The DOI matches its Crossref record; 92 of the 92 references it cites were found in a registry or an index; 2 of the 128 sources its claims cite were checked for support.
Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer
Open accessAbstract
Multiple organizations around the world have issued evidence‐based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health‐related outcomes (eg, fatigue, anxiety, depression, function, and quality of life). Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active. Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. The authors propose using the American College of Sports Medicine's Exercise Is Medicine initiative to address this practice gap. The simple proposal is for clinicians to assess, advise, and refer patients to either home‐based or community‐based exercise or for further evaluation and intervention in outpatient rehabilitation. To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming. Behavior change is one of many challenges to enacting the proposed practice changes. Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development. In conclusion, there is a call to action for key stakeholders to create the infrastructure and cultural adaptations needed so that all people living with and beyond cancer can be as active as is possible for them.
Overview
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Claims the paper makes
62 Not checked yet · 7 Own interpretation · 6 No basis given · 2 Own result · 1 Supported · 1 Supported so far
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These programs are located in South America, North America, Europe, Asia, Oceania, and the Middle East.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Implementation Issues > Identification/Awareness of HCP-Supervised and Community-Based Exercise Programming: The Need for a Registry
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Multiple organizations around the world have issued evidence-based exercise guidance for patients with cancer and cancer survivors.”
- Also stated in: § Introduction · plain
“Multiple US and international organizations have published exercise recommendations for patients living with and beyond cancer, including the American Cancer Society (ACS),1 the American College of Sports Medicine (ACSM),2 Exercise and Sports Science Australia,3 Cancer Care Ontario,4 and the Clinical Oncology Society of Australia.5”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Abstract
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Introduction · plain
None of the sources cited for this claim have been checked yet.
In the paper
“Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active.”
- Also stated in: § Introduction · hedged
“Despite the exercise recommendations noted above, an analysis of greater than 9000 cancer survivors from the ACS Study of Cancer Survivors II (SCS-II) cohort indicated that only between 30% and 47% met current physical activity guidelines.12,13”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Abstract
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Introduction · hedged
In the paper
“Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health-related outcomes (eg, fatigue, anxiety, depression, function, and quality of life).”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Abstract
What the sources say
- Not checked yetcites [10] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“current evidence indicates that exercise under supervision yields better outcomes.10,43-47”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Step 3: Refer
What the sources say
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“there is substantial evidence suggesting exercise is associated with improved cancer-specific survival in patients with breast, colon, and prostate cancer.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Introduction
What the sources say
- Not checked yetcites [6] source
- Not checked yetcites [7]
- Not checked yetcites [8]
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The safety of these recommendations is supported by the finding of no adverse effects of exercise after cancer in general or as recommended by oncology clinicians in multiple trials16,36 and multiple meta-analyses.37-39”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > What Oncology Clinicians Can Do Now: Assess, Advise, and Refer
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“There is programming in Canada and the Netherlands that has achieved many of these aspirational goals.51,52”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Care Coordination: Transitioning Into and Between HCP-Supervised Versus Community Exercise Programming
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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None of the sources cited for this claim have been checked yet.
