Usability, acceptability, and implementation strategies for the Exercise in Cancer Evaluation and Decision Support...

Area of Science:

• Oncology
• Rehabilitation Medicine
• Exercise Science

Background:

• Cancer guidelines recommend cancer rehabilitation or exercise services (CR/ES) for survivors.
• A challenge exists in matching survivors with appropriate CR/ES at the right time.
• The EXCEEDS algorithm was developed to aid clinical decision-making and access to CR/ES.

Purpose of the Study:

• To evaluate the usability and acceptability of the EXCEEDS algorithm.
• To determine pragmatic implementation priorities for the EXCEEDS algorithm.

Main Methods:

• Delphi methodology was employed.
• Participants (N=133) completed online questionnaires including simulated case vignettes and acceptability/priority ranking items.
• Chi-squared tests and descriptive statistics were used to analyze usability, acceptability, and implementation priorities.

Main Results:

• EXCEEDS use increased guideline-concordant recommendations for medical clearance (83.4% vs. 66.5%) and CR/ES triage (60.9% vs. 51.1%).
• Mean acceptability was high (3.90 ± 0.47) with high inter-rater agreement in 3 of 4 domains.
• Implementation priorities identified include user groups, platforms, and strategies.

Conclusions:

• The EXCEEDS algorithm is a pragmatic and acceptable clinical decision support tool for CR/ES recommendations.
• Further research is needed to assess the algorithm's usability and acceptability within real-world clinical settings.