Tremolada 2018.
| Methods | Study design: cross‐sectional study Instrument used to assess fatigue: SF‐36 Vitality subscale Validated questionnaire: yes Cut‐off score or criterion for severe fatigue: a score ≤ 50 Time points at which outcome data were collected: NA, cross‐sectional study Inclusion criteria: being cured for cancer by HSCT in paediatric age, at least 5 years from the end of the therapies, being currently 15 ‐ 25 years old Exclusion criteria: childhood cancer survivors treated for brain tumours, survivors with sensory deficiencies or genetic syndromes, survivors who were unable to complete the questionnaires autonomously |
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| Participants | Sample characteristics: N of participants original cohort: unknown; N of participants described study group: 32; N of participants study group of interest: 32; N of participants fatigue assessed: 32 Participant characteristics: Tumour type: haematological tumours (leukaemias, non‐Hodgkin lymphoma) n = 21, solid tumours (Hodgkin lymphoma, solid tissue, other) n = 11 Tumour stage: nm Age at diagnosis: mean 8.1 years (SD 4.3; range 0.4 ‐ 16.1) Time since end of therapy: mean 8.5 years (SD 3.2; range 5 ‐ 16) Age at assessment: mean 19.4 years (SD 3.84; range 14.1 ‐ 25) F/M: 15/17 BMI: nm Race/ethnicity: White n = 32 Marital status: engaged n = 19, single n = 6, not reported n = 7 Highest completed education level: 0 ‐ 8 years of schooling n = 9, 9 ‐ 13 years of schooling n = 21, > 13 years of schooling n = 1, not reported n = 1 Employment: not working, student n = 19, looking for a job n = 4, part‐time n = 2, full‐time n = 7 Physical activity level: nm Sleeping problems: nm Psychosocial problems: nm Comorbidities/late effects: nm Genetic factors/mutations: nm |
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| Interventions | N of participants chemotherapy: 32 N of participants radiotherapy: 32 N of participants surgery: 0 N of participants SCT: 32 N of participants total body irradiation: 32 |
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| Outcomes | Severe fatigue: N of participants with severe fatigue: 8/32 (25.0%) Risk and associated factors: Dependent factor: fatigue (continuous)a Univariable: Non‐significant: gender (r = −0.150, P = 0.411), age at assessment (r = 0.081, P = 0.659), age at diagnosis (r = 0.218, P = 0.230), diagnosis type (r = −0.042, P = 0.818), time since end of therapy (r = −0.012, P = 0.950), relapse (r = −0.200, P = 0.272), years of schooling |
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| Notes | Funding sources: this study was supported by a grant from foundation Istituo della Ricerca Pediatrica Città della Speranza. Open access sponsored by Provincia Autonoma di Bolzano, Alto Adige Declaration of interest: nm The following data were obtained from the study author: N of participants chemotherapy, radiotherapy or surgery, N of participants with severe fatigue aAnalysis was performed with fatigue score on a continuous scale as outcome (Pearson correlation). No effect estimate or P value was reported for years of schooling |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Representative study group (selection bias) | Unclear risk | Size of original cohort is unclear |
| 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) | 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 severe fatigue (reporting bias) All outcomes | Low risk | The authors reported which instrument they used to assess fatigue; definition of severe fatigue is based on data query |
| 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 | Unclear risk | Correlation coefficients are calculated, but not for all factors |