Tor D Tosteson's research while affiliated with Dartmouth College and other places

Publications (315)

Article
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A joint modeling approach on survival and longitudinal data has proven to be valuable in end of life applications, especially when there is a strong relationship between the longitudinal measurements and survival outcomes in the presence of high mortality rates. We have implemented a novel joint modeling approach, a flexible terminal trend model, t...
Article
Background: Patient-reported outcome measures (PROMs) offer a collaborative opportunity between the patient and the care team to improve the quality of care. Objectives: To define PROMs in patients receiving hematopoietic stem cell transplant (HSCT), a pre-visit questionnaire (PVQ) was developed, which included a single agenda-setting question, the...
Article
751 Background: Plasma uracil concentration >16 ng/mL is used in some countries as a screening test for DPD deficiency. We conducted this exploratory study to evaluate the association of uracil concentration with 5-FU exposure, toxicity, and DPYD genotype in patients without known DPD deficiency. The main hypothesis was that lower uracil concentrat...
Article
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Research articles in the clinical and translational science literature commonly use quantitative data to inform evaluation of interventions, learn about the etiology of disease, or develop methods for diagnostic testing or risk prediction of future events. The peer review process must evaluate the methodology used therein, including use of quantita...
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Context: Emotion regulation by the physician can influence the effectiveness of serious illness conversations. The feasibility of multimodal assessment of emotion regulation during these conversations is unknown. Objective: To develop and assess an experimental framework for evaluating physician emotion regulation during serious illness conversa...
Article
6608 Background: Unplanned delays are common during FOLFOX chemotherapy, and cytopenias (neutropenia and/or thrombocytopenia) are the most common cause of delays. We evaluated a novel, provider-driven FOLFOX dose-adjustment algorithm designed to reduce unplanned delays while maintaining chemotherapy dose intensity. Methods: We conducted a pragmatic...
Article
e12503 Background: Up to 50% of breast cancer survivors are unable to complete the recommended 5-year course of adjuvant endocrine therapy (AET), usually due to side effects. Patients who develop side effects may change to a different medication (‘switch’) or may treat side effects with additional medications or non-pharmacologic strategies. While...
Article
Importance: Surveillance after prior colon polyps is the most frequent indication for colonoscopy in older adults. However, to our knowledge, the current use of surveillance colonoscopy, clinical outcomes, and follow-up recommendations in association with life expectancy, factoring in both age and comorbidities, have not been studied. Objective:...
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Purpose In the genomic era, more women with low-risk breast cancer will forego chemotherapy and rely on adjuvant endocrine therapy (AET) to prevent metastatic recurrence. However, some of these patients will unfortunately relapse. We sought to understand this outcome. Preliminary work suggested that early discontinuation of AET, also known as non-p...
Article
439 Background: Clinician emotion regulation (ER), self and the patient’s, likely moderates successful prognostic discussions with patients, yet challenges around its evaluation limit its investigation. We performed a pilot study to develop and assess an experimental framework that uses multimodal assessment (self-report, observer, and biometric da...
Article
Purpose Increased oxygen levels may enhance the radiosensitivity of brain metastases treated with stereotactic radiosurgery (SRS). This project administered hyperbaric oxygen (HBO) prior to SRS to assess feasibility, safety, and response. Methods 38 patients were studied, 19 with 25 brain metastases treated with HBO prior to SRS, and 19 historical...
Article
Purpose: To characterize the use of telemedicine for oncology care over the course of the COVID-19 pandemic in Northern New England with a focus on factors affecting trends. Methods: We performed a retrospective observational study using patient visit data from electronic health records from hematology-oncology and radiation-oncology service lin...
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Objective To determine the effectiveness of HOBSCOTCH (Home-based self-management and cognitive training changes lives) in a real-world setting, and to assess feasibility of a virtual intervention, we conducted a multi-site, pragmatic replication trial at four New England epilepsy centers. Methods HOBSCOTCH is an 8-session intervention addressing...
Article
Background: Colonoscopy is frequently performed in older adults, yet data on current use, and clinical outcomes of and follow-up recommendations after colonoscopy in older adults are lacking. Methods: This was an observational study using the New Hampshire Colonoscopy Registry of adults age ≥65 years undergoing colonoscopy for screening, surveil...