In the paper
“The evidence base strongly supports adoption of the EIM approach for all patients with chronic conditions, including people living with and beyond cancer.1-3,5,10,23”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > What Oncology Clinicians Can Do Now: Assess, Advise, and Refer
What the sources say
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A recent comprehensive review of interventions for cancer survivors across different approaches, samples, and settings (128 randomized controlled trials, for a total of 13,050 patients with cancer) revealed that supervised programs produced larger effects on physical activity than unsupervised programs. 47”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Behavioral Considerations and Patient Preferences
What the sources say
- Not checked yetcites [47] source
plaindirectn = 13,050- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 22
- Probably not a substantial claim. 19
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Reasons for a lack of regular exercise among people living with and beyond cancer are multifactorial, but multiple studies have documented a lack of recommendation from an oncology clinician.15-17”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Introduction
What the sources say
- Not checked yetcites [15] source
- Not checked yetcites [16] source
- Supportedcites [17] source
The Conclusions (page unavailable) report that only 35% of eligible oncology visits included a physical-activity communication. They also cite a separate patient survey in which only 34% of breast-cancer patients and 36% of prostate-cancer patients reported receiving an exercise recommendation from their oncologist. Together, these findings support the attributed point that studies have documented a lack of clinician recommendations. (LLM, conf=0.88)
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“The ACSM expert panel concluded that there is sufficient evidence to support the efficacy of specific doses of exercise training to address cancer-related health outcomes, including fatigue, quality of life, physical function, anxiety, and depressive symptoms.10”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Introduction
What the sources say
- Supportedcites [10] source
The Abstract (Results) says there was enough evidence to conclude that specific doses of exercise training could improve anxiety, depressive symptoms, fatigue, physical functioning, and health-related quality of life. The Summary and Future Directions likewise describes evidence-based prescriptions for all five outcomes. The paper uses “physical functioning” and “health-related quality of life” for the citing sentence’s “physical function” and “quality of life.” (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Supported
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As part of the efforts of the 2018 ACSM Roundtable, the authors have developed a registry with 150 programs from 25 countries, as described below.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Step 3: Refer
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The registry at exerciseismedicine.org/movingthroughcancer suggests that qualified fitness professionals, coaches, exercise physiologists, or volunteers mostly provide the exercise instruction in the community setting.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Community-Based Programs
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of the 150 programs identified through this process, 90 are HCP-supervised exercise programs, and 60 are community programs.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Implementation Issues > Identification/Awareness of HCP-Supervised and Community-Based Exercise Programming: The Need for a Registry
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The ACSM expert panel concurred with other recent reviews, concluding that exercise prevents at least 7 types of cancer”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Introduction
What the sources say
- Not checked yetcites [6] source
- Not checked yetcites [7]
- Not checked yetcites [8]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Observed barriers to clinicians referring patients to exercise programming include lack of awareness of the potential value of exercise in cancer populations, uncertainty regarding the safety or suitability of exercise for a particular patient, lack of awareness regarding available programs to help facilitate exercise in cancer populations, need for education and skills development for making”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Introduction
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In summary, the scientific evidence base supports exercise, and patients and clinicians generally agree that patients should be moving throughout their cancer therapy and survivorship.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Introduction
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In the Health Information National Trends Survey (HINTS) cohort, approximately 45% of cancer survivors reported regular physical activity, although this varied by tumor site (32% vs 53% in breast cancer vs prostate cancer survivors, respectively).9”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Introduction
What the sources say
- Not checked yetcites [9] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“This 2018 review of evidence retained the conclusions from the 2010 Roundtable that exercise training and testing was generally safe for cancer survivors and that every survivor should “avoid inactivity.”2”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Introduction
What the sources say
- Not checked yetcites [2] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“A meta-analysis of 14 randomized controlled trials among breast cancer survivors found that, although large effects on physical activity were reported by programs that provided more supervision, interventions by telephone or email were also effective.44”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Behavioral Considerations and Patient Preferences
What the sources say
- Not checked yetcites [44] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“A major barrier to implementing this approach is that, at present, there is no payment model that would support it.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Care Coordination: Transitioning Into and Between HCP-Supervised Versus Community Exercise Programming
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“To date, the EIM approach has been adopted in several primary health care clinics31 as well as broadly across 3 large health care systems in the United States.32-35”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > What Oncology Clinicians Can Do Now: Assess, Advise, and Refer
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although there are many competing considerations during oncology visits, particularly for patients undergoing treatment, the steps in recommending exercise do not require much time or skill by the oncology clinician and have been successfully integrated into cancer care follow-up visits.67”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Behavioral Considerations and Patient Preferences
What the sources say
- Not checked yetcites [67] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Data from the United Kingdom indicated that 31% of people living with and beyond cancer are completely inactive.14”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Introduction
What the sources say
- Not checked yetcites [14]
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“There is consistent evidence that supervised exercise is more effective but that there is still benefit to home-based exercise.10”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Behavioral Considerations and Patient Preferences
What the sources say
- Not checked yetcites [10] source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Another review concluded that interventions that have used behavioral theory tend produce the largest overall effect size for behavior change.64”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Behavioral Considerations and Patient Preferences
What the sources say
- Not checked yetcites [64] source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“studies suggest that 9% of nurses and from 19% to 23% of oncology physicians refer patients with cancer to exercise programming.13,17,21,22”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Introduction
What the sources say
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The LIVESTRONG at the YMCA program adheres to ACSM guidelines for survivors engaging in exercise and has currently served over 60,600 people in 707 communities.81”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > United States: LIVESTRONG at the YMCA
What the sources say
- Not checked yetcites [81]
plainn = 60,600- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“For example, OncoMove, a homebased, self-managed exercise program, costs $53 per patient, whereas OnTrack, a physical therapist-supervised, facility-based exercise program, costs $866 per patient.85”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Implementation Issues > Cost and Compensation
What the sources say
- Not checked yetcites [85] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The LIVESTRONG at the YMCA program costs less than OnTrack at $500 per patient, partially because of its reliance on exercise trainers rather than physical therapists.86”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Implementation Issues > Cost and Compensation
What the sources say
- Not checked yetcites [86]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“It is as yet unclear whether such programs are more cost-effective compared with monodimensional programs.90”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Implementation Issues > Cost and Compensation
What the sources say
- Not checked yetcites [90] source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- The authors state this as an assumption: It is often assumed that multidimensional programs offer larger benefits.
