Evidence map›Paper›PMID 40000106›Full record

ArticleBMJ open quality2025

All Wales Ovarian Cancer Prehabilitation Project (AWOCPP).

Josh Courtney McMullan, Catherine Smith, Rosalind Jones, Caryl Butterworth, Christine Davies, Helen Long, Jacqueline Pottle, Claire Jarrom, Richard Peevor, Rachel Jones and 4 more

Abstract read
In one paragraph

Article in BMJ open quality, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Observational
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

14 authors.

Josh Courtney McMullanGynaecological Oncology, University Hospital of Wales, Cardiff, Cardiff, UK joshcmcmullan@doctors.org.uk.ORCID http://orcid.org/0009-0007-1061-489X
Catherine SmithGynaecological Oncology, University Hospital of Wales, Cardiff, Cardiff, UK.
Rosalind JonesYsbyty Gwynedd, Bangor, Gwynedd, UK.
Caryl ButterworthYsbyty Gwynedd, Bangor, Gwynedd, UK.
Christine DaviesSingleton Hospital, Swansea, UK.
Helen LongUniversity Hospital of Wales, Cardiff, Cardiff, UK.
Jacqueline PottleYsbyty Gwynedd, Bangor, Gwynedd, UK.
Claire JarromUniversity Hospital of Wales, Cardiff, Cardiff, UK.
Richard PeevorYsbyty Gwynedd, Bangor, Gwynedd, UK.
Rachel JonesSingleton Hospital, Swansea, UK.
Preeti GuptaUniversity Hospital of Wales, Cardiff, Cardiff, UK.
Louise HannaVelindre Hospital, Cardiff, Cardiff, UK.
Emma HudsonVelindre Hospital, Cardiff, Cardiff, UK.
Sadie JonesUniversity Hospital of Wales, Cardiff, Cardiff, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Over 50% of patients with ovarian cancer are diagnosed with advanced disease (stage 3+) in Wales when treatment typically involves chemotherapy, combined with cytoreductive surgery. Postoperative morbidity is common resulting in prolonged hospital stays and delays in returning to chemotherapy. Patients with advanced ovarian cancer commonly have modifiable risk factors that can be targeted for improvement with personalised prehabilitation. Multimodal personalised prehabilitation has been shown to have a positive impact on perioperative outcomes and length of stay (LOS).Quality improvement methods were used to implement a multimodal prehabilitation programme for all patients with advanced ovarian cancer planned for surgery in Wales. A unique approach to determining an individual patient's modifiable risk factors was devised that enabled a personalised prehabilitation programme to be created including exercise, smoking cessation, medical and nutritional optimisation and emotional support. Data were collected to enable future health economic evaluation of the programme in anticipation of national role out as standard of care. To evaluate if the prehabilitation intervention was impacting the quality of care, the following outcome measures were assessed: LOS, postoperative complications and surgery to chemotherapy interval (SCI). These measures were compared with a historical Welsh data set from 2018 to 2019 when access to prehabilitation was not available.Following the implementation of prehabilitation for ovarian cancer, the median LOS reduced from 6 to 5 days (p=0.29). There was a reduction in postoperative complications: from 16.9% to 12.7% (Grade 2), 4.4% to 1.8% (Grade 3), 0.6% to 0% (Grade 4+5). The median SCI following prehabilitation was 43.5 days (range 27-91) compared with 40 days (range 15-182 (p=0.65)).Prehabilitation has had a positive impact on the treatment pathways for advanced ovarian cancer in Wales. Means of improving patient engagement and establishing cost-effective delivery need to be developed to make this intervention standard of care.

Indexed as

Ovarian NeoplasmsPreoperative CareAdultAgedFemaleHumansLength of StayMiddle AgedPostoperative ComplicationsWalesAllied Health OccupationsLength of StayObstetrics and gynaecologyOccupational TherapyQuality improvement

Identifiers

PMID40000106
PMCPMC12083423

What OpenQuestion holds

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Registered trials

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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.