Van Dijk 2008.
| 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: history of cancer in childhood or adolescence, finished treatment at least 5 years ago, survivor aged between 16 and 40 years, attended late effects outpatient clinic between November 2004 and December 2005 Exclusion criteria: mental retardation |
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| Participants | Sample characteristics: N of participants original cohort: unknown; N of participants described study group: 60; N of participants study group of interest: 60; N of participants fatigue assessed: 60 Participant characteristics: Tumour type: ALL n = 27, AML n = 5, (non) Hodgkin lymphoma n = 15, solid tumour n = 11, brain tumour n = 2 Tumour stage: nm Age at diagnosis: mean 8.3 years (SD 4.5; range 1 ‐ 16) Time since diagnosis: mean 15.2 years ( SD 5.3; range 6 ‐ 28) Age at assessment: mean 24.6 years (SD 5.6; range 17 ‐ 39) F/M: 29/31 BMI: nm Race/ethnicity: White n = 60 Marital status: married or living as married n = 16, other n = 41, unknown n = 3 Highest completed education level: nm Employment: nm Physical activity level: SF‐36 physical functioning mean 87.3 (SD 20) Sleeping problems: nm Psychosocial problems: nm Comorbidities/late effects: nm Genetic factors/mutations: nm |
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| Interventions | N of participants chemotherapy: 20 N of participants radiotherapy: 1 N of participants surgery: 2 N of participants surgery + radiotherapy: 1 N of participants surgery +chemotherapy: 8 N of participants chemotherapy + radiotherapy: 20 N of participants surgery, chemotherapy and radiotherapy: 8 |
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| Outcomes | Severe fatigue: N of participants with severe fatigue: 37/60 (61.7%) Risk and associated factors: Dependent factor: fatigue (continuous)a Univariable: Non‐significant: age at diagnosis (< 12 years (mean 53.7) vs ≥ 12 years (mean 49.8)) |
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| Notes | Funding sources: supported by the 'Stichting Vrouwen VU‐hulp' Declaration of interest: nm The following data were obtained from the study author: N of participants with severe fatigue aAnalysis was performed with fatigue score on a continuous scale as outcome (Mann‐Whitney U‐test). Effect estimate and P value were not reported in the article. |
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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, 71 eligible participants, 60 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) | 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 | Low risk | Mean fatigue scores for both groups are presented |