Time to Prioritise Quality Over Quantity in Prehabilitation Trials: A Literature Review
Wilson Jiang1, Michael Solomon1, Sascha Karunaratne1, Paula R Beckenkamp2, Kari Clifford3, John Woodfield3, Daniel Steffens11Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), New South Wales, Sydney, Australia., 2Faculty of Medicine and Health, Discipline of Physiotherapy, The University of Sydney, New South Wales, Australia., 3Department of Surgical Sciences (Dunedin), University of Otago, New Zealand.,
Objectives: The increasing number of prehabilitation randomised controlled trials (RCTs) for cancer surgery patients emphasises the need for high-quality evidence. Therefore, this study aims to assess reporting quality and risk of bias in prehabilitation RCTs. Methods: A comprehensive search was conducted across multiple databases, including MEDLINE, Embase, The Cochrane Library, CINAHL, AMED, and PsycINFO to identify RCTs evaluating the effectiveness of exercise, nutrition, and/or psychological interventions on postoperative complications and/or length of hospital stay in adult patients undergoing cancer surgery. Trials were assessed for risk of bias, reporting quality and other relevant metrics. Results: Of the 74 included RCTs, 55 had a high risk of bias. Deviations from intended interventions (55%) and missing outcome data (32%) were the most frequently identified items with a high risk of bias. Only nine of 13 TIDieR items were adequately reported, and just nine RCTs provided information on intervention modifications. 55% of trials provided a protocol, with 68% altering primary and/or secondary aims. Conclusions: Prehabilitation RCTs exhibit poor reporting quality and high risk of bias. More transparent trials are needed to assess the effectiveness of prehabilitation programs. Identifying barriers to improving the quality would assist in enhancing the reliability of future trials.
Cite This Article
Jiang W, Solomon M, Karunaratne S, Beckenkamp P, Clifford K, Woodfield J, et al. Time to Prioritise Quality Over Quantity in Prehabilitation Trials: A Literature Review. EJMO. 2023; 7(3): 287-288
Corresponding Author: Wilson Jiang