Els van de Vijver

85 Table 2: Methodology and quality assessment First author (year of publication) and study type Patient selection Disease activity score Fatigue score Study quality Marcus (2009) [6] Case- control study Patients: recruited during scheduled clinical appointments at University Hospital, USA. Healthy controls: adolescent children of hospital employees CD: PCDAI CU and IBDU: PGA PedsQL Multidimensional Fatigue Scale, IMPACT-III, PedsQL 4.0 Generic Core Scales Children’s Depression Inventory: Short Form Good; no sample size justification Nicholas (2007) [13] Cross- sectional study Patients: recruited from the database of Reference Children’s Hospital, Canada No distinction made Semi structured interview designed by author Poor; Patients purposively selected, questionnaires not validated, participation rate not reported Pirinen (2010) [16] Case- control study Patients: recruited from the database of the Population Register Center, Finland Healthy controls: matched VAS disease severity Youth self-reported questionnaire, Sleep Self Report, child behavior checklist Medium; Subjective score to assess disease severity, exact sleep duration unknown Werkstetter (2012) [8] Case- control study Patients: recruited from University Hospital, Germany Healthy controls: matched CD: PCDAI UC: PUCAI SenseWear Pro2 accelerometer, German KINDL, IMPACT III Good; no sample size justification Rogler (2013) [7] Cross-sectional study Patients: recruited from Swiss IBD cohort study, Switzerland CD: PCDAI UC: PUCAI KIDSCREEN-27 Medium; numbers in text and table do not match Loonen (2002) [12] Cross-sectional study Patients: recruited from a database of two large tertiary referral centers, The Netherlands 5-item symptom card (completed by patients) TACQOL, IMPACT-II Good; validated questionnaires, the results compared with healthy controls Tojek (2002) [14] Cross- sectional study Patients: recruited from routine outpatient visit in 2 urban paediatric gastroenterology hospitals, USA No distinction made Questions designed by author Medium; parental factors can influence adolescent’s health, the converse remains possible, only mothers investigated, questionnaires not validated Ondersma (1996) [15] Cross- sectional study Patients: recruited from 2 paediatric gastroenterology hospitals, USA No distinction made 10-item Subjective Illness Questionnaire (parts or RCMAS and CDI) Medium; no sample size justification, parts of validated questionnaires CDI: Children’s Depression Inventory, CD: Crohn’s disease, IBD: inflammatory bowel disease, PCDAI: paediatric Crohn’s disease activity index, PedsQL: paediatric quality of life, PGA: Physician Global Assessment, PUCAI: paediatric ulcerative colitis activity index, RCMAS: Revised Children’s Manifest Anxiety Scale, UC: ulcerative colitis. Systematic review: fatigue 85