Evidence map›Paper›PMID 39084871›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2024

Underlying disease risk among patients with fatigue: a population-based cohort study in primary care.

Becky White, Nadine Zakkak, Cristina Renzi, Meena Rafiq, Arturo Gonzalez-Izquierdo, Spiros Denaxas, Brian D Nicholson, Georgios Lyratzopoulos, Matthew E Barclay

Abstract read
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Becky WhiteEpidemiology of Cancer Healthcare and Outcomes (ECHO) Research Group, Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK.ORCID http://orcid.org/0000-0002-0643-7890
Nadine ZakkakDepartment of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London; Cancer Intelligence, Cancer Research UK, London, UK.ORCID http://orcid.org/0000-0003-4155-7756
Cristina RenziECHO Research Group, Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK; associate professor, Faculty of Medicine, University Vita-Salute San Raffaele, Milan, Italy.ORCID http://orcid.org/0000-0003-3845-9493
Meena RafiqECHO Research Group, Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK; Department of General Practice and Primary Care, Centre for Cancer Research, University of Melbourne, Melbourne, Australia.ORCID http://orcid.org/0000-0002-1837-1542
Arturo Gonzalez-IzquierdoCentre for Health Data Science, Institute of Applied Health Research, University of Birmingham, Birmingham; Institute of Health Informatics (IHI), University College London, London, UK.ORCID http://orcid.org/0000-0002-0984-5830
Spiros DenaxasIHI, University College London, London; British Heart Foundation Data Science Centre, London, UK.ORCID http://orcid.org/0000-0001-9612-7791
Brian D NicholsonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-0661-7362
Georgios LyratzopoulosEpidemiology of Cancer Healthcare and Outcomes (ECHO) Research Group, Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK.ORCID http://orcid.org/0000-0002-2873-7421
Matthew E BarclayEpidemiology of Cancer Healthcare and Outcomes (ECHO) Research Group, Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK.ORCID http://orcid.org/0000-0003-1148-1922

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPresenting to primary care with fatigue is associated with a wide range of conditions, including cancer, although their relative likelihood is unknown.

aimTo quantify associations between new-onset fatigue presentation and subsequent diagnosis of various diseases, including cancer. DESIGN AND

settingA cohort study of patients presenting in English primary care with new-onset fatigue during 2007-2017 (the fatigue group) compared with patients who presented without fatigue (the non-fatigue group), using Clinical Practice Research Datalink data linked to hospital episodes and national cancer registration data.

methodThe excess short-term incidence of 237 diseases in patients who presented with fatigue compared with those who did not present with fatigue is described. Disease-specific 12-month risk by sex was modelled and the age-adjusted risk calculated.

resultsThe study included 304 914 people in the fatigue group and 423 671 in the non-fatigue group. In total, 127 of 237 diseases studied were more common in men who presented with fatigue than in men who did not, and 151 were more common in women who presented with fatigue. Diseases that were most strongly associated with fatigue included: depression; respiratory tract infections; insomnia and sleep disturbances; and hypo/hyperthyroidism (women only). By age 80 years, cancer was the third most common disease and had the fourth highest absolute excess risk in men who presented with fatigue (fatigue group: 7.01%, 95% confidence interval [CI] = 6.54 to 7.51; non-fatigue group: 3.36%, 95% CI = 3.08 to 3.67; absolute excess risk 3.65%). In women, cancer remained relatively infrequent; by age 80 years it had the thirteenth highest excess risk in patients who presented with fatigue.

conclusionThis study ranked the likelihood of possible diagnoses in patients who presented with fatigue, to inform diagnostic guidelines and doctors' decisions. Age-specific findings support recommendations to prioritise cancer investigation in older men (aged ≥70 years) with fatigue, but not in women at any age, based solely on the presence of fatigue.

Indexed as

cancercohort studiesdiagnosisfatigueprimary health careprodromal symptoms

Identifiers

PMID39084871
PMCPMC11653409

What Socratic holds

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LicenceCC BY
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Registered trials

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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 Socratic graph.