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Background: Background: The COVID-19 pandemic necessitated a rapid shift to telemedicine to minimize patient and provider exposure risks. While telemedicine has been utilized in a variety of primary and specialty care settings for many years, it has been slow to be adopted in oncology care. Health care provider and administrator perspectives on fa...
Article
Background: Pathogenic variants of the DPYD gene are strongly associated with grade ≥3 toxicity during fluoropyrimidine chemotherapy. We conducted a systematic review and meta-analysis to estimate the risk of treatment-related death associated with DPYD gene variants. Methods: We searched for reports published prior to September 17, 2020 that de...
Article
Introduction: The COVID-19 pandemic resulted in an exponential increase in telehealth. In response to the pandemic, Dartmouth-Hitchcock Health (D-HH) and its Norris Cotton Cancer Center (NCCC) closed non-essential in-person services on March 17, 2020 and began reopening on April 27, 2020. We examined outpatient telehealth utilization at D-HH and NC...
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Rigorous scientific review of research protocols is critical to making funding decisions, and to the protection of both human and non-human research participants. Given the increasing complexity of research designs and data analysis methods, quantitative experts, such as biostatisticians, play an essential role in evaluating the rigor and reproduci...
Preprint
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Objectives: There is a paucity of evidence on how to facilitate shared decision-making under real-world conditions and, in particular, whether interventions should target patients, health care providers, or both groups. Our objectives were to assess the comparative effectiveness, feasibility, and acceptability of patient- and provider-targeted inte...
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Background Snowmobiling is a popular activity that leads to geriatric trauma admissions; however, this unique trauma population is not well characterized. We aimed to compare the injury burden and outcomes for geriatric versus nongeriatric adults injured riding snowmobiles. Materials and methods A retrospective cohort study was performed using the...
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Background Downhill skiing accounts for a large portion of geriatric sport-related trauma. We assessed the national burden of geriatric versus nongeriatric ski trauma. Materials and methods Adults presenting to level 1/2 trauma centers after ski-associated injuries from 2011 to 2015 were identified from the National Trauma Data Bank by ICD-9 code....
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Objective The aryl hydrocarbon receptor (AHR) plays a key role in obesity. In vitro studies revealed that the tryptophan metabolite kynurenine (Kyn) activates AHR signaling in cultured hepatocytes. The objective of this study was to determine whether Kyn activated the AHR in mice to induce obesity. Methods Mice were fed a low‐fat diet and the same...
Article
The calculation of quality of care measures based on electronic medical records (EMRs) may be inaccurate because of incomplete capture of past services. We evaluate the influence of different statistical approaches for calculating the proportion of patients who are up-to-date for a preventive service, using the example of colorectal cancer (CRC) sc...
Article
Background Wire-localized excision of non-palpable breast cancer is imprecise, resulting in positive margins 15–35% of the time. Methods Women with a confirmed diagnosis of non-palpable invasive breast cancer (IBC) or ductal carcinoma in situ (DCIS) were randomized to a new technique using preoperative supine magnetic resonance imaging (MRI) with...
Article
Objectives: Fractures of the hip, distal radius, and proximal humerus are common in the Medicare population. This study's objective was to characterize patterns and duration of opioid use, including regional variations in use, after both surgical and nonoperative management. Design: Population-based cohort study. Setting and participants: A co...
Article
Drugs that increase the risk of fracture are commonly prescribed to survivors of a fragility fracture. This study shows that starting new high-risk medications after fracture increases the risk of a second, potentially preventable fracture. For most drug classes, however, it is safe to continue medications taken before the fracture. Introduction M...
Article
Background: Use of breast cancer screening is influenced by factors associated with patients, primary care providers, practices, and health systems. Objective: We examined the relative effects of these nested levels on four breast cancer screening metrics. Design: A web-based survey was completed at 15 primary care practices within two health...
Article
Study design: Prospective evaluation of an informational web-based calculator for communicating estimates of personalized treatment outcomes. Objective: To evaluate the usability, effectiveness in communicating benefits and risks, and impact on decision quality of a calculator tool for patients with intervertebral disc herniations, spinal stenos...
Article
Objectives: There is an increasing demand for and use of alternative and complementary therapies, such as reiki and massage therapy, in hospital-based settings. Most controlled studies and practice-based reports include oncology and surgical patient populations; thus the effect in a more heterogeneous hospitalized patient population is hard to est...
