Identifying relative efficacy of components of prehabilitation in adult surgical patients: protocol for a systematic review and component network meta-analysis
Open accessAbstract
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.
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Research works printed but not linked: 2
- [4]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.
- [36]McIsaac DI, Gill M, Boland L. Prehabilitation in adult surgical patients: an umbrella review of systematic reviews. Ann Surg 2021: Submitted. 34922735
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McIsaac, D. I., Kidd, G., Gillis, C., Branje, K., Al-Bayati, M., Baxi, A., Grudzinski, A. L., Boland, L., Veroniki, A.-A., Wolfe, D., et al. (2025) · BMJ · doi:10.1136/bmj-2024-081164 · Cited by 168 · see citing works
Self-citation
- Authors
- McIsaac, D. I., Hutton, B., Veroniki, A., Gill, M., Boland, L., Branje, K., Grudzinski, A. L., Hladkowicz, E., Shaw, J., & Gillis, C.
- Affiliations
- University of Ottawa (CA)
- St. Michael's Hospital (CA)
- Patient Partner, Calgary, Alberta, Canada
- Ottawa Hospital Research Institute (CA)
- McGill University (CA)
- Corresponding author
- McIsaac, Daniel I
- ORCID
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2022-11
- Volume
- 12
- Issue
- 11
- Pages
- e068797
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC9677017
- OpenAlex
- W4309619185
- Cited by
- 7
- References
- 58
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3
- FWCI
- 0.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- The Canadian Institutes of Health Research (179837)
- Topics
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- prehabilitation, surgical patients, physical activity, nutrition, psychosocial interventions, cognitive intervention, postoperative complications, physical recovery, length of hospital stay, multicomponent intervention, component network meta-analysis
- MeSH terms
- Network Meta-Analysis, Network Meta-Analysis as Topic, Systematic Reviews as Topic, Preoperative Exercise, Adult, Humans, Postoperative Complications, Meta-Analysis as Topic, Exercise
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