Johannsdottir 2012.

Methods	Study design: cross‐sectional study Instrument used to assess fatigue: Fatigue Questionnaire Validated questionnaire: yes Cut‐off score or criterion for severe fatigue: sum score of ≥ 4 on the Fatigue Questionnaire and symptom duration of ≥ 6 months Time points at which outcome data were collected: NA, cross‐sectional study Inclusion criteria: a histologically‐verified diagnosis of AML, IA, or WT, treatment according to established protocols in the period from 1985 to 2001, age ≥ 1 year at time of diagnosis, age ≥ 13 years at time of assessment, complete remission at time of assessment, no secondary malignancy, no cancer treatment during the previous 3 years Exclusion criteria: Down syndrome or mental retardation
Participants	Sample characteristics: N of participants original cohort: unknown; N of participants described study group: 398 ; N of participants study group of interest: 398; N of participants fatigue assessed: 395 Participant characteristics: Tumour type: AML n = 90, WT n = 183, IA n = 125 Tumour stage: nm Age at diagnosis: range 1 ‐ 18 years, YG mean 5.5 years (SD 2.9), OG mean 8.0 years (SD 4.1) Time since diagnosis: YG mean 10 years (SD 3.2), OG mean 16 years (SD 3.7) Age at assessment: YG mean 16 years (SD 1.7), OG mean 24 (SD3.3) F/M:YG 73/78, OG 136/111 BMI: nm Race/ethnicity: nm Marital status: nm Highest completed education level: nm Physical activity level: nm Sleeping problems: nm Psychosocial problems: nm Comorbidities: nm Genetic factors/mutations: nm
Interventions	N of participants chemotherapy: 34 N of participants surgery: 94 N of participants surgery + radiotherapy: 20 N of participants surgery + chemotherapy: 104 N of participants surgery, chemotherapy and radiotherapy:73 N of participants BMT/SCT: 56 N of participants treatment unknown: 11 N of participants treatment not stated: 6
Outcomes	Severe fatigue: N of participants with severe fatigue: 43/395 (10.9%), YG 10/149 (6.7%), OG 33/246 (13.4%) Risk and associated factorsa: Dependent factor: severe fatigue (yes/no) Univariable: Signifcant: diagnosis (ref = controls, AML OR 1.63 (95% CI 0.62 to 4.30), IA OR 2.56 (95% CI 1.30 to 5.06) P < 0.01, WT OR 2.98 (95% CI 1.61 to 5.50) P < 0.01) Non‐significant: age at assessment (OR 1.03 (95% CI 0.97 to 1.08)), gender (OR 1.58 (95% CI 0.97 to 2.55)), academic education (OR 0.69 (95% CI 0.40 to 1.20)), married/cohabiting (OR 1.32 (95% CI 0.83 to 2.11)), gainfully employed (OR 1.10 (95% CI 0.67 to 1.80)), treatment modalities, time since diagnosis Multivariable: Significant: age at assessment (OR 1.08, (95% CI 1.01 to 1.16) P < 0.05) Non‐significant: gender (female; OR 1.54 (95% CI 0.94 to 2.54), academic education (OR 0.63 (95% CI 0.36 to 1.12)), married/cohabiting (OR 1.09 (95% CI 0.64 to 1.85)), gainfully employed (OR 1.18 (95% CI 0.67 to 2.07))
Notes	Funding sources: The study was supported by a grant from the Norwegian Cancer Society and the Nordic Cancer Union without any involvement in the conduction of study or writing of this article Declaration of interest: nm Results are presented separately for young survivors (YG; aged 13 ‐ 18 years, n = 151) and older survivors (OG; aged ≥ 19 years, n = 247) aResults are presented of the analysis with the fatigued OG (n = 33) and control group (n = 44). Effect estimates for treatment modalities and time since diagnosis were not reported. P values were not reported for non‐significant risk and associated factors in the article
Risk of bias
Bias	Authors' judgement	Support for judgement
Representative study group (selection bias)	High risk	Size of original cohort is unclear, 584 eligible participants, 398 described study group, < 90%
Adequate follow‐up assessment (attrition bias)	Low risk	Outcome was assessed for > 95% of the study group of interest
Blinded outcome assessor (detection bias) All outcomes	High risk	Outcome assessors were not blinded to the investigated determinant
Adjustment important confounders	High risk	Follow‐up was not taken into account
Well‐defined study group (reporting bias)	Unclear risk	Type of cancer and cancer treatment are mentioned but information about specific chemotherapeutic agents, radiotherapy fields and doses are not reported. Inclusion and exclusion criteria are described
Well‐defined follow‐up (reporting bias)	Low risk	Length of follow‐up was mentioned
Well‐defined outcome severe fatigue (reporting bias) All outcomes	Low risk	The authors reported which instrument they used to assess fatigue and what they considered to be severe fatigue
Well‐defined outcome fatigue (reporting bias)	Low risk	Authors reported which instrument they used to assess fatigue, and how they described fatigue (severe fatigue)
Well‐defined risk estimation	Unclear risk	Prevalence rates are provided for subgroups based on age at assessment and odds ratio are calculated, but not for all factors