Dropout from exercise trials among cancer survivors-An individual patient data meta-analysis from the POLARIS study.
cancer
decision tree
exercise oncology
individual patient data meta-analysis
Journal
Scandinavian journal of medicine & science in sports
ISSN: 1600-0838
Titre abrégé: Scand J Med Sci Sports
Pays: Denmark
ID NLM: 9111504
Informations de publication
Date de publication:
Feb 2024
Feb 2024
Historique:
revised:
04
01
2024
received:
07
09
2023
accepted:
25
01
2024
medline:
10
2
2024
pubmed:
10
2
2024
entrez:
10
2
2024
Statut:
ppublish
Résumé
The number of randomized controlled trials (RCTs) investigating the effects of exercise among cancer survivors has increased in recent years; however, participants dropping out of the trials are rarely described. The objective of the present study was to assess which combinations of participant and exercise program characteristics were associated with dropout from the exercise arms of RCTs among cancer survivors. This study used data collected in the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study, an international database of RCTs investigating the effects of exercise among cancer survivors. Thirty-four exercise trials, with a total of 2467 patients without metastatic disease randomized to an exercise arm were included. Harmonized studies included a pre and a posttest, and participants were classified as dropouts when missing all assessments at the post-intervention test. Subgroups were identified with a conditional inference tree. Overall, 9.6% of the participants dropped out. Five subgroups were identified in the conditional inference tree based on four significant associations with dropout. Most dropout was observed for participants with BMI >28.4 kg/m There are several systematic differences between cancer survivors completing and dropping out from exercise trials, possibly affecting the external validity of exercise effects.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14575Subventions
Organisme : KWF Kankerbestrijding
Organisme : Helse Sør-Øst RHF
Informations de copyright
© 2024 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.
Références
Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc. 2019;51(11):2375-2390.
Buffart LM, Kalter J, Sweegers MG, et al. Effects and moderators of exercise on quality of life and physical function in patients with cancer: an individual patient data meta-analysis of 34 RCTs. Cancer Treat Rev. 2017;52:91-104.
Sweegers MG, Altenburg TM, Brug J, et al. Effects and moderators of exercise on muscle strength, muscle function and aerobic fitness in patients with cancer: a meta-analysis of individual patient data. Br J Sports Med. 2019;53(13):812.
Van Vulpen JK, Sweegers MG, Peeters PHM, et al. Moderators of exercise effects on cancer-related fatigue: a meta-analysis of individual patient data. Med Sci Sports Exerc. 2020;52(2):303-314.
Friedenreich CM, Stone CR, Cheung WY, Hayes SC. Physical activity and mortality in cancer survivors: a systematic review and meta-analysis. JNCI Cancer Spectrum. 2020;4(1):pkz080.
Spence RR, Sandler CX, Newton RU, Galvão DA, Hayes SC. Physical activity and exercise guidelines for people with cancer: why are they needed, who should use them, and when? Semin Oncol Nurs. 2020;36:151075.
Fuller JT, Hartland MC, Maloney LT, Davison K. Therapeutic effects of aerobic and resistance exercises for cancer survivors: a systematic review of meta-analyses of clinical trials. Br J Sports Med. 2018;52(20):1311.
Thomsen SN, Lahart IM, Thomsen LM, et al. Harms of exercise training in patients with cancer undergoing systemic treatment: a systematic review and meta-analysis of published and unpublished controlled trials. EClinicalMedicine. 2023;59:101937.
Bell ML, Kenward MG, Fairclough DL, Horton NJ. Differential dropout and bias in randomised controlled trials: when it matters and when it may not. BMJ. 2013;346:e8668.
Barry AE. How attrition impacts the internal and external validity of longitudinal research. J Sch Health. 2005;75(7):267-270.
Adams RN, Mosher CE, Blair CK, Snyder DC, Sloane R, Demark-Wahnefried W. Cancer survivors' uptake and adherence in diet and exercise intervention trials: an integrative data analysis. Cancer. 2015;121(1):77-83.
Steins Bisschop CN, Courneya KS, Velthuis MJ, et al. Control group design, contamination and drop-out in exercise oncology trials: a systematic review. PLoS One. 2015;10(3):e0120996.
Strandberg E, Bean C, Vassbakk-Svindland K, et al. Who makes it all the way? Participants vs. decliners, and completers vs. drop-outs, in a 6-month exercise trial during cancer treatment. Results from the Phys-can RCT. Supportive Care Cancer. 2022;30(2):1739-1748.
Turner RR, Steed L, Quirk H, et al. Interventions for promoting habitual exercise in people living with and beyond cancer. Cochrane Database Syst Rev. 2018;9:CD010192.
Dettori JR. Loss to follow-up. Evid Based Spine Care J. 2011;2(1):7-10.
Hayes SC, Newton RU, Spence RR, Galvão DA. The exercise and sports science Australia position statement: exercise medicine in cancer management. J Sci Med Sport. 2019;22(11):1175-1199.
