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. 2023 Aug 4;9(3):e003056. doi: 10.1136/rmdopen-2023-003056

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© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Identified determinants of fatigue categorised within the ICF model. The overall direction of associations between determinants and fatigue across reviews were summarised and colour-coded for (A) rheumatoid arthritis, (B) spondyloarthritis, (C) osteoarthritis and (D) fibromyalgia. A positive association indicates that an increase in the factors contributes to more severe experiences of fatigue. These summaries are reported independent of strength (weak, moderate or strong) and statistical significance of the associations. The bubble size represents the number of underlying studies according to the reviews that studied these associations. *In multivariable analyses, only worrying coping retained its significant association with fatigue. †Higher fatigue during winter was suggested, but multivariable analyses were inconsistent. ‡Variable summarising a concept that includes ≥2 dimensions: for details, see online supplemental file S7–S10. FM, fibromyalgia; ICF, international classification of functioning; GI, gastrointestinal.