In the paper
“This skilled workforce is relatively inexpensive and accessible compared with physical or occupational therapists or clinical exercise physiologists.76”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Community-Based Programs
What the sources say
- Not checked yetcites [76] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“OnTrack, in contrast, had an incremental costeffectiveness ratio compared with usual care of €26,916 per quality-adjusted life-year, which falls within some endorsed willingness-to-pay thresholds.85”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Implementation Issues > Cost and Compensation
What the sources say
- Not checked yetcites [85] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the net pros and cons of relying on EMRs to automate aspects of care that have historically been restricted to in-person, clinic-based delivery are not known.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Implementation Issues > Capacity for Triage and Referral
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
- Rests on an assumption: Current-generation EMRs have unprecedented capability to collect and synthesize diverse patient information and can populate algorithms that drive interfaces and automated delivery.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Waiting to start referrals until the full infrastructure is in place misses the opportunity for a greater proportion of patients to become active through the admittedly imperfect infrastructure that currently exists.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Care Coordination: Transitioning Into and Between HCP-Supervised Versus Community Exercise Programming
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Changing behavior is complex and depends on personal, social, and environmental factors as well as individual and community resources.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Behavioral Considerations and Patient Preferences
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
In the paper
“MoveMore is based on guidelines stating that support should be provided for at least 1 year to bring about long-term behavior change, and the regularity and format of that support is informed by the individual’s personal needs and preferences.80”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > United Kingdom: MoveMore program
What the sources say
- Not checked yetcites [80]
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The successful promotion of exercise programming along the cancer continuum requires behavior change for many people affected by cancer.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Behavioral Considerations and Patient Preferences
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Both MoveMore and the LIVESTRONG at the YMCA programs have been independently evaluated and shown to be effective in significantly improving self-reported physical activity levels, quality-of-life physical function, and cardiorespiratory fitness.76,82”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > United States: LIVESTRONG at the YMCA
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Exercise is only effective in improving clinical outcomes if the patient “fills the script” (does the exercise program).”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Behavioral Considerations and Patient Preferences
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In particular, it is currently unclear who should be in charge of the referral and triage process; who should begin the process; or who should be reimbursed or rewarded for actions related to assessment, advice, and referral to exercise and rehabilitative programming.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Care Coordination: Transitioning Into and Between HCP-Supervised Versus Community Exercise Programming
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Community-based programs are generally perceived to be more accessible and affordable and reduce the barriers of distance, cost, and time compared with participation in HCP-supervised exercise programs.74,75”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Community-Based Programs
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The exponential growth of exercise oncology research has driven the need for revised cancer exercise guidelines10 and a roadmap for oncology clinicians to follow to improve physical and psychological outcomes from cancer diagnosis and for the balance of life.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Summary
What the sources say
- Not checked yetcites [10] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In 2014, revenues in the US fitness industry topped $24 billion, and memberships are increasing steadily.97”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Implementation Issues > Mainstream Health and Fitness Industry
What the sources say
- Not checked yetcites [97]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At 16 million survivors in the United States, cancer survivors might be prevalent enough to form a niche (or 2).”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Implementation Issues > Mainstream Health and Fitness Industry
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Current practice is failing those diagnosed with cancer.”
