Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2009
Ordering blood tests for patients with unexplained fatigue in general practice: what does it yield? Results of the VAMPIRE trial.
Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 4 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Overuse of diagnostic testing in healthcare: a systematic review.BMJ quality & safety · 2022Pooled it
- Functional Somatic Symptoms.Deutsches Arzteblatt international · 2019Pooled it
- Pooled it
- The differential diagnosis of tiredness: a systematic review.BMC family practice · 2016Pooled it
- Additional Investigations and Referrals by Primary Care Physicians in Uncertain Clinical Situations: Cross-Sectional Study Using Virtual Patient-Based Scenarios.JMIR formative research · 2026Article
- Prevalence of Ferritin Testing, Iron Deficiency, and Iron Supplementation Among Women with Fatigue in Ambulatory Care.Journal of general internal medicine · 2026Article
- GPs' perspectives on diagnostic testing in children with persistent non-specific symptoms: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Fatigue as main symptom in an elderly multiple myeloma patient: a Case Report.Frontiers in medicine · 2025Article
- Underlying disease risk among patients with fatigue: a population-based cohort study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Prioritising primary care patients with unexpected weight loss for cancer investigation: diagnostic accuracy study (update).BMJ (Clinical research ed.) · 2024Article
- The Influence of Branched-Chain Amino Acid Supplementation on Fatigue and Tryptophan Metabolism After Acute and Chronic Exercise in Older Adults: Protocol for a Pilot Randomized Controlled Trial.JMIR research protocols · 2023Article
- Approach to fatigue in primary care.Singapore medical journal · 2022Article
- Making and managing medical anomalies: Exploring the classification of 'medically unexplained symptoms'.Social studies of science · 2020Article
- "A false sense of confidence" The perceived role of inflammatory point-of-care testing in managing urinary tract infections in Dutch nursing homes: a qualitative study.BMC geriatrics · 2020Article
- RETRACTED: Prioritising primary care patients with unexpected weight loss for cancer investigation: diagnostic accuracy study.BMJ (Clinical research ed.) · 2020Article
- Artificial intelligence and diagnosis in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Article
- Chronic fatigue syndrome: identifying zebras amongst the horses.BMC medicine · 2009Article
- Tired all the time: can new research on fatigue help clinicians?The British journal of general practice : the journal of the Royal College of General Practitioners · 2009Article
- Interventions to Educate Family Physicians to Change Test Ordering: Systematic Review of Randomized Controlled Trials.Academic pathologyArticle
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnexplained fatigue is frequently encountered in general practice. Because of the low prior probability of underlying somatic pathology, the positive predictive value of abnormal (blood) test results is limited in such patients.
aimThe study objectives were to investigate the relationship between established diagnoses and the occurrence of abnormal blood test results among patients with unexplained fatigue; to survey the effects of the postponement of test ordering on this relationship; and to explore consultation-related determinants of abnormal test results. DESIGN OF STUDY: Cluster randomised trial.
settingGeneral practices of 91 GPs in the Netherlands.
methodGPs were randomised to immediate or postponed blood-test ordering. Patients with new unexplained fatigue were included. Limited and expanded sets of blood tests were ordered either immediately or after 4 weeks. Diagnoses during the 1-year follow-up period were extracted from medical records. Two-by-two tables were generated. To establish independent determinants of abnormal test results, a multivariate logistic regression model was used.
resultsData of 325 patients were analysed (71% women; mean age 41 years). Eight per cent of patients had a somatic illness that was detectable by blood-test ordering. The number of false-positive test results increased in particular in the expanded test set. Patients rarely re-consulted after 4 weeks. Test postponement did not affect the distribution of patients over the two-by-two tables. No independent consultation-related determinants of abnormal test results were found.
conclusionResults support restricting the number of tests ordered because of the increased risk of false-positive test results from expanded test sets. Although the number of re-consulting patients was small, the data do not refute the advice to postpone blood-test ordering for medical reasons in patients with unexplained fatigue in general practice.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.