Rigor Reviewed

Rigor-Reviewed Manuscript

Supervised, structured and individualized exercise in metastatic breast cancer: a randomized controlled trial.

Name: Αlpha¹ Rigor Record — Supervised, structured and individualized exercise in metastatic breast cancer: a randomized controlled trial.
Item: Supervised, structured and individualized exercise in metastatic breast cancer: a randomized controlled trial.
Rating: 39
Author: Αlpha¹

Hiensch AE, Depenbusch J, Schmidt ME, Monninkhof EM, Pelaez M, Clauss D, Gunasekara N, Zimmer P, Belloso J, Trevaskis M, Rundqvist H, Wiskemann J, Müller J, Sweegers MG, Fremd C, Altena R, Gorecki M, Bijlsma R, van Leeuwen-Snoeks L, Ten Bokkel Huinink D, Sonke G, Lahuerta A, Mann GB, Francis PA, Richardson G, Malter W, van der Wall E, Aaronson NK, Senkus E, Urruticoechea A, Zopf EM, Bloch W, Stuiver MM, Wengstrom Y, Steindorf K, May AM

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Αlpha¹ Rigor Review — 1★ (Critical), 2 critical, 2 high issues for “Supervised, structured and individualized exercise in metastatic breast cancer: a randomized controlled trial.”

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Αlpha¹ Editorial

This rigor review was examined and confirmed by Αlpha¹ Editorial · August 16, 2026

Αlpha¹ Rigor Review

Rigor Reviewed

1 / 5

Critical — a demonstrable failure

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

StatisticsImpossible or misreported statistic ×2−2★
CitationsUnresolved reference ×4−1★
IntegrityIntegrity concern−0.5★
ClaimsEfficacy rests on an unvalidated surrogate endpoint−0.5★
ClaimsTreatment effect not shown to be clinically meaningful−0.5★
StatisticsPrinted percentage does not match its own count (capped) ×3−0.25★

A demonstrable critical failure caps the rating at the minimum, regardless of the deductions above.

Model-reported confidence: highReviewer agreement: highEngine: 7.39.0Source: full text

Not verified in this report

The numeric-impossibility checks (GRIM/GRIMMER/DEBIT/SPRITE) did not run: 4 reported means were read, and their group size is not stated where the values are printed (this source has no machine-readable table structure). These checks need the count the mean was averaged over, so none was performed.

Problems surfaced6 types

Numerical inconsistencies3

Values that contradict each other or are impossible for the stated sample: recomputed p-values and test statistics, GRIM/GRIMMER checks on summary numbers, percentages against their own counts, totals against their parts, and estimates against their own confidence intervals.

Summary statistic impossible for the stated N (GRIM/GRIMMER)Recomputed
Printed percentage does not match its own countRecomputed
Internal contradictions in the reported numbersAssessed

Overstated conclusions2

Conclusions that reach past what the paper's own results support — including a significance claim that no longer holds when the statistic is recomputed, and efficacy resting on an unvalidated surrogate endpoint.

Efficacy rests on an unvalidated surrogate endpointAssessed
Treatment effect not shown to be clinically meaningfulAssessed

Broken references and links1

References checked against Crossref, OpenAlex and Retraction Watch for retractions and resolvability, plus declared data and code links probed for whether they resolve to content matching the paper.

References not resolvable to a published paperRecomputed

This Αlpha¹ Rigor Review uses AI Rigor Reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.

Critical findings

• PERCENT: 42% does not match the reported count 43/179
• PERCENT: 24.6% does not match the reported count 46/179

This is a well-conducted and transparently reported randomized controlled trial. The methodology is rigorous, with clear randomization, power analysis, and appropriate statistical methods. Minor reporting issues (a potential percentage typo in Table 1 and a few copyedit items) do not undermine the overall integrity.

Both reviewers classified the study as interventional, which is adopted. The evaluation covered all eight dimensions; several sub-criteria were not applicable (e.g., animal housing, cell line authentication) due to the human trial nature. The statistics verification recomputed only a subset of tests; the remaining were not machine-verifiable but no errors were found.

6 major claims checked against the paper's own evidence: all adequately supported.

Premise concern: surrogate not validated for clinical benefit; effect size not shown to be clinically meaningful.

Recomputed 3 tests: 3 consistent, 0 inconsistent; 3 via agent-written checks. 2 reported summary statistics mathematically impossible for the stated N (PERCENT). 3 printed percentages that do not match their own count.

1 integrity concern flagged (0 high).

Reporting

Eight Dimensions8 pass

The introduction cites prior research on exercise in cancer survivors, acknowledges the scarcity of evidence in metastatic breast cancer, and justifies the need for a high-quality trial. The rationale links the premise to the study objectives, and limitations of prior research are addressed by designing an adequately powered trial.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 95% conf

The paper establishes a clear scientific premise with extensive prior work and a logical rationale for the study.

Evidence

paraphrase[Main, paragraph 2]

“Two systematic reviews in patients with advanced cancer, including patients with MBC, concluded that exercise interventions are safe and feasible, and that this is also true for patients with bone metastases. However, insufficient data are available to draw any conclusions regarding the effects of exercise on fatigue, HRQOL and other cancer-related and treatment-related side effects.”

direct quote[Main, paragraph 2]

“Hence, a high-quality and adequately powered study is needed to assess the effects of exercise in patients with MBC.”