Pemberger 2005.
| Methods | Study design: cross‐sectional study (questionnaire survey) Instrument used to assess fatigue: SF‐36 Vitality subscale Validated questionnaire: yes Cut‐off score or criterion for severe fatigue: NAa Time points at which outcome data were collected: NA, cross‐sectional study Inclusion criteria: at least 18 years of age, at least 5 years off therapy, no evidence of disease, diagnosed with cancer in the years 1975 ‐ 1995 Exclusion criteria: nm |
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| Participants | Sample characteristics: N of participants original cohort: unknown; N of participants described study group: 78; N of participants study group of interest: 78; N of participants fatigue assessed: 78 Participant characteristics: Tumour type: haematological n = 44, bone and soft tissue sarcoma n = 17, CNS tumour n = 4, tumours of internal organs n = 13 Tumour stage: nm Age at diagnosis: mean 8.0 years (SD 5.0)b Time since diagnosis and/or end of therapy: mean 14.7 years (SD 4.0) and mean 13.6 years (SD 3.8) Age at assessment: mean 22.6 years (SD 3.8) F/M: 38/40 BMI: nm Race/ethnicity: nm Marital status: married n = 9, unmarried n = 66, other marital status n = 3 Highest completed education level: still attending school n = 24, university degree n = 2, college n = 13, vocational school n = 22, technical college n = 13, high school n = 4 Employment: nm Physical activity level: nm Sleeping problems: nm Psychosocial problems: nm Comorbidities/late effects: no late effect n = 26, single late effect n = 23, multiple late effects (≥ 2) n = 29; cardiovascular n = 3, constitutional n = 11, dermatology/skin n = 5, endocrine n = 11, gastrointestinal n = 1, hepatic n = 13, immunology n = 2, musculoskeletal n = 17, neurology n = 19, ocular/visual n = 1, pain n = 3, pulmonary n = 3, renal n = 4, sexual/reproductive function n = 9 Genetic factors/mutations: nm |
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| Interventions | N of participants chemotherapy: 76 N of participants radiotherapy: 52 N of participants surgery: 50 |
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| Outcomes | Severe fatigue N of participants with severe fatigue: NDa Risk and associated factors: Dependent factor: fatigue (continuous)c Significant: gender (female) |
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| Notes | Funding sources: supported by the Kinder‐Krebs‐Hilfe Declaration of interest: nm aAuthors report fatigue on continuous scale. Additional information on severe fatigue was requested and not available. bThe study author confirmed that at least 90% of the participants were under 18 at diagnosis. cAnalysis was performed with fatigue score on a continuous scale as outcome. No effect estimate or P value was reported and unclear if analysis was univariable or multivariable. |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Representative study group (selection bias) | High risk | Size of original cohort is unclear, 106 eligible participants, 78 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 | Important prognostic factors and follow‐up were 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 is mentioned |
| Well‐defined outcome fatigue (reporting bias) | Low risk | Authors reported which instrument they used to assess fatigue, and how they described fatigue (continuous scale) |
| Well‐defined risk estimation | High risk | None were calculated |