Article
Background: The National Lung Screening Trial (NLST) reported lung cancer and all-cause mortality reductions for low-dose computed tomography (LDCT) versus chest x-ray (CXR) screening. Although LDCT lung screening has received a grade B from the United States Preventive Services Task Force and is a covered service under most health plans, concerns...
Article
Study design: Randomized trial with a concurrent observational cohort study OBJECTIVE.: To compare eight-year outcomes between surgery and nonoperative care and among different fusion techniques for symptomatic lumbar degenerative spondylolisthesis (DS). Summary of background data: Surgical treatment of DS has been shown to be more effective tha...
Article
Background: Our previous case series suggested that a 1-week, low-calorie and low-fat diet was associated with decreased intraoperative blood loss in patients undergoing liver surgery. Objective: The current study evaluates the effect of this diet in a randomized controlled trial. Methods: We randomly assigned 60 patients with a body mass inde...
Article
Background context: Pain, pain-related disability, and functional limitations are common consequences of intervertebral disc herniation (IDH). We hypothesized that surgical treatment reduces pain, leading to improvement in pain-related disabilty and, ultimately, better physical health. Purpose: To evaluate pathways for improvements in quality of...
Article
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Objective: Randomized controlled trials (RCTs) of early palliative care interventions in advanced cancer have positively impacted patient survival, yet the mechanisms remain unknown. This secondary analysis of 2 RCTs assessed whether an early palliative care intervention moderates the relationship between depressive symptoms and survival. Method:...
Article
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Introduction Despite the observed and theoretical advantages of shared decision-making in a range of clinical contexts, including contraceptive care, there remains a paucity of evidence on how to facilitate its adoption. This paper describes the protocol for a study to assess the comparative effectiveness of patient-targeted and provider-targeted i...
Article
Background context: Minimally invasive lumbar spinal stenosis procedures have uncertain long-term value. Purpose: This study sought to characterize factors affecting the long-term cost-effectiveness of such procedures using interspinous spacer devices ("spacers") relative to decompression surgery as a case study. Study design: Model-based cost...
Article
Study design: Retrospective analysis of prospective data from the degenerative spondylolisthesis (DS) arm of the Spine Patient Outcomes Research Trial. Objective: To identify risk factors for reoperation in patients treated surgically for DS and compare outcomes between patients who underwent reoperation with non-reoperative patients. Summary o...
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Digital breast tomosynthesis (DBT) has shown potential to improve breast cancer screening and diagnosis compared to digital mammography (DM). The FDA approved DBT use in conjunction with conventional DM in 2011, but coverage was approved by CMS recently in 2015. Given changes in coverage policies, it is important to monitor diffusion of DBT by insu...
Article
Introduction: Insurance reimbursement for clinical services provided by complementary healthcare professionals in the United States likely differs by provider specialty. It is hypothesized that a lower likelihood of insurance reimbursement demonstrates that complementary healthcare services are not utilized to an optimal level and are not financia...
Article
Background: Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. Objective: To describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Design: Observational co...
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Objectives: The patient-centered medical home (PCMH) continues to gain momentum as a primary care delivery system. We evaluated whether medical home transformation of primary care practices is associated with the use of breast cancer screening, a broadly endorsed preventive service. Study design: Retrospective cohort study evaluating 12 Brigham...
Article
Importance: Patients who have a fragility fracture are at high risk for subsequent fractures. Prescription drugs represent 1 factor that could be modified to reduce the risk of subsequent fracture. Objective: To describe the use of prescription drugs associated with fracture risk before and after fragility fracture. Design, setting, and partici...
Article
Objective: A transient decrease in seizure frequency has been identified during therapeutic brain stimulation trials with stimulator in patients in the inactive sham group. This study was performed to examine whether the implantation of intracranial electrodes decreases seizure occurrence and explores factors that may be associated. Methods: A r...
Article
Objective: The primary objective for this study was to assess social cognition in patients with focal epilepsy using a naturalistic task, which accurately models complex real-world social interaction. Methods: We conducted an observational study of social cognition in 43 patients with focal epilepsy and in 22 controls. Patients and controls comp...