§ Exercise is Medicine in Oncology: Engaging clinicians to help patients move through cancer > Summary
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
- Rests on an assumption: Current practice is failing those diagnosed with cancer.
The paper relies on this without support.
A lack of clarity among oncology clinical staff about their role in assessing, advising, and referring patients to exercise is among the reasons most people living with and beyond cancer are not regularly physically active.
“Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise.”
The paper relies on this without support.
Enacting the proposed practice changes will require care coordination with appropriate professionals and changes in the behaviors of clinicians, patients, and exercise/rehabilitation providers.
“To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming.”
The paper relies on this without support.
Behavior change is one of many challenges to enacting the proposed practice changes.
“Behavior change is one of many challenges to enacting the proposed practice changes.”
The paper relies on this without support.
Implementation challenges include capacity for triage and referral, need for a program registry, costs and compensation, and workforce development.
“Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development.”
The paper relies on this without support.
Transitions between HCP-supervised exercise programs and community programs are notoriously challenging.
“Transitions between HCP-supervised exercise programs and community programs are notoriously challenging.”
The paper relies on this without support.
The majority of programs require physician approval before patient participation.
“The majority of programs require physician approval before patient participation; hence, the behaviors of oncology clinicians (eg, medical, surgical, or radiation oncologists; oncology nurse practitioners; oncology nurses; allied health professionals) are key to patients being informed about and eligible to participate in programs and ongoing support for engagement in exercise programs.”
The paper relies on this without support.
The steps in recommending exercise do not require much time or skill by the oncology clinician.
“the steps in recommending exercise do not require much time or skill by the oncology clinician”
The paper relies on this without support.
Adverse event reporting in exercise oncology is not standardized.
“In truth, adverse event reporting in the field of exercise oncology is not standardized.”
The paper relies on this without support.
The cancer population is shifting to be more geriatric and multimorbid, and therapeutic arsenal is expanding with extended late-stage survival, taxing human and institutional resources.
“This all occurs within the setting of demographic shifting to a more geriatric and multimorbid cancer population, as well as an expanding therapeutic arsenal and extended, late-stage survival that collectively tax the human and institutional resources devoted to cancer care.”
The paper relies on this without support.
Providers are tasked with addressing multiple health conditions in addition to exercise counseling during visits of shrinking duration.
“Furthermore, providers are being tasked with addressing multiple health conditions among patients with cancer in addition to exercise counseling (eg, fertility preservation, distress screening and management, and survivorship care planning). All of these health conditions are to be addressed during patient visits of shrinking duration.”
The paper relies on this without support.
Current-generation EMRs have unprecedented capability to collect and synthesize diverse patient information and can populate algorithms that drive interfaces and automated delivery.
“Current-generation EMRs have unprecedented capability to collect and synthesize diverse sources of information related to patients’ function, physical activity (self-report and from wearables), and adherence. By triangulating patient-reported outcome, performance, and clinical data, EMRs can populate algorithms that drive important dimensions of patient-EMR and provider-EMR interfaces, including”
The authors state this as an assumption.
It is often assumed that multidimensional programs offer larger benefits.
“Although it is often assumed that multidimensional programs offer larger benefits, they are also inherently more expensive.”
The paper relies on this without support.
The current system for education and training in oncology exercise and rehabilitation is more aligned with continuing education than with standardized curriculum content and board specialty training and certification.
“The current system for education and training in the specialty practice of oncology exercise and rehabilitation, however, is more aligned with health care and medical continuing education programming rather than codified in standardized medical, nursing, and physical therapy curriculum content and board specialty training and certification.”
The paper relies on this without support.
In community settings, the workforce most likely to work with the cancer population are fitness instructors/personal trainers based in community halls, gyms, and leisure centers.
“In a community setting, the workforce most likely (knowingly or unknowingly) to work with the cancer population are fitness instructors/personal trainers based in locally funded community halls and gyms and in privately funded gyms and leisure centers.”
