Enhancing safety of exercise for individuals with bone metastases: Screening recommendations developed through Delphi consensus process.
Bibliographic record
Abstract
e24042 Background: Exercise has been shown to improve physical function and quality of life in individuals with bone metastases. To facilitate better integration of exercise services into clinical care for these more complex patients, the purpose was to understand the current views of an expert panel on the appropriate exercise screening approach for adults with bone metastases. Methods: Physicians, physical therapists and exercise physiologists with clinical or research expertise in providing medical and/or exercise advice to individuals with bone metastases were identified. A 3-round modified online Delphi survey was used to establish a consensus, with a priori consensus set to 70%. Results: Response rates were 68% (73/107), 81% (59/73) and 97% (57/59) for each Delphi round. Key consensus points were: a) medical guidance (i.e. communication and medical information from a physician) is recommended prior to commencing structured exercise for all individuals with bone lesions (90% consensus) and is required when individuals present with bone pain, have received past medical treatment for bone pain, or have a history of disease-related fractures (90% consensus); b) the primary objective of exercise professionals for seeking medical guidance is to obtain medical information (e.g., bone scan reports) to guide clinical decision making for exercise prescription (93% consensus) and for bi-directional communication (i.e., for overall patient care and safety) (75% consensus) versus requiring a direct referral from a physician for liability coverage (39% consensus); c) the physician group that exercise professionals most commonly approach for medical guidance are medical oncologists (84% consensus) or radiation oncologists (63% consensus) compared to primary care providers (33% consensus), orthopedic surgeons (40% consensus) or physiatrists (16%); d) as part of pre-exercise screening by an exercise professional, information should be collected on the number, location and type of bone lesion(s), level of bone pain and any other bone-related symptom (100% consensus). Conclusions: This represents the current views of a range of physicians, physical therapists, exercise physiologists and researchers who provide medical and/or exercise advice to adults with bone metastases. These findings will inform the work of the International Bone Metastases Exercise Working Group to establish the first exercise guidelines for adults with bone metatases.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.166 | 0.161 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".