Buffart LM, Kalter J, Chinapaw MJM, et al. Predicting OptimaL cAncer RehabIlitation and supportive care (POLARIS): rationale and design for meta-analyses of individual patient data of randomized controlled trials that evaluate the effect of physical activity and psychosocial interventions on health-related quality of life in cancer survivors. Syst Rev. 2013;2(1):75.
Courneya KS, Segal RJ, Mackey JR, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol. 2007;25(28):4396-4404.
Wiskemann J, Dreger P, Schwerdtfeger R, et al. Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation. Blood. 2011;117(9):2604-2613.
Ivarsson A, Stenling A. Prediction of injury risk in sports. Wiley StatsRef: Statistics Reference Online. Wiley; 2019:1-6.
Venkatasubramaniam A, Wolfson J, Mitchell N, Barnes T, JaKa M, French S. Decision trees in epidemiological research. Emerg Themes Epidemiol. 2017;14:11.
Hothorn T, Hornik K, Zeileis A. Unbiased recursive partitioning: a conditional inference framework. J Comput Graph Stat. 2006;15(3):651-674.
Musanti R. A study of exercise modality and physical self-esteem in breast cancer survivors. Med Sci Sports Exerc. 2012;44(2):352-361.
Winters-Stone KM, Torgrimson-Ojerio B, Dieckmann NF, Stoyles S, Mitri Z, Luoh S-W. A randomized-controlled trial comparing supervised aerobic training to resistance training followed by unsupervised exercise on physical functioning in older breast cancer survivors. J Geriatr Oncol. 2022;13(2):152-160.
Stout NL, Baima J, Swisher AK, Winters-Stone KM, Welsh J. A systematic review of exercise systematic reviews in the cancer literature (2005-2017). PM R. 2017;9(2):347-384.
Winters-Stone KM, Dobek J, Bennett JA, Nail LM, Leo MC, Schwartz A. The effect of resistance training on muscle strength and physical function in older, postmenopausal breast cancer survivors: a randomized controlled trial. J Cancer Surviv. 2012;6(2):189-199.
Serra MC, Ryan AS, Ortmeyer HK, Addison O, Goldberg AP. Resistance training reduces inflammation and fatigue and improves physical function in older breast cancer survivors. Menopause. 2018;25(2):211-216.
Maddalozzo GF, Widrick JJ, Cardinal BJ, Winters-Stone KM, Hoffman MA, Snow CM. The effects of hormone replacement therapy and resistance training on spine bone mineral density in early postmenopausal women. Bone. 2007;40(5):1244-1251.
von Wagner C, Knight K, Steptoe A, Wardle J. Functional health literacy and health-promoting behaviour in a national sample of British adults. J Epidemiol Community Health. 2007;61(12):1086-1090.
Kari JT, Viinikainen J, Böckerman P, et al. Education leads to a more physically active lifestyle: evidence based on mendelian randomization. Scand J Med Sci Sports. 2020;30(7):1194-1204.
Avancini A, Pala V, Trestini I, et al. Exercise levels and preferences in cancer patients: a cross-sectional study. Int J Environ Res Public Health. 2020;17(15):5351.
Ormel HL, van der Schoot GGF, Sluiter WJ, Jalving M, Gietema JA, Walenkamp AME. Predictors of adherence to exercise interventions during and after cancer treatment: a systematic review. Psychooncology. 2018;27(3):713-724.
Lin AW, Marchese SH, Finch LE, Stump T, Gavin KL, Spring B. Obesity status on associations between cancer-related beliefs and health behaviors in cancer survivors: implications for patient-clinician communication. Patient Educ Couns. 2021;104(8):2067-2072.
Sun V, Raz DJ, Kim JY, et al. Barriers and facilitators of adherence to a perioperative physical activity intervention for older adults with cancer and their family caregivers. J Geriatr Oncol. 2020;11(2):256-262.
Knudsen MD, Wang L, Wang K, et al. Changes in lifestyle factors after endoscopic screening: a prospective study in the United States. Clin Gastroenterol Hepatol. 2022;20(6):e1240-e1249.
Bell K. Remaking the self: trauma, teachable moments, and the biopolitics of cancer survivorship. Cult Med Psychiatry. 2012;36(4):584-600.
Gil Herrero L, McNeely ML, Courneya KS, et al. Safety, feasibility, and effectiveness of implementing supervised exercise into the clinical care of individuals with advanced cancer. Clin Rehabil. 2022;36:1666-1678.
Berlin JA, Santanna J, Schmid CH, Szczech LA, Feldman HI. Individual patient- versus group-level data meta-regressions for the investigation of treatment effect modifiers: ecological bias rears its ugly head. Stat Med. 2002;21(3):371-387.
Lambert PC, Sutton AJ, Abrams KR, Jones DR. A comparison of summary patient-level covariates in meta-regression with individual patient data meta-analysis. J Clin Epidemiol. 2002;55(1):86-94.
Newman P. Predicting injuries: are we using the appropriate statistical approach? J Sci Med Sport. 2017;20:S130-S131.