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. 2022 Nov 17;12(11):e068797.
doi: 10.1136/bmjopen-2022-068797.

Identifying relative efficacy of components of prehabilitation in adult surgical patients: protocol for a systematic review and component network meta-analysis

Daniel I McIsaac  1   2   3 , Brian Hutton  2   3 , Areti Veroniki  4 , Marlyn Gill  5 , Laura Boland  6 , Karina Branje  7   2 , Alexa L Grudzinski  7 , Emily Hladkowicz  7   2 , Julia Shaw  7   2 , Chelsia Gillis  8 ; Prehabilitation Knowledge Network Authorship Group
Collaborators, Affiliations

Identifying relative efficacy of components of prehabilitation in adult surgical patients: protocol for a systematic review and component network meta-analysis

Daniel I McIsaac et al. BMJ Open. .

Abstract

Introduction: Prehabilitation is a high-priority intervention for patients, the public, clinicians and health systems. However, existing knowledge syntheses are generally low quality and do not provide insights regarding the relative efficacy of different prehabilitation components (eg, exercise, nutrition, psychosocial or cognitive interventions). The objective of the planned review is to evaluate the relative efficacy of different prehabilitation components to inform current care, implementation and future research.

Methods and analysis: We will perform a systematic review and component network meta-analysis (CNMA). We will use a peer-reviewed search strategy to identify all randomised trials of prehabilitation in adult surgical patients from Ovid Medline, Embase, the CINAHL, PsycINFO, Web of Science and the Cochrane Central Register of Controlled Trials, along with grey literature. All stages of the review and data extraction process will be performed in duplicate, following recommended best practices. To compare the relative efficacy of different prehabilitation components (prespecified as exercise, nutrition, psychosocial or cognitive interventions), we will use CNMA, an extension of network meta-analysis that allows estimation of the contributions to efficacy of each component of a multicomponent intervention through direct and indirect comparisons. We will use additive CNMA models for critical outcomes (postoperative complications, patient-reported recovery, physical recovery and length of stay); standard care will be the common reference condition. Pre-specified sensitivity and subgroup analyses will be conducted.

Ethics and dissemination: This review of published data does not require ethical review. Results will be disseminated via scientific conferences, peer-reviewed publications, social and traditional media and via our research network to target partners and organisations.

Keywords: Quality in health care; REHABILITATION MEDICINE; SURGERY.

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Conflict of interest statement

Competing interests: None declared.

References

    1. Meara JG, Leather AJM, Hagander L, et al. . Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 2015;386:569–624. 10.1016/S0140-6736(15)60160-X - DOI - PubMed
    1. Shrime MG, Bickler SW, Alkire BC, et al. . Global burden of surgical disease: an estimation from the provider perspective. Lancet Glob Health 2015;3 Suppl 2:S8–9. 10.1016/S2214-109X(14)70384-5 - DOI - PubMed
    1. Number, percentage and average acute length of stay for top 10 high-volume inpatient surgeries by Province/Territory, HMDB, 2015–2016, 2017. Available: https://www.cihi.ca/en/quick-stats
    1. Shaw J, Beasley E, Hladkowicz E. A survey of older people after major surgery: Prioritization of routine and patient-reported postoperative outcome measures. In: Ottawa Quaity & Patient Safety Conference, 2018.
    1. Vascular Events In Noncardiac Surgery Patients Cohort Evaluation (VISION) Study Investigators, Devereaux PJ, Chan MTV, et al. . Association between postoperative troponin levels and 30-day mortality among patients undergoing noncardiac surgery. JAMA 2012;307:2295–304. 10.1001/jama.2012.5502 - DOI - PubMed

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