Evidence map›Paper›PMID 37474828›Full record

SynthesisSurgical endoscopy2023

Impact of enhanced recovery pathways on patient-reported outcomes after abdominal surgery: a systematic review.

Charbel El-Kefraoui, Uyen Do, Andrew Miller, Araz Kouyoumdjian, David Cui, Elahe Khorasani, Tara Landry, Alexandre Amar-Zifkin, Lawrence Lee, Liane S Feldman and 1 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Charbel El-KefraouiDivision of Experimental Surgery, McGill University, Montreal, QC, Canada.
Uyen DoCentre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Andrew MillerFaculty of Medicine, McGill University, Montreal, QC, Canada.
Araz KouyoumdjianDivision of Experimental Surgery, McGill University, Montreal, QC, Canada.
David CuiDepartment of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada.
Elahe KhorasaniDivision of Experimental Surgery, McGill University, Montreal, QC, Canada.
Tara LandryBibliothèque de la Santé, Université de Montréal, Montreal, QC, Canada.
Alexandre Amar-ZifkinMedical Libraries, McGill University Health Centre, Montreal, QC, Canada.
Lawrence LeeDivision of Experimental Surgery, McGill University, Montreal, QC, Canada.
Liane S FeldmanDivision of Experimental Surgery, McGill University, Montreal, QC, Canada.
Julio F FioreDivision of Experimental Surgery, McGill University, Montreal, QC, Canada. julio.fiorejunior@mcgill.ca.ORCID http://orcid.org/0000-0002-0019-8673

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEvidence supports that enhanced recovery pathways (ERPs) reduce length of stay and complications; however, these measures may not reflect the perspective of patients who are the main stakeholders in the recovery process. This systematic review aimed to appraise the evidence regarding the impact of ERPs on patient-reported outcomes (PROs) after abdominal surgery.

methodsFive databases (Medline, Embase, Biosis, Cochrane, and Web of Science) were searched for randomized controlled trials (RCTs) addressing the impact of ERPs on PROs after abdominal surgery. We focused on distinct periods of recovery: early (within 7 days postoperatively) and late (beyond 7 days). Risk of bias was assessed using Cochrane's RoB 2.0. Results were appraised descriptively as heterogeneity hindered meta-analysis. Certainty of evidence was evaluated using GRADE.

resultsFifty-six RCTs were identified [colorectal (n = 18), hepatopancreaticobiliary (HPB) (n = 11), upper gastrointestinal (UGI) (n = 10), gynecological (n = 7), urological (n = 7), general surgery (n = 3)]. Most trials had 'some concerns' (n = 30) or 'high' (n = 25) risk of bias. In the early postoperative period, ERPs improved patient-reported general health (colorectal, HPB, UGI, urological; very low to low certainty), physical health (colorectal, gynecological; very low to low certainty), mental health (colorectal, gynecological; very low certainty), pain (all specialties; very low to moderate certainty), and fatigue (colorectal; low certainty). In the late postoperative period, ERPs improved general health (HPB, UGI, urological; very low certainty), physical health (UGI, gynecological, urological; very low to low certainty), mental health (UGI, gynecological, urological; very low certainty), social health (gynecological; very low certainty), pain (gynecological, urological; very low certainty), and fatigue (gynecological; very low certainty).

conclusionThis review supports that ERPs may have a positive impact on patient-reported postoperative health status (i.e., general, physical, mental, and social health) and symptom experience (i.e., pain and fatigue) after abdominal surgery; however, data were largely derived from low-quality trials. Although these findings contribute important knowledge to inform evidence-based ERP implementation, there remains a great need to improve PRO assessment in studies focused on postoperative recovery.

Indexed as

Colorectal NeoplasmsPainFatigueHumansPatient Reported Outcome MeasuresEnhanced recoveryPatient-reported outcomesPerioperative careSurgery

Identifiers

PMID37474828

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.