Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
J Surg Res. 2021 Feb;258:443-452. doi: 10.1016/j.jss.2020.09.026. Epub 2020 Oct 29.
Prehabilitation is a new field of research that aims to optimize modifiable surgical risk factors before surgery to improve patient-oriented outcomes preoperatively and postoperatively. As with any new intervention, the pressing questions that arise include what interventions work, for whom they work, and when do they work best? Given that prehabilitation can be resource intensive, and that preoperative patient characteristics are likely to produce variation in response to treatment, establishing answers to these questions is critical for successful implementation of prehabilitation in clinical practice. The objective of this review article is to describe the illuminating potential of including "third-variable effects" into the integration of research design; by planning for and including measurements of mediators, moderators, and confounders in the design and analysis of prehabilitation research, we can begin to answer practical, clinically relevant questions.
术前康复是一个新的研究领域，旨在优化手术前可改变的手术风险因素，以改善术前和术后以患者为中心的结局。与任何新干预措施一样，出现的紧迫问题包括哪些干预措施有效、对谁有效以及何时效果最佳？鉴于术前康复可能需要大量资源，并且术前患者特征可能导致对治疗的反应存在差异，因此为成功将术前康复应用于临床实践，确定这些问题的答案至关重要。本文的目的是描述在研究设计中纳入“第三变量效应”的启示潜力；通过在术前康复研究的设计和分析中计划和纳入中介、调节和混杂因素的测量，我们可以开始回答实际的、临床相关的问题。