Article
Background context: Chronic neck pain is a prevalent and disabling condition among older adults. Despite the large burden of neck pain, little is known regarding the cost-effectiveness of commonly used treatments. Purpose: This study aimed to estimate the cost-effectiveness of home exercise and advice (HEA), spinal manipulative therapy (SMT) plu...
Article
Context: Little is known about whether early palliative care (EPC) support for family caregivers (CGs) impacts depressive symptoms and grief after care recipients die. Objectives: To assess after-death CG depressive symptom and grief scores for early compared to delayed group CGs. Methods: We conducted a randomized controlled trial (10/2010-9/...
Article
Objective: Cognitive difficulties in epilepsy are common and add to disability beyond seizures alone. A self-management intervention targeting cognitive dysfunction was developed and assessed for whether it improves quality of life, objective memory, and mood in adults with epilepsy. Methods: The HOme Based Self-management and COgnitive Training...
Article
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Palliative medicine is an interdisciplinary specialty focusing on improving quality of life (QOL) for patients with serious illness and their families. Palliative care programs are available or under development at over 80% of large US hospitals (300+ beds). Palliative care clinical trials present unique analytic challenges relative to evaluating t...
Article
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We report on second fracture occurrence in the year following a hip, shoulder or wrist fracture using insurance claims. Among 273,330 people, 4.3 % had a second fracture; risk did not differ by first fracture type. Estimated adjusted second fracture probabilities may facilitate population-based evaluation of secondary fracture prevention strategies...
Article
We conducted a randomized controlled trial (RCT) of an early palliative care intervention (ENABLE: Educate, Nurture, Advise, Before Life Ends) for persons with advanced cancer and their family caregivers. Not all patient participants had a caregiver coparticipant; hence, we explored whether there were relationships between patient survival, having...
Article
Objective: The purpose of this study was to determine whether use of chiropractic manipulative treatment (CMT) was associated with lower healthcare costs among multiply-comorbid Medicare beneficiaries with an episode of chronic low back pain (cLBP). Methods: We conducted an observational, retrospective study of 2006 to 2012 Medicare fee-for-serv...
Article
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Background: Primary care providers and health systems have prominent roles in guiding effective cancer screening. Objective: To characterize variation in screening abnormality rates and timely initial follow-up for common cancer screening tests. Design: Population-based cohort undergoing screening in 2011, 2012, or 2013 at seven research cente...
Article
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Study design: Secondary analysis of randomized and non-randomized prospective cohorts. Objective: To examine the effect of patient treatment expectations on treatment outcomes for patients with intervertebral disc herniation. Summary of background data: Patient expectations about treatment effectiveness may have important relationships with cl...
Article
Study design: A retrospective subgroup analysis was performed on surgically treated patients from the lumbar spinal stenosis (SpS) arm of the Spine Patient Outcomes Research Trial (SPORT), randomized and observational cohorts. Objective: To identify risk factors for reoperation in patients treated surgically for SpS and compare outcomes between...
Article
Objective: Patients who use complementary and integrative health services like chiropractic manipulative treatment (CMT) often have different characteristics than do patients who do not, and these differences can confound attempts to compare outcomes across treatment groups, particularly in observational studies when selection bias may occur. The...
Article
Methods: Early vs. delayed RCT (10/2010-9/2013) of 123 FCGs of community dwelling persons with advanced cancer in a rural, New Hampshire NCI-designated comprehensive cancer center and affiliated outreach clinics and a Vermont VA medical center receiving a multicomponent intervention (ENABLE [Educate, Nurture, Advise, Before Life Ends]) consisting...
Article
Background: Lumbar discectomy and laminectomy in patients with intervertebral disc herniation (IDH) is common, with variable reported reoperation rates. Our study examined which baseline characteristics might be risk factors for reoperation and compared outcomes between patients who underwent reoperation and those who did not. Methods: We perfor...
Article
The purpose of this study was to evaluate the effectiveness of ultrasound-guided cryoablation in treating small invasive ductal carcinoma and to assess the role of contrast-enhanced (CE) MRI in determining the outcome of cryoablation. Twenty consecutive participants with invasive ductal carcinomas up to 15 mm, with limited or no ductal carcinoma in...
