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Outcomes reported in randomised trials of surgical prehabilitation: a scoping review. | LitMetric

AI Article Synopsis

  • The scoping review aimed to systematically map the various outcomes and assessment tools used in surgical prehabilitation trials, highlighting the heterogeneity of reported results.
  • A total of 76 trials, mostly involving abdominal or orthopedic surgeries, identified 50 different outcomes assessed through 184 tools, with a strong reliance on observer, clinician, and patient-reported metrics.
  • The study concludes that standardizing outcome reporting and assessment tools is essential for improving the clarity and reliability of evidence in prehabilitation research.

Article Abstract

Background: Heterogeneity of reported outcomes can impact the certainty of evidence for prehabilitation. The objective of this scoping review was to systematically map outcomes and assessment tools used in trials of surgical prehabilitation.

Methods: MEDLINE, EMBASE, PsychInfo, Web of Science, CINAHL, and Cochrane were searched in February 2023. Randomised controlled trials of unimodal or multimodal prehabilitation interventions (nutrition, exercise, psychological support) lasting at least 7 days in adults undergoing elective surgery were included. Reported outcomes were classified according to the International Society for Pharmacoeconomics and Outcomes Research framework.

Results: We included 76 trials, mostly focused on abdominal or orthopaedic surgeries. A total of 50 different outcomes were identified, measured using 184 outcome assessment tools. Observer-reported outcomes were collected in 86% of trials (n=65), with hospital length of stay being most common. Performance outcomes were reported in 80% of trials (n=61), most commonly as exercise capacity assessed by cardiopulmonary exercise testing. Clinician-reported outcomes were included in 78% (n=59) of trials and most frequently included postoperative complications with Clavien-Dindo classification. Patient-reported outcomes were reported in 76% (n=58) of trials, with health-related quality of life using the 36- or 12-Item Short Form Survey being most prevalent. Biomarker outcomes were reported in 16% of trials (n=12) most commonly using inflammatory markers assessed with C-reactive protein.

Conclusions: There is substantial heterogeneity in the reporting of outcomes and assessment tools across surgical prehabilitation trials. Identification of meaningful outcomes, and agreement on appropriate assessment tools, could inform the development of a prehabilitation core outcomes set to harmonise outcome reporting and facilitate meta-analyses.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11213997PMC
http://dx.doi.org/10.1016/j.bja.2024.01.046DOI Listing

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