4 Cardio-oncology and home-based, multimodal rehabilitation programmes: a scoping review
Bibliographic record
Abstract
Background Home-based, multimodal, self-management interventions (HMSIs) have been evidenced to effectively promote recovery for cardiac rehabilitation (CR) patients. Given the cardiotoxic effects of certain cancer treatment, research and guidelines have increasingly recommended that HMSIs based on models of CR are adapted for cancer patients. Yet, it is unclear if empirically-based, cardio-oncology-informed HMSIs are available. Aim This scoping review investigates cancer-related HMSIs by assessing their remit, evidence-base, degree of implementation and integration of CR principles. Methods The review was conducted in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR) Guidelines. AMED, Cochrane Library, CINAHL, Embase, MEDLINE and PsycInfo databases were searched for articles from January 2010 to January 2023. Inclusion criteria comprised articles based on interventions meeting the criteria: (a) home-/web-based (b) self-management (c) multimodal (targeting two or more modalities such as exercise, nutrition, or psychological wellbeing). The literature search and data extraction were conducted independently by two reviewers. Results (cross-referenced to ensure inter-rater consistency) were verified by a third reviewer. Results The initial search produced 302 articles, screened and assessed for eligibility . Thirty-eight articles, representing 28 interventions, were included in the scoping review. Thirteen were based in the US and Canada, only 2 in the UK. There was significant variation in the research underpinning the interventions: while 25% had associated randomised controlled trials, 57% were only outlined in protocols and pilot feasibility studies. Few were generalisable to all cancer patients, as many focused on one specific cancer type or topic. No intervention targeted the effects of cardio-toxicity recommended by cardio-oncology literature and guidelines. Conclusion With increasing risks of cardiotoxicity and a lack of evidence-based HMSIs available for cancer patients (particularly in the UK), there is an opportunity for CR to expand to meet the needs of those living with and beyond cancer.
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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 | 0.015 | 0.059 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.006 |
| Bibliometrics | 0.020 | 0.020 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.005 | 0.002 |
| Insufficient payload (model declined to judge) | 0.013 | 0.001 |
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".