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To determine the effect of early versus delayed initiation of a palliative care intervention for family caregivers (CGs) of patients with advanced cancer. Between October 2010 and March 2013, CGs of patients with advanced cancer were randomly assigned to receive three structured weekly telephone coaching sessions, monthly follow-up, and a bereaveme...
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Randomized controlled trials have supported integrated oncology and palliative care (PC); however, optimal timing has not been evaluated. We investigated the effect of early versus delayed PC on quality of life (QOL), symptom impact, mood, 1-year survival, and resource use. Between October 2010 and March 2013, 207 patients with advanced cancer at a...
Article
Randomized trial with a concurrent observational cohort study. To compare 8-year outcomes of surgery with nonoperative care for symptomatic lumbar spinal stenosis. Surgery for spinal stenosis has been shown to be more effective than nonoperative treatment during 4 years, but longer-term data are less clear. Surgical candidates from 13 centers in 11...
Article
Full-text available
Breast cancer screening is central to early breast cancer detection. Identifying and monitoring process measures for screening is a focus of the National Cancer Institute’s Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) initiative, which requires participating centers to report structured data across the cance...
Article
5 Background: We previously demonstrated improved depression and survival in advanced cancer patients participating in two palliative care (PC) RCTs: ENABLE II (EII; N=322) compared intervention vs. usual care, and ENABLE III (EIII; N=207) compared immediate vs. delayed intervention. The interventions were identical, except in EIII, the interventio...
Article
41 Background: In palliative care studies, the primary outcomes are often health related quality of life measures (HRLQ). Randomized trials and prospective cohorts typically recruit patients with advanced stage of disease and follow them until death or end of the study. During this time, HRLQ measures are collected at regular intervals. The typical...
Article
49 Background: Randomized “early intervention” or “fast-track” trials (also sometimes called delayed intervention, delayed-start, or wait list designs) have been proposed as an alternative to traditional RCTs comparing palliative care interventions to non-palliative or other supportive care groups. The fast-track arm receives intervention immediate...
Article
Background: The Spine Patient Outcomes Research Trial aimed to determine the comparative effectiveness of surgical care versus nonoperative care by measuring longitudinal values: outcomes, satisfaction, and costs. Methods: This paper aims to summarize available evidence from the Spine Patient Outcomes Research Trial by addressing 2 important que...
Article
Objectives: Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed nonspecific and may be due to multiple biologic and behavioral etiologies. Re...
Article
Full-text available
Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed non-specific and may be due to multiple biologic and behavioral etiologies. Researchers us...
Article
LBA9513 Background: Family caregivers of individuals with advanced cancer experience significant burden and diminished QOL; few interventions have been found to reduce these outcomes. Methods: Randomized clinical trial conducted from 10/11/2010 to 9/5/2013 of immediate versus delayed (initiated 12 weeks after randomization) entry patients (n=207) a...
Article
The estimation of treatment effects is one of the primary goals of statistics in medicine. Estimation based on observational studies is subject to confounding. Statistical methods for controlling bias due to confounding include regression adjustment, propensity scores and inverse probability weighted estimators. These methods require that all confo...
Article
Full-text available
Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed non-specific and may be due to multiple biologic and behavioral etiologies. Researchers us...
Article
Full-text available
Study Design. Retrospective analysis of Medicare claims linked to a multi-center clinical trial.Objective. The Spine Patient Outcomes Research Trial (SPORT) provided a unique opportunity to examine the validity of a claims-based algorithm for grouping patients by surgical indication. SPORT enrolled patients for lumbar disc herniation, spinal stenos...
Article
Study Design. Retrospective analysis of Medicare claims linked to a multi-center clinical trial.Objective. The Spine Patient Outcomes Research Trial (SPORT) provided a unique opportunity to examine the validity of a claims-based algorithm for grouping patients by surgical indication. SPORT enrolled patients for lumbar disc herniation, spinal stenos...
Article
Study design: Concurrent prospective randomized and observational cohort studies. Objective: To assess the 8-year outcomes of surgery versus nonoperative care. Summary of background data: Although randomized trials have demonstrated small short-term differences in favor of surgery, long-term outcomes comparing surgical with nonoperative treatm...

