Ruccione 2013.
| Methods | Study design: cross‐sectional study (subanalysis from a prospective longitudinal study) Instrument used to assess fatigue: PedsQL Multidimensional Fatigue Scale 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: completed cancer treatment, be disease‐free, English‐speaking, cognitively able to complete study questionnaires Exclusion criteria: incomplete information |
|
| Participants | Sample characteristics: N of participants original cohort: unknown; N of participants described study group: 94; N of participants study group of interest: 94; N of participants fatigue assessed: 94 Participant characteristics: Tumour type: leukaemia n = 36, lymphoma n = 23, CNS tumour n = 9, bone tumour n = 7, soft tissue tumour n = 19 Tumour stage: nm Age at diagnosis: 3 ‐ 12 years n = 40, 13 ‐ 15 years n = 21, ≥ 16 years n = 22b Time since end of therapy: ≤ 6 months n = 94 Age at assessment: mean 14.8 year (SD 2.74) F/M: 45/49 BMI: nm Race/ethnicity: White non‐Hispanic n = 40, Hispanic n = 44, other n = 10 Marital status: NA Highest completed education level: nm Employment: NA Physical activity level: PedsQL Physical functioning summary score mean 75.9 (SD 21.3) Sleeping problems: nm Psychosocial problems: depression: CES‐DC mean score 11 (SD 9.7) Comorbidities/late effects: pain (single item) mean 1.4 (SD 1.8); post‐traumatic stress (Post‐traumatic Stress Disorder Reaction Index) mean 17.6 (SD 15.4) Genetic factors/mutations: nm |
|
| Interventions | N of participants chemotherapy: 90 N of participants radiotherapy: 36 N of participants surgery: nm N of participants SCT: 5 |
|
| Outcomes | Severe fatigue: N of participants with severe fatigue: NDa Risk and associated factors: Dependent factor: fatigue (continuous)c Univariable: Significant: depression (r = 0.64, P < 0.0001), pain (r = 0.42, P < 0.0001), post‐traumatic stress (r = 0.65, P < 0.0001) |
|
| Notes | Funding sources: Funding was provided by CureSearch National Childhood Cancer Foundation for Adolescent and Young Adult Oncology Research through the generosity of Aflac, Inc. Dr Meeske is supported by a STOP Cancer Career Development Award Declaration of interest: The authors have no conflicts of interest to disclose aAuthors report fatigue on continuous scale. Additional information on severe fatigue was requested and not available. bInformation received from study author: all participants were under 18 at diagnosis. Numbers do not add up to total N of described study group. Unclear what correct numbers were. cAnalyses were performed with the subscale score for general fatigue as outcome (Pearson correlation) |
|
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Representative study group (selection bias) | High risk | Size of original cohort is unknown, 119 eligible participants, 94 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 | No multivariable analyses |
| Well‐defined study group (reporting bias) | High risk | Only chemotherapy and radiotherapy are mentioned as type of treatment, no information available about surgery. Inclusion and exclusion criteria are described |
| Well‐defined follow‐up (reporting bias) | Unclear risk | Length of follow‐up is not reported, but all participants had completed therapy within the past 6 months |
| 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 | Low risk | Correlation coefficients are calculated |