Evidence map›Paper›PMID 39846269›Full record

ArticleOrthopaedic surgery2025

Construction and Development of an Enhanced Recovery After Surgery Program for the Surgical Management of Patients With Spinal Metastasis: A Modified Delphi Study.

Fanjie Li, Wenlong Yu, Haohan Zhou, Fan Zhang, Zihuan Zhou, Qiang Gao, Xin Gao, Luosheng Zhang, Yinjie Yan, Quan Huang and 3 more

Abstract readConsensus StatementMulticenter Study
In one paragraph

Article in Orthopaedic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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

5 citing papers in PubMed.

  1. Trial
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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

13 authors.

Fanjie LiDepartment of Orthopaedics, Maanshan General Hospital of Ranger-Duree Healthcare, Anhui, China.
Wenlong YuDepartment of Orthopaedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.ORCID https://orcid.org/0009-0000-1776-4400
Haohan ZhouDepartment of Orthopedics Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Fan ZhangDepartment of Orthopaedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Zihuan ZhouDepartment of Orthopedics Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Qiang GaoDepartment of Orthopaedics, Maanshan General Hospital of Ranger-Duree Healthcare, Anhui, China.
Xin GaoDepartment of Orthopedics Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Luosheng ZhangDepartment of Orthopedics Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Yinjie YanDepartment of Orthopaedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Quan HuangDepartment of Orthopedics Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Xinghai YangDepartment of Orthopedics Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Peilin ChuDepartment of Orthopaedics, Maanshan General Hospital of Ranger-Duree Healthcare, Anhui, China.ORCID https://orcid.org/0000-0002-4825-0637
Mengchen YinDepartment of Orthopaedics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.ORCID https://orcid.org/0000-0001-7404-1495

Funding

National Natural Science Foundation of China 82072961National Natural Science Foundation of China 822051451National Natural Science Foundation of China 82273363Project of Shanghai Municipal Health Commission 20204Y0165Project of Shanghai Municipal Health Commission 20224Y0165Project of Shanghai University of Traditional Chinese Medicine "Visit famous schools and worship famous teachers" 079Project of Young Elite Scientists Sponsorship Program by CACM 2023-QNRC2-A03Shanghai Pujiang Talent Program 2020PJD062Shanghai "Rising Stars of Medical Talents"-Youth Development Program-Youth Medical Talents-Specialist Program SHWSRS 2023-062
6 · The paper itself

Abstract

objectiveAs an effective treatment for spinal metastasis (SM), ERAS protocol can significantly reduce the length of hospital stay and complications in patients. Establishing an ERAS program for perioperative care after SM surgery is a clinical problem that needs to be addressed urgently. We aimed to develop an Enhanced Recovery After Surgery (ERAS) program and Surgical Safety Checklist (SSC) that conferred clinical benefit to patients with SM and made it relatively easy to manage the condition. We believe that our findings could help establish and promote the continuous improvement of additional ERAS programs for SM.

methodsThis is a modified Delphi study. We used a two-round process using data acquired from a review of relevant literature and involving a multidisciplinary panel of experts from different hospitals in China. The modified Delphi survey was conducted from February 1, 2024 to April 20, 2024. The experts were invited to evaluate each of the current relevant ERAS recommended topics to determine the appropriateness of inclusion in the ERAS program and SSC with the 5-point Likert scale. Used the results to create specific ERAS and SSC (70% consensus) programs. Close to consensus (65%-69% consensus) findings were considered for the follow-up survey.

resultsA multicenter, multidisciplinary group of physicians (n = 75), including clinical workers, researchers, anesthesiologists, nursing specialists, psychologists, nutritionists, and caregivers, with experience in managing patients with SM, were asked to participate. Using the modified Delphi process, we arrived at a consensus for the ERAS program. This included 37 consolidated items in the domains in the following order: preoperative, intraoperative, postoperative, and discharge. The SSC included 37 consolidated items in the domains in the following order: before the induction of anesthesia, before skin incision, and before the patient leaves the operating room.

conclusionThis study, based on the modified Delphi process, helped us develop ERAS and SCC consensus-driven best practice recommendations, including suggestions related to perioperative anesthesia, surgery, and nursing for SM. We hope that this study, in which we integrated both traditional Chinese and Western medical treatment protocols, can provide a basis for a rapid rehabilitation program for surgical interventions in SM.

Indexed as

Enhanced Recovery After SurgeryPerioperative CareSpinal NeoplasmsChecklistChinaDelphi TechniqueHumansDelphi studydevelopmentenhanced recovery after surgeryspinal metastasissurgical safety checklist

Identifiers

PMID39846269
PMCPMC11872384

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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.