SynthesisBMC family practice2016
The differential diagnosis of tiredness: a systematic review.
Synthesis in BMC family practice, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Prevalence, aetiologies and prognosis of the symptom cough in primary care: a systematic review and meta-analysis.BMC family practice · 2021Pooled it
- Coughing children in family practice and primary care: a systematic review of prevalence, aetiology and prognosis.BMC pediatrics · 2021Pooled it
- A Literature Review of GP Knowledge and Understanding of ME/CFS: A Report from the Socioeconomic Working Group of the European Network on ME/CFS (EUROMENE).Medicina (Kaunas, Lithuania) · 2020Pooled it
- Association of serum 25-hydroxyvitamin D levels with fatigue severity in adults: A cross-sectional study.Northern clinics of Istanbul · 2026Article
- Development and validation of the tiredness identification index: a combined scale for the assessment of fatigue and sleepiness.Sleep advances : a journal of the Sleep Research Society · 2026Article
- Use of thyroid hormones in euthyroid patients with unexplained fatigue: analyses of aggregate data from European national surveys of professional endocrine society members.Frontiers in endocrinology · 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
- [Fatigue in chronic physical diseases].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2024Review
- Mediating effects of social support, mental health between stress overload, fatigue and turnover intention among operating theatre nurses.BMC nursing · 2023Article
- The Temporal Relationship between Depressive Symptoms and Loneliness: The Moderating Role of Self-Compassion.Behavioral sciences (Basel, Switzerland) · 2023Article
- Underlying cancer risk among patients with fatigue and other vague symptoms: a population-based cohort study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- Association of Anemia with Clinical Symptoms Commonly Attributed to Anemia-Analysis of Two Population-Based Cohorts.Journal of clinical medicine · 2023Article
- Quality of life in the older adults: The protective role of self-efficacy in adequate coping in patients with chronic diseases.Frontiers in psychology · 2023Article
- Clinical Characteristics of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Diagnosed in Patients with Long COVID.Medicina (Kaunas, Lithuania) · 2022Article
- A comprehensive review of approaches to detect fatigue using machine learning techniques.Chronic diseases and translational medicine · 2022Review
- A Novel Physical Fatigue Assessment Method Utilizing Heart Rate Variability and Pulse Arrival Time towards Personalized Feedback with Wearable Sensors.Sensors (Basel, Switzerland) · 2022Article
- Fatigue as the Chief Complaint–Epidemiology, Causes, Diagnosis, and Treatment.Deutsches Arzteblatt international · 2021Review
- Short-term cognitive fatigue effect on auditory temporal order judgments.Experimental brain research · 2020Article
- Time for a reassessment of the treatment of hypothyroidism.BMC endocrine disorders · 2019Article
- Comparing comorbidity measures and fatigue post myocardial infarction.Applied nursing research : ANR · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTiredness is one of the most frequent complaints in primary care. Although often self-limiting and frequently associated with psychosocial stress, patients but also their physicians are often uncertain regarding a serious cause and appropriate diagnostic work-up. We conducted a systematic review and meta-analysis of studies reporting on differential diagnosis of fatigue in primary care.
methodsMEDLINE, EMBASE and conference abstracts were searched for primary care based studies of patients presenting with tiredness. Twenty-six studies were included. We report on anaemia, malignancy, serious organic disease, depression and the chronic fatigue syndrome (CFS) as causes of tiredness as presenting complaint.
resultsWe found considerable heterogeneity of estimates which was reduced by limiting our analysis to high quality studies. Prevalences were as follows-anaemia: 2.8 % (CI (confidence interval) 1.6-4.8 %); malignancy: 0.6 % (CI 0.3-1.3 %); serious somatic disease: 4.3 % (CI 2.7-6.7 %); depression 18.5 % (CI 16.2-21.0 %). Pooling was not appropriate for CFS. In studies with control groups of patients without the symptom of tiredness, prevalence of somatic disease was identical to those complaining of tiredness. Depression, however, was more frequent among those with tiredness.
conclusionsSerious somatic disease is rare in patients complaining of tiredness. Since prevalence is similar in patients without tiredness, the association may not be causal. Extensive investigations are only warranted in case of specific findings from the history or clinical examination. Instead, attention should focus on depression and psychosocial problems.
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Registered trials
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.