Abstract Background Fatigue is a common symptom in people living with inflammatory bowel diseases (IBD) with a prevalence of up to 80% in patients during a flare and in up to half of all patients with IBD even when the disease is in remission. Fatigue can be assessed via questionnaires, but this is not regularly done in clinical practice. This study retrospectively evaluated fatigue prevalence before and after the introduction of a regular structured assessment via questionnaires. Methods In March 2023, the IBD outpatient unit at University Medical Center Mannheim introduced the standardized assessment of fatigue using the FACIT Fatigue questionnaire. To identify the prevalence of fatigue prior to the introduction of these assessments, we analyzed patient reports from Jan 1st 2022 through Dec 31st 2022, searching our clinical documentation system for keywords related to fatigue. Secondly, we used a Large Language Model (LLM) to detect fatigue-related symptoms documented in the afore-mentioned system during the same period of time. The LLM search was performed using a Llama 3.1 70B model of Meta with a “reasoning” approach. To examine fatigue prevalence, we used the FACIT Fatigue questionnaire, a self-report instrument with scores ranging between 0 – 52, with lower scores indicating more fatigue. The presence of fatigue in our sample was defined as the percentage of patients with FACIT-Fatigue scores 30, indicating severe fatigue. Results In 2022, there were 1515 documented IBD outpatient contact entries in our database. Of these, the semantic search via search function identified 124 fatigue-related entries, resulting in a fatigue symptom prevalence of 8,2%. Analyzing the anonymized patient reports with the LLM yielded a prevalence of 8.9%. (Fig. 1). From March 2023 to December 2024, 439 outpatients with IBD (70.9% Crohńs Disease, 28.9% Ulcerative Colitis) completed the FACIT Fatigue questionnaire. Of these, n = 149 scored 30 points, indicating a prevalence of severe fatigue in 33.9% of the returned questionnaires. Conclusion This retrospective comparison of fatigue prevalence in a German tertiary IBD center before and after the introduction of a structured fatigue assessment reveals striking differences in the fatigue detection rates, with less than 10% of consultation notes mentioning fatigue, but every third patient reporting severe fatigue in questionnaire-based assessments. The generalizability of these results is limited by the monocentric approach and the descriptive nature of the data with a lack of a possibility for formal statistical comparison due to different methods of fatigue assessment at different time points. However, this study supports recommendations for a structured assessment of fatigue in IBD outpatients. Conflict of interest: Dr. Knödler, Laura-Louise: Fees for preparing presentations: presentation at CED compact 2024 and CED compact 2025: CED Service GmbH Reimbursement of participation fees for education courses: Janssen Cilag (participation in the CEDxperts program 2021-2022), AbbVie (participation in the CED Skills Lab 2025), AbbVie and Ferring (participation in the DACED conferences) Grants: Clinician Scientist Program ICON: University of Heidelberg Medical Faculty Mannheim Wilke, Eva Lina: Fees for preparing presentations: presentation at CED compact 2024 and CED compact 2025: CED Service GmbH Reimbursement of participation fees for education courses: Janssen Cilag (participation in the CEDxperts program 2021-2022), AbbVie (participation in the CED Skills Lab 2025), AbbVie and Ferring (participation in the DACED conferences) Grants: Clinician Scientist Program ICON: University of Heidelberg Medical Faculty Mannheim Herrmann, Eva Katrin: No conflict of interest Wiest, Isabella: Speakers honoraria: AstraZeneca Ebert, Matthias Philip: No conflict of interest Reindl, Wolfgang: Speaker fees from Janssen, Abbvie, Takeda, MSD,Falk Advisory fees Janssen, Abbvie, Takeda Thomann, Anne: Personal Fees: Speakers honoraria and/or advisory boards: Alfasigma, Abbvie, Falk Foundation, Ferring, Galapagos, Hexal, Janssen/J & J, Takeda Non-financial Support: Travel support: Allergosan, Janssen/J & J, Takeda, Abbvie
Knödler et al. (Thu,) studied this question.