Development and Validation of a Simulation Model-Based Tool to Support Individualized Physical Activity Discussions...

Area of Science:

• Oncology
• Public Health
• Biostatistics

Background:

• Clinical guidelines advocate for personalized physical activity prescriptions for cancer survivors.
• A gap exists in practical tools to support individualized physical activity discussions and prescriptions.
• Postmenopausal breast cancer survivors require tailored guidance for physical activity.

Purpose of the Study:

• To develop and validate a simulation model-based tool.
• To estimate individualized survival outcomes based on postdiagnosis physical activity.
• To support personalized physical activity prescriptions for breast cancer survivors.

Main Methods:

• Adapted a simulation modeling approach from the Cancer Intervention and Surveillance Modeling Network.
• Estimated 10-year breast cancer-specific and all-cause survival for 60,480 subgroups of postmenopausal women (stage I-III).
• Varied subgroups by age, weight status (BMI), stage, tumor subtype, treatment, and physical activity levels (aerobic and muscle-strengthening).

Main Results:

• Survival benefits varied significantly based on individual characteristics and physical activity levels.
• Example: For a specific patient profile, increasing aerobic activity showed absolute increases in 10-year survival by 2.8% (cancer-specific) and 3.4% (all-cause).
• The simulation model demonstrated strong external validity, accurately replicating survival rates in independent datasets.

Conclusions:

• Simulation model-based estimates can effectively support clinical decision-making.
• The tool can facilitate guideline-recommended individualized discussions and physical activity prescriptions.
• Personalized physical activity recommendations can enhance survival outcomes for breast cancer survivors.