Flowchart heart failure.

<p>1a. The first question is <i>“Symptoms¹?”</i>, “number 1″ refers to block 1 under the step diagram, in this block symptoms of heart failure are shown, so the user knows which symptoms could occur; When the answer is “NO”. 1b. Is the <i>“EF<40%-20% or the FS<15%”</i> YES grade 3 heart failure. NO grade ≤2 heart failure. When the answer is “YES” Go to question “Responsive to intervention²?” 2. Question <i>“Responsive to intervention²?”</i>, block 2 in which common interventions for heart failure are shown; When the answer is “NO” grade 4 heart failure. When the answer is “YES” grade 3 heart failure. When it is “UNKNOWN” go to question “ <i>Device³, life threatening consequences⁴ or heart transplant?”</i>. 3. Question “ Device³, life threatening consequences⁴ or heart transplant?”, block 3 under the step diagram, in this block devices used as treatment for heart failure are shown. In block 4 the life threatening consequences associated with heart failure are stated; When the answer is “NO” grade 3 heart failure. When the answer is “YES” grade 4 heart failure. Ref. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0100432#pone.0100432-Dickstein1" target="_blank">[10]</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0100432#pone.0100432-McMurray1" target="_blank">[11]</a>. ICD-10 = International classification of disease version 10. EF = ejection fraction. SF = shortening fraction. CRT-P or D = cardiac resynchronisation therapy pacemaker or defibrillator. ICD = implantable cardioverse defibrillator. LVAD = left ventricular assistance device.</p

Definitions of cardiac events (using CTCAEv3.0 and CTCAEv4.0).

<p>Definitions of cardiac events (using CTCAEv3.0 and CTCAEv4.0).</p

Result second consistency assessment (non-physician (NP) vs non-physician (extensive training) (NPE)).

<p>Result second consistency assessment (non-physician (NP) vs non-physician (extensive training) (NPE)).</p

Estimated numbers of the separate types of CEs based on the assumption of 750 cardiac cases.

<p>Estimated numbers of the separate types of CEs based on the assumption of 750 cardiac cases.</p

Inclusion criteria for each data provider within PCSF.

<p>Inclusion criteria for each data provider within PCSF.</p

Late Cardiac Events after Childhood Cancer: Methodological Aspects of the Pan-European Study PanCareSurFup

<div><p>Background and Aim</p><p>Childhood cancer survivors are at high risk of long-term adverse effects of cancer and its treatment, including cardiac events. The pan-European PanCareSurFup study determined the incidence and risk factors for cardiac events among childhood cancer survivors. The aim of this article is to describe the methodology of the cardiac cohort and nested case-control study within PanCareSurFup.</p><p>Methods</p><p>Eight data providers in Europe participating in PanCareSurFup identified and validated symptomatic cardiac events in their cohorts of childhood cancer survivors. Data on symptomatic heart failure, ischemia, pericarditis, valvular disease and arrhythmia were collected and graded according to the Criteria for Adverse Events. Detailed treatment data, data on potential confounders, lifestyle related risk factors and general health problems were collected.</p><p>Results</p><p>The PanCareSurFup cardiac cohort consisted of 59,915 5-year childhood cancer survivors with malignancies diagnosed between 1940 and 2009 and classified according to the International Classification of Childhood Cancer 3. Different strategies were used to identify cardiac events such as record linkage to population/ hospital or regional based databases, and patient- and general practitioner-based questionnaires.</p><p>Conclusion</p><p>The cardiac study of the European collaborative research project PanCareSurFup will provide the largest cohort of 5-year childhood cancer survivors with systematically ascertained and validated data on symptomatic cardiac events. The result of this study can provide information to minimize the burden of cardiac events in childhood cancer survivors by tailoring the follow-up of childhood cancer survivors at high risk of cardiac adverse events, transferring this knowledge into evidence-based clinical practice guidelines and providing a platform for future research studies in childhood cancer patients. </p></div

Definitions of cardiac events (using CTCAEv3.0 and CTCAEv4.0)^*.

<p>Definitions of cardiac events (using CTCAEv3.0 and CTCAEv4.0)^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0162778#t001fn001" target="_blank">*</a>}.</p