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The following is a summary of “Effects of a novel differential diagnosis aid for managing patients with unexplained fatigue in primary care: a prospective randomized, controlled, open and multicenter study in primary care,” published in the May 2025 issue of BMC Primary Care by Känel et al. 

Researchers conducted a retrospective study to evaluate whether the Fatigue Differential Diagnostic Aid (FDDA) supported clinicians in improving the management of unexplained fatigue.  

They performed a cluster-randomized, controlled, open-label, multicenter study comparing the FDDA with usual care in individuals presenting unexplained fatigue as the main reason for the encounter. The primary endpoint was the difference in Patient Global Impression of Change (PGIC) between groups at 3 months. Secondary endpoints included PGIC change at 6 months, percentage with fatigue reduction, mean fatigue decrease, clinician confidence in diagnosis, patient satisfaction with diagnostic and treatment quality, number of clinician-reported visits, referral rates to specialists, and time to final diagnosis. Patients described fatigue using terms like weakness, exhaustion, lack of energy, difficulty initiating or sustaining activities, poor concentration, sleep issues, dizziness, and sometimes depression or anxiety. 

The results showed that 112 primary care practitioners (PCPs) in Switzerland were randomized between 2017 and 2020 into the FDDA group (n = 57) and the usual care group (n = 55). Of these, 15 FDDA and 22 usual care PCPs enrolled a total of 93 individuals (FDDA: n = 40; usual care: n = 53), below the targeted sample size. There was no significant difference in PGIC at 3 months between groups (D = 0.06, 95%-CI: -0.41 to -0.53, P= 0.802). Secondary endpoints showed no difference in PGIC at 6 months or in overall (OA) fatigue reduction. However, 18.9% more individuals in the FDDA group reported less fatigue at either 3 or 6 months (95%-CI: -33.6 to -4.3%, P= 0.011). Satisfaction with treatment management was higher in the FDDA group at 1 month (56.8% vs 25.0%, P= 0.004) and 3 months (64.9% vs 31.0%, P= 0.003). The FDDA group also had a higher median number of visits (4.0 vs 3.0, P< 0.001).  

Investigators concluded that the FDDA did not enhance SOA outcomes but showed benefits in fatigue reduction and care satisfaction. 

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-025-02873-3