Pathology testing in the tired patient--a rational approach

Area of Science:

• General Practice
• Clinical Pathology
• Diagnostic Testing

Background:

• General practitioners (GPs) commonly encounter patients with nonspecific symptoms like tiredness.
• Pathology testing is a frequent diagnostic tool used by GPs for these patients.

Purpose of the Study:

• To examine the pathology tests regularly ordered by GPs for investigating tiredness.
• To assess the diagnostic value and rationale behind these tests in general practice.

Main Methods:

• Review of common pathology tests requested by GPs for patients presenting with tiredness.
• Analysis of the utility and yield of these tests in identifying significant pathology.

Main Results:

• GPs investigate approximately 50% of tired patients, often during the initial consultation.
• Tiredness accounts for 4.6% of all pathology tests and 2.3% of the growth in GP-ordered pathology tests.
• Commonly requested tests include Full Blood Count (FBC), electrolytes and urea (EUC), thyroid-stimulating hormone (TSH), ferritin, and liver function tests (LFTs).

Conclusions:

• Investigations for tiredness are primarily aimed at excluding serious diagnoses and providing patient reassurance.
• Current pathology testing practices for tiredness demonstrate a low detection rate for serious underlying conditions.
• There is a need for evidence-based guidelines tailored to general practice to optimize the investigation of tired patients.