Verberne 2012.

Methods	Study design: cross‐sectional study Instrument used to assess fatigue: PedsQL Multidimensional Fatigue Scale Validated questionnaire: yes Cut‐off score or criterion for severe fatigue: normative mean total score for Dutch population of the PedsQL child form: 76.84 (SD 12.67); cut‐off score for severe fatigue: total fatigue score < 51.50 Time points at which outcome data were collected: NA, cross‐sectional study Inclusion criteria: between 4 and 18 years old, > 6 months after end of treatment, diagnosed after 2003 Exclusion criteria: Down syndrome
Participants	Sample characteristics: N of participants original cohort: unknown; N of participants described study group: 109; N of participants study group of interest: 109; N of participants fatigue assessed: 109, 71 with child forma Participant characteristics: Tumour type: CNS tumour n = 31, HL n = 4, NHL n = 11, ALL n = 12, WT n = 13, neuroblastoma n = 7, bone tumour n = 7, non‐CNS germ cell tumour n = 4, liver tumour n = 3, soft tissue or other tumour n = 17 Tumour stage: nm Age at diagnosis: mean 7.1 years (range 0.0 ‐ 16.9) Time since end of therapy: mean 2.4 years (range 0.5 ‐ 6.0) Age at assessment: mean 10.3 years (range 4.0 ‐ 17.9) F/M: 48/61 BMI: < 25 n = 60, ≥ 25 ‐ ≤ 30 n = 5, > 30 n = 3, unknown n = 3 Race/ethnicity: White n = 47, Hispanic n = 0, other n = 14, unknown n=10 Marital status: NA Highest completed education level: nm Employment: NA Physical activity level: nm Sleeping problems: sleep duration: 9 ‐ 11 hrs n = 62, 8 ‐ 9 hrs n = 26, 7 ‐ 8 hrs n = 13, 5 ‐ 7 hr n = 3, < 5 hr n = 1b DIMS: mean 11.7 (SD 3.8)c SWTD: mean 7.8 (SD 2.6)c DOES: mean 8.8 (SD 2.8)c SHY: mean 2.6 (SD 1.6)c Daytime sleepiness (ESS): mean 4.5 (SD 4.0)c Psychosocial problems: nm Comorbidities/late effects: nm Genetic factors/mutations: nm
Interventions	N of participants surgery: 20 N of participants surgery + chemotherapy: 34 N of participants surgery + chemotherapy + cranial irradiation: 11 N of participants surgery + chemotherapy + radiotherapy: 12 N of participants surgery + radiotherapy: 2 N of participants chemotherapy: 20 N of participants chemotherapy + radiotherapy: 7 N of participants no treatment: 3
Outcomes	Severe fatigue: N of participants with severe fatigue: 8/71 (11.3%) Risk and associated factors: Dependent factor: fatigue (continuous)d Univariable: Significant: DOES ( r = −0.78, P < 0.001), SWTD (r = −0.37, P < 0.05) Non‐significant: DIMS (r = −0.15), SHY (r = −0.08), daytime sleepiness (r = −0.30)
Notes	Funding sources: This study was not funded Declaration of interest: The authors declare that there is no conflict of interest The following data were obtained from the study author: N of participants with severe fatigue, BMI and race/ethnicity aonly for the participants that filled in the child form of the PedsQL questionnaire (8 ‐ 18 years at assessment), fatigue was assessed based on the presented criterion for severe fatigue. bNumbers do not add up to total N of described study group. Unclear what correct numbers were. cPresented means are from CNS tumour survivors only dAnalyses were performed with fatigue score on a continuous scale as outcome (Pearson correlation). P values were not reported for non‐significant risk and associated factors in the article. Analyses included only CNS tumour survivors
Risk of bias
Bias	Authors' judgement	Support for judgement
Representative study group (selection bias)	High risk	Size of original cohort is unclear, 129 eligible participants, 109 described study group, < 90%
Adequate follow‐up assessment (attrition bias)	Low risk	Outcome was assessed for 65% ‐ 95% of the study group of interest
Blinded outcome assessor (detection bias) All outcomes	High risk	The 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 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	Correlation coefficients are calculated