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. 2011 Jul 6;2011(7):CD008205. doi: 10.1002/14651858.CD008205.pub2

Ballauff 1999

Methods Prospective cohort study
Participants N of patients original cohort: 50; N of patients described study group: 50; N of patients study group of interest: 50; N of patients with liver function tests: 50
Tumour: various tumours; Time period diagnosis/treatment: 1980‐1991; Age at diagnosis: nm; Age at follow‐up: median 12.3 (6.7‐24.5) yr; F/M%: 36/64; BMI: nm
N of patients hepatitis virus infection: 14/50 (28.0%) anti‐HCV+, HCV‐RNA+, 2/50 (4.0%) anti‐HCV+, HCV‐RNA and 2/50 (4.0%) HBsAntigen+
N of patients acute liver disease: 43/50 (86.0%) elevated AST/ALT during chemotherapy; 13/50 (26.0%) elevated bilirubin and GGT during chemotherapy
Follow‐up duration: median 3.6 (0.5‐11.8) yr after end of treatment; Completion of follow‐up: 100%
Interventions N of patients chemotherapy: 50/50 (100%); Chemotherapy type: nm; Chemotherapy dose: nm
N of patients radiotherapy involving the liver: nm; Radiotherapy field: nm; Radiotherapy dose: nm
N of patients hepatectomy: nm
N of patients BMT: nm
N of patients blood transfusion: 50/50 (100%)
Outcomes Method of detection of hepatic late adverse effects: ALT, AST, bilirubin, GGT (frequency of testing nm)
Definition of hepatic late adverse effects: ALT > normal (24 U/L), AST > normal (22 U/L), bilirubin >1.5 mg/dL (normal: 0.3 mg/dL), GGT >100 U/L (normal: 20 U/L)
N of patients hepatic late adverse effects at end of follow‐up: 16/50 (32.0%)
Risk factors: Chronic HBV/HCV infection: 13/16 (81.3%) with abnormal liver function tests chronic HBV/HCV infection versus 2/34 (5.9%) with normal liver function tests chronic HBV/HCV infection (P=0.001) (Univariate)
Notes
Risk of bias
Bias Authors' judgement Support for judgement
Representative study group Low risk Described study group consisted of more than 90% of the original cohort
Complete follow‐up assessment Low risk Outcome was assessed for more than 90% of the study group of interest
Blinded outcome assessor Unclear risk Unclear if outcome assessors were blinded to the investigated determinant
Adjustment important confounders High risk Important prognostic factors or follow‐up were not taken into account
Well defined study group High risk Type of chemotherapy was not mentioned
Well defined follow‐up Low risk Length of follow‐up was mentioned
Well defined outcome High risk Outcome definition was not objective and precise
Well defined risk estimation Low risk Chi2 was calculated