups are small. The 12+ months-between-surveys group is 31 people.
- The highest-need subgroup analysis is affected by regression to the mean.
- The SF-36 measures function and quality of life, not post-exertional malaise (the defining feature of ME/CFS). A normal-range score reflects normal-range functioning on this instrument, not a clinical determination of recovery.
- We are transparent about all of this, and we will report the updated numbers as the larger cohort matures, whichever direction they move.
The Questions a Careful Reviewer Should Ask
These are the toughest fair questions about our data, asked the way a skeptical clinician or researcher would ask them, with our honest answers. We'd rather raise them ourselves than have you wonder if we've thought about them.
Your SF-36 sample is only 178 people. Isn't that small?
▼Does the SF-36 data show the same people improving over time?
▼Is the "clients who started with the lowest scores improved most" result just regression to the mean?
▼Without a control group, how do you know the recovery system caused any of this?
▼The NSHA is a questionnaire you designed yourselves. Why should anyone trust it?
▼"64% improved" by how much? Does any tiny change count?
▼What about the people who didn't improve and stopped filling in surveys?
▼Explore the Data Yourself: The Live Outcomes Dashboard
The numbers on this page are a fixed snapshot, dated September 16, 2026, while the dashboard moves as new surveys come in. The full dataset lives in an interactive dashboard that reads our SF-36 responses directly, scores them with the standard RAND-36 method, and shows the before-and-after change across all eight domains with filters, effect sizes, and confidence intervals. It's recomputed from the latest survey data each time it's opened, so as the 643 pending follow-up surveys come in, the dashboard updates with them.
All charts run on de-identified data. Access is code-gated, and we share it with verified healthcare professionals.
We verify each request and reply with your access code and our practitioner packet: the outcomes one-pager, the methodology and limitations write-up, and our referral guide. Prefer email? Write to [email protected] or message us on LinkedIn.
Already have a code? Open the dashboard.
Want the Full Picture?
We keep a detailed outcomes whitepaper with the complete methodology, scoring approach, sample sizes, and every limitation. If you are a clinician evaluating our work, or a person deciding whether this is worth your time, we would rather you scrutinize it than take our word for it.
For Practitioners: request the whitepaper
You can also watch clients tell their stories on our recovery stories page, or take the free Nervous System Health Assessment to see where you stand.