Khan 2014.

Methods	Study design: cross‐sectional study Instrument used to assess fatigue: Brief Fatigue Inventory Validated questionnaire: yes Cut‐off score or criterion for severe fatigue: mean score > 7a Time points at which outcome data were collected: NA, cross‐sectional study Inclusion criteria: treatment on institutional protocol, at least 5 years from the time of ALL diagnosis, at least 1 year from completion of all cancer therapy, English as a primary language, absence of a pre‐existing cognitive disorder preventing study evaluation Exclusion criteria: nm
Participants	Sample characteristics: N of participants original cohort: unknown; N of participants described study group: 162; N of participants study group of interest: 162; N of participants fatigue assessed: 162 Participant characteristics: Tumour type: ALL n = 162 Tumour stage: nm Age at diagnosis: median 3.9 years (range 0.4 ‐ 18.6) Time since diagnosis and/or end of therapy: median 10.2 years (range 5 ‐ 22.7) and median 7.4 years (range 1.9 ‐ 20.3) Age at assessment: median 15.7 years (range 6.9 ‐ 29.0) F/M: 72/90 BMI: nm Race/ethnicity: White n = 146 Marital status: nm Highest completed education level: nm Employment: nm Physical activity level: nm Sleeping problems: nm Psychosocial problems: nm Comorbidities: pre‐hypertension n = 15, definite hypertension n = 6, seizures n = 17, back pain n = 37 Genetic factors/mutations: nm
Interventions	N of participants chemotherapy: 162 N of participants cranial irradiation: 23 N of participants surgery: 0 N of participants SCT: 0 Received chemotherapeutic agents: triple intrathecal therapy with cytarabine, methotrexate and hydrocortisone: n = 162
Outcomes	Severe fatigue: N of participants with severe fatigue: 3/162 (1.9%) Risk and associated factors: Dependent factor: mild to severe fatigue (yes/no)b Multivariable: Significant: relapse (OR 8.35 (95% CI 1.16 to 59.93), P = 0.03)
Notes	Funding sources: Grant CA21765 from the National cancer institute and by the Lebanese Syrian associated charities Declaration of interest: nothing to declare aNot every survivor completed the BFI, only if the screening question was positive for fatigue/energy loss bAnalysis was performed with mild to severe fatigue as outcome (mean score ≥ 1). It is unclear which other variables were included in the multivariable model
Risk of bias
Bias	Authors' judgement	Support for judgement
Representative study group (selection bias)	High risk	Size of original cohort is unclear, 432 eligible participants, 162 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	Unclear risk	Unclear which other variables were included in multivariable model
Well‐defined study group (reporting bias)	Unclear risk	Type of cancer and cancer treatment are mentioned but information about doses is not reported. Inclusion and exclusion criteria are described
Well‐defined follow‐up (reporting bias)	Low risk	Length of follow‐up is 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 (mild to severe fatigue)
Well‐defined risk estimation	Unclear risk	Odds ratio is provided for significant factor. Unclear which other variables were included in multivariable model.