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      The influence of telehealth-based cancer rehabilitation interventions on disability: a systematic review

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          Abstract

          Purpose

          To characterize delivery features and explore effectiveness of telehealth-based cancer rehabilitation interventions that address disability in adult cancer survivors.

          Methods

          A systematic review of electronic databases (CINAHL Plus, Cochrane Library: Database of Systematic Reviews, Embase, National Health Service’s Health Technology Assessment, PubMed, Scopus, Web of Science) was conducted in December 2019 and updated in April 2021.

          Results

          Searches identified 3,499 unique studies. Sixty-eight studies met inclusion criteria. There were 81 unique interventions across included studies. Interventions were primarily delivered post-treatment and lasted an average of 16.5 weeks ( SD = 13.1). They were most frequently delivered using telephone calls (59%), administered delivered by nursing professionals (35%), and delivered in a one-on-one format (88%). Risk of bias of included studies was primarily moderate to high. Included studies captured 55 measures of disability. Only 54% of reported outcomes had data that allowed calculation of effect sizes ranging -3.58 to 15.66.

          Conclusions

          The analyses suggest small effects of telehealth-based cancer interventions on disability, though the heterogeneity seen in the measurement of disability makes it hard to draw firm conclusions. Further research using more diverse samples, common measures of disability, and pragmatic study designs is needed to advance telehealth in cancer rehabilitation.

          Implications for Cancer Survivors

          Telehealth-based cancer rehabilitation interventions have the potential to increase access to care designed to reduce disability across the cancer care continuum.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s11764-022-01181-4.

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          Most cited references98

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            Cancer Statistics, 2021

            Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence. Incidence data (through 2017) were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2018) were collected by the National Center for Health Statistics. In 2021, 1,898,160 new cancer cases and 608,570 cancer deaths are projected to occur in the United States. After increasing for most of the 20th century, the cancer death rate has fallen continuously from its peak in 1991 through 2018, for a total decline of 31%, because of reductions in smoking and improvements in early detection and treatment. This translates to 3.2 million fewer cancer deaths than would have occurred if peak rates had persisted. Long-term declines in mortality for the 4 leading cancers have halted for prostate cancer and slowed for breast and colorectal cancers, but accelerated for lung cancer, which accounted for almost one-half of the total mortality decline from 2014 to 2018. The pace of the annual decline in lung cancer mortality doubled from 3.1% during 2009 through 2013 to 5.5% during 2014 through 2018 in men, from 1.8% to 4.4% in women, and from 2.4% to 5% overall. This trend coincides with steady declines in incidence (2.2%-2.3%) but rapid gains in survival specifically for nonsmall cell lung cancer (NSCLC). For example, NSCLC 2-year relative survival increased from 34% for persons diagnosed during 2009 through 2010 to 42% during 2015 through 2016, including absolute increases of 5% to 6% for every stage of diagnosis; survival for small cell lung cancer remained at 14% to 15%. Improved treatment accelerated progress against lung cancer and drove a record drop in overall cancer mortality, despite slowing momentum for other common cancers.
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              Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement

              Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.
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                Author and article information

