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 .
Conclusions Serious somatic disease is rare in patients complaining of tiredness .
Since prevalence is similar in patients without tiredness , the association may not be causal .
Background Tiredness 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 .
Frequency of 'warning signs of cancer' in Norwegian general practice, with prospective recording of subsequent cancer.
BACKGROUND Early diagnosis of cancer is an important challenge in general practice . Symptoms are the most common starting points . OBJECTIVE To assess the association between symptoms presented and subsequent cancer . DESIGN A cohort study of all patients seen consecutively by GPs . Prospect i ve recording of cancer diagnosis , new cancer or new recurrence . SETTING Two hundred and eighty-three general practice surgeries and 10 working days . METHOD During patient consultations , GPs registered seven focal symptoms and three general symptoms , commonly considered as warning signs of cancer ( WSC ) . Follow-up 6 - 11 months later with registration of any subsequent diagnosis of cancer was done . RESULTS Of 51 073 patients , 6321 ( 12.4 % ) had recordings of 7704 WSC . During a median follow-up period of 8 months , 263 patients were diagnosed with cancer and 59 of them with recurrence of a previously diagnosed cancer . Of the cancer patients , 106 ( 40 % ) had presented one or more WSC during a preceding consultation . Examined symptoms had likelihood ratios for cancer from 1.5 to 8.2 and positive predictive values ( PPVs ) from 0.8 % to 3.8 % . Limited to older age groups , PPVs were a little higher . General symptoms were rarely associated with cancer unless a focal symptom had been recorded as well . Multiple symptoms increased the probability of cancer . CONCLUSION 12.4 % of GP patients presented with WSC  .  A general symptom may have cancer diagnostic value , but usually , only when it occurs along with a focal symptom . PPV of any single symptom is low , and decisions about referral require additional information
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 .
Conclusions Serious somatic disease is rare in patients complaining of tiredness .
Since prevalence is similar in patients without tiredness , the association may not be causal .
Background Tiredness 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 .