Identifying relative efficacy of components of prehabilitation in adult surgical patients: protocol for a systematic review and component network meta-analysis. Issue 11 (17th November 2022)

• Record Type: Journal Article
• Authors: McIsaac, Daniel I; Hutton, Brian; Veroniki, Areti; Gill, Marlyn; Boland, Laura; Branje, Karina; Grudzinski, Alexa L; Hladkowicz, Emily; Shaw, Julia; Gillis, Chelsia
• Other Names: author non-byline.; Akhtar Shamsuddin author non-byline.; Atkins Marlis author non-byline.; Aucoin Sylvie author non-byline.; Auer Rebecca author non-byline.; Basualdo-Hammond Carlota author non-byline.; Beaule Paul author non-byline.; Brindle Mary author non-byline.; Bryson Gregory author non-byline.; Carli Franco author non-byline.; Eskander Antoine author non-byline.; Fergusson Dean author non-byline.; Fiore Julio F author non-byline.; Forster Alan author non-byline.; Gillam Melani author non-byline.; Gramlich Leah author non-byline.; Holroyd-Leduc Jayna author non-byline.; Jackson Timothy author non-byline.; Khadaroo Rachel author non-byline.; Lalu Manoj author non-byline.; Love Cameron author non-byline.; Martel Guillaume author non-byline.; McCartney Colin author non-byline.; McKeen Dolores author non-byline.; Meliambro Amanda author non-byline.; Moloo Husein author non-byline.; Moore Ronald author non-byline.; Muscedere John author non-byline.; Nantel Julie author non-byline.; Poitras Stephane author non-byline.; Scheede-Bergdahl Celena author non-byline.; Shorr Risa author non-byline.; Taljaard Monica author non-byline.; Wallace Tom author non-byline.; Wijeysundera Duminda author non-byline.;
• Is Part Of: BMJ open. Volume 12:Issue 11(2022)
• Publication Date: 2022-11-17
• Subjects: SURGERY -- Quality in health care -- REHABILITATION MEDICINE; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2022-068797
• Languages: English
• ISSNs: 2044-6055

Abstract

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.