Critical appraisal:Dillon KE, Sammel MD, Ginsberg JP, Lechtenberg L, Prewitt M, Gracia CR 2013

Critical Appraisal

Article being appraised

Dillon KE, Sammel MD, Ginsberg JP, Lechtenberg L, Prewitt M, Gracia CR. Pregnancy after cancer: results from a prospective cohort study of cancer survivors. Pediatr Blood Cancer 2013 Dec;60(12):2001-6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/24038829.

Applicable clinical question

In female cancer survivors is measuring AMH, FSH, inhibin B, AFC or assessment of menstrual history, accurate in assessing ovarian function as measured by successful conception?

Key Facts

Study Design

cohort study, risk factors

Study aims:

to compare incidence of pregancy and surrogate measures of fertility (MOF) over a mean 25 months in survivors of cancer versus age matched controls

Number of Patients:

84

control group 98
similar ages but cases were all comers, whereas controls had to have a regular menstrual cycle to be included

Reported outcome(s):

pregnancy rates
gonadotropins, E2, inhibin B, AMH and AFC

Results of outcome(s):

pregnancy rates similar but all MOF significantly impaired in cases versus controls

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-2

Risk of bias

High risk of bias

Comments: Oncology survivors were all inclusive, controls had to have regular menstrual cycle

Both groups included women on the OCP as they 'can' become pregnant Original paper by Gracia CR et al 2012 (PubMed: 22137491) will describe cohort better. Percent of oncology survivors that participated versus could is not described. Gracia article needs to be reviewed. Unknown selection biases without reviewing this

Result of appraisal

Included