The paper relies on this without support.
There are few validated training pathways for preparing fitness instructors or volunteers to safely and effectively provide exercise programming to the cancer population in community settings.
“There are few validated training pathways for preparing fitness instructors or volunteers to safely and effectively provide exercise programming to the cancer population in the community setting.”
The paper relies on this without support.
Current practice is failing those diagnosed with cancer.
“Current practice is failing those diagnosed with cancer.”
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Metadata
- Authors
- Schmitz, K. H., Campbell, A. M., Stuiver, M. M., Pinto, B. M., Schwartz, A. L., Morris, G. S., Ligibel, J. A., Cheville, A., Galvão, D. A., Alfano, C. M., Patel, A. V., Hue, T., Gerber, L. H., Sallis, R., Gusani, N. J., Stout, N. L., Chan, L., Flowers, F., Doyle, C., Helmrich, S., Bain, W., Sokolof, J., Winters‐Stone, K. M., Campbell, K. L., & Matthews, C. E.
- Affiliations
- Pennsylvania State University (US)
- Edinburgh Napier University (GB)
- Amsterdam UMC Location University of Amsterdam (NL)
- University of South Carolina (US)
- Northern Arizona University (US)
- Wingate University (US)
- Dana-Farber Cancer Institute (US)
- Mayo Clinic (US)
- Exercise Medicine Research Institute, Edith Cowan University Joondalup Western Australia Australia
- American Cancer Society (US)
- University of California, San Francisco (US)
- George Mason University (US)
- Kaiser Permanente (US)
- Penn State Cancer Institute (US)
- National Institutes of Health (US)
- Macmillan Cancer Support (GB)
- Patient Advocate Berkeley California
- Sunflower Wellness San Francisco California
- NYU Langone Health (US)
- Oregon Health & Science University (US)
- University of British Columbia (CA)
- National Cancer Institute (US)
- Corresponding author
- Schmitz, Kathryn H.
- ORCID
- Schmitz, Kathryn H.
- Campbell, Anna M.
- Stuiver, Martijn M.
- Pinto, Bernardine M.
- Schwartz, Anna L.
- Ligibel, Jennifer A.
- Cheville, Andrea
- Galvão, Daniel A.
- Alfano, Catherine M.
- Patel, Alpa V.
- Hue, Trisha
- Gerber, Lynn H.
- Sallis, Robert
- Gusani, Niraj J.
- Stout, Nicole L.
- Chan, Leighton
- Winters‐Stone, Kerri M.
- Campbell, Kristin L.
- Matthews, Charles E.
- Venue
- CA: A Cancer Journal for Clinicians
- Publisher
- Wiley
- Published
- 2019-10-16
- Volume
- 69
- Issue
- 6
- Pages
- 468-484
- ISSN
- 0007-9235 (ISSN-L)
- 1542-4863
- PMC
- PMC7896280
- OpenAlex
- W2980368443
- Cited by
- 789
- References
- 92
- Citations by year
- 2026: 66 · 2025: 141 · 2024: 132 · 2023: 84 · 2022: 135 · 2021: 141 · 2020: 85 · 2019: 4
- FWCI
- 38.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- CA A Cancer Journal for Clinicians (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (acceptedVersion, cc-by)
- PubMed Central (acceptedVersion)
- Australasian Journal of Paramedicine (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- eScholarship (California Digital Library) (submittedVersion)
- Edinburgh Napier Research Repository (Edinburgh Napier University) (submittedVersion, cc-by)
- Edinburgh Napier Research Repository (Edinburgh Napier University) (submittedVersion, other-oa)
- Funders
- Macmillan Cancer Support
- American College of Sports Medicine
- American Cancer Society
- American Physical Therapy Association
- Koninklijk Nederlands Genootschap voor Fysiotherapie
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- Exercise is Medicine, cancer survivors, cancer prevention, physical activity, clinician engagement, exercise referral, home-based exercise, community-based exercise, cancer rehabilitation, behavior change, implementation barriers, care coordination
- MeSH terms
- Community Health Services, Exercise Therapy, Humans, Medical Oncology, Neoplasms, Practice Guidelines as Topic, Delivery of Health Care, Integrated
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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