                Contributors
                rachelle.brick@nih.gov
                Journal
                J Cancer Surviv
                J Cancer Surviv
                Journal of Cancer Survivorship
                Springer US (New York )
                1932-2259
                1932-2267
                26 February 2022
                : 1-26
                Affiliations
                [1 ]GRID grid.48336.3a, ISNI 0000 0004 1936 8075, Cancer Prevention Fellowship Program, Division of Cancer Prevention, , National Cancer Institute, ; 9609 Medical Center Drive, Rockville, MD 20850 USA
                [2 ]GRID grid.484215.e, VA Central Office, Health Services Research and Development, ; 1100 1st St NE, Suite 6, Washington, DC 20002 USA
                [3 ]GRID grid.231844.8, ISNI 0000 0004 0474 0428, Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, , University Health Network, ; 200 Elizabeth Sr. PMB-B-045, Toronto, ON M5G 2C4 Canada
                [4 ]ReVital Cancer Rehabilitation, Select Medical, 4714 Gettysburg Road, Mechanicsburg, PA 17055 USA
                [5 ]Ivy Rehab Network, 1311 Mamaroneck Ave, Suite 140, White Plains, NY 10605 USA
                [6 ]GRID grid.255272.5, ISNI 0000 0001 2364 3111, Duquesne University School of Nursing, ; 600 Forbes Avenue, Pittsburgh, PA 15282 USA
                [7 ]GRID grid.21925.3d, ISNI 0000 0004 1936 9000, Department of Obstetrics, Gynecology, and Reproductive Sciences and UPMC Hillman Cancer Center at UPMC Magee, School of Medicine, , University of Pittsburgh, ; 300 Halket Street, Pittsburgh, PA 15213 USA
                [8 ]GRID grid.21925.3d, ISNI 0000 0004 1936 9000, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, , University of Pittsburgh, Bridgeside Point I, ; 100 Technology Drive, Pittsburgh, PA 15219 USA
                [9 ]GRID grid.415224.4, ISNI 0000 0001 2150 066X, Department of Biostatistics, , Princess Margaret Cancer Center, ; 610 University Ave, Toronto, ON Canada
                [10 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Biostatistics Division, Dalla Lana School of Public Health, , University of Toronto, ; 155 College St, Toronto, ON Canada
                [11 ]GRID grid.16753.36, ISNI 0000 0001 2299 3507, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, ; Chicago, IL 60611 USA
                [12 ]GRID grid.16753.36, ISNI 0000 0001 2299 3507, Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, , Northwestern University, ; 645 North Michigan Avenue, 11th Floor, Chicago, IL 60611 USA
                [13 ]GRID grid.16753.36, ISNI 0000 0001 2299 3507, Department of Medical Social Sciences, Feinberg School of Medicine, , Northwestern University, ; 645 North Michigan Avenue, 11th Floor, Chicago, IL 60611 USA
                [14 ]GRID grid.38142.3c, ISNI 000000041936754X, Department of Physical Medicine and Rehabilitation, , Harvard Medical School, ; Boston, MA USA
                [15 ]GRID grid.32224.35, ISNI 0000 0004 0386 9924, Massachusetts General Hospital, ; 55 Fruit Street, Boston, MA USA
                [16 ]GRID grid.62560.37, ISNI 0000 0004 0378 8294, Brigham and Women’s Hospital, ; 55 Fruit Street, Boston, MA USA
                [17 ]GRID grid.416228.b, ISNI 0000 0004 0451 8771, Spaulding Rehabilitation Hospital, ; 55 Fruit Street, Boston, MA USA
                [18 ]GRID grid.416555.6, ISNI 0000 0004 0371 5941, Department of Rehabilitation Services, , Northside Hospital, ; 1000 Johnson Ferry Road, Atlanta, GA 30342 USA
                [19 ]GRID grid.94365.3d, ISNI 0000 0001 2297 5165, National Institutes of Health Library, Office of Research Services, OD, NIH, MSC 1150, ; 10 Center Drive, Bethesda, MD 20892 USA
                [20 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Department of Occupational Science & Occupational Therapy, , University of Toronto, ; 500 University Avenue, Toronto, ON M5G 1VT Canada
                [21 ]GRID grid.253615.6, ISNI 0000 0004 1936 9510, George Washington University School of Medicine and Health Sciences, ; 2300 I St. NW, Washington, DC 20052 USA
                [22 ]GRID grid.429502.8, ISNI 0000 0000 9955 1726, Department of Occupational Therapy, , MGH Institute of Health Professions, ; Charlestown Navy Yard, Building 79/96, 79 13th Street, Boston, MA 02129 USA
                Author information
                http://orcid.org/0000-0001-7099-7799
                Article
                1181
                10.1007/s11764-022-01181-4
                8881759
                35218521
                619b2246-f7b1-439a-9349-a1cfa3eab7e7
                © This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2022

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 5 January 2022
                : 2 February 2022
                Funding
                Funded by: National Cancer Institute
                Award ID: 3UM1CA233035-01S1
                Award Recipient :
                Categories
                Review

                Oncology & Radiotherapy
                telehealth,cancer rehabilitation,neoplasm,function,intervention,disability
                Oncology & Radiotherapy
                telehealth, cancer rehabilitation, neoplasm, function, intervention, disability

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