Citations

... Dalam hasil penelitian ini, dinyatakan juga bahwa LVI merupakan faktor yang mempengaruhi prognosis dan outcome pasien. 42 Menurut penelitian yang dilakukan oleh Kuhn (2023), terdapat bukti kuat yang menunjukkan bahwa LVI pada karsinoma payudara berkaitan dengan karakteristik klinikopatologis yang lebih agresif, seperti ukuran tumor yang lebih besar, tingkat histologis yang lebih tinggi, staging T yang lebih tinggi, dan metastasis kelenjar getah bening aksila. LVI merupakan faktor prognostic negatif independent yang terkait dengan kekambuhan local dan distant metastasis serta DFS dan OS yang lebih buruk, bahkan pada pasien dengan kelenjar getah bening aktif. ...
... The formation of BM depends on the extravasation of tumor cells, perivascular tumor cell growth, and the co-option of pre-existing vessels in a complex multistep process [33][34][35]. In addition, cerebral perfusion and oxygenation are crucial for the effect of local radiotherapy on BM [36,37], and alterations in cerebral perfusion could also modulate the efficacy of systemic treatment [38,39]. Taking into account this relevant interplay of BM formation and treatment with vascular architecture, there is a strong need to more precisely understand the effects of vascular risk factors that could influence development and prognosis of BM. ...
... However, to date, none of these CBSIs have gained FDA approval, mainly due to their toxicity and lack of clinical benefits, problems that are related to their specific chemical structures. Compounds such as CA-4P, VERU-111, OXi4503, ABT-751, BNC105P and ZD6126 are currently undergoing or have completed clinical trials [17][18][19][20], but none are currently approved for clinical applications in cancer treatment due to their causation of undesirable adverse events [21], lack of bioavailability and low aqueous solubility [22,23]. Some other compounds are in preclinical studies. ...
... Saudi Arabia (46), China (21), and Canada (38) each contributed to publish one relevant study. Most of the article (n = 17) were published in 2022 [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. Table 2 shows a summary of the articles included in the study. ...
... Saudi Arabia (46), China (21), and Canada (38) each contributed to publish one relevant study. Most of the article (n = 17) were published in 2022 [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. Table 2 shows a summary of the articles included in the study. ...
... The program has been proven to improve quality of life and subjective cognition. 37 The program is currently disseminated throughout the Unites States and can be delivered virtually. ...
... Yet, recent data show that adherence to the new recommendation is troublingly lowonly 8%, with nearly all (95%) of nonadherence reflecting earlier colonoscopy use than guidelines recommend (35). These low-risk surveillance colonoscopies use a large share of colonoscopy capacity [surveillance for low-risk adenomas is the most common indication for colonoscopy among adults aged older than 70 years (36)], and this share is expected to grow with implementation of the new US Preventive Services Task Force guidelines and new quality metrics (adenoma detection rates), as well as technological advances that incentivize and enable detection of smaller polyps (19,37). A recently launched comparativeeffectiveness study, Colonoscopy vs Stool-based Testing for Older Adults With a History of Colon Polyps (GC is co-investigator), assesses effectiveness of fecal immunochemical testing in place of colonoscopy for patients with a history of low-risk adenomas. ...
... An estimated 2 million patients worldwide receive these antimetabolite drugs annually to treat a variety of solid tumors such as colorectal, pancreatic, breast, and head and neck cancers [1]. About 30% of patients develop severe FP-associated toxicity, including diarrhea, hand-foot syndrome, mucositis, and myelosuppression, which can be fatal for ~ 0.1% of patients [3,4]. ...
... Telehealth is one vehicle for addressing these gaps [8][9][10], and for this study, "telehealth" is broadly defined as "sharing medical information in writing, by video, by phone, or by other digital means". While it has the potential to reach underserved rural and remote cancer survivor populations, telehealth utilization in cancer care has been limited due to concerns regarding poor technology infrastructure and insufficient understanding of best practices for implementation throughout the cancer care continuum [8,[11][12][13][14][15]. ...
... repository before starting recruitment as a supplementary to the registration (NCT05174182). The embedded statistical analysis plan follows regulatory and academic recommendations and guidelines, as well as open-science practices [25][26][27][28]. Exercises in the experimental intervention is described by parameters proposed by Toigo & Boutellier [24], and domains from CERT [23] (Checklist for Exercise Reporting Template) and TIDieR [22] (Template for Intervention Description and Replication). ...