Department of Health Care Management, Technische Universität Berlin, Berlin, Berlin, Germany
Department of Health Care Management, Technische Universität Berlin, Berlin, Berlin, Germany.
BMJ Open. 2020 Dec 31;10(12):e040262. doi: 10.1136/bmjopen-2020-040262.
Preoperative functional capacity is an important predictor of postoperative outcomes. Prehabilitation aims to optimise patients' functional capacity before surgery to improve postoperative outcomes. As prolonged hospital stay and postoperative complications present an avoidable use of healthcare resources, prehabilitation might also save costs.The aim of this systematic review is to investigate the cost-effectiveness of prehabilitation programmes for patients awaiting elective surgery compared with usual preoperative care. The results will be useful to inform decisions about the implementation of prehabilitation programmes and the design of future economic evaluations of prehabilitation programmes.
We will search PubMed, Embase, the Centre for Reviews and Dissemination Database, the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov for full or partial economic evaluations of preoperative prehabilitation programmes conducted in any population compared with usual preoperative care. Studies will be included regardless of the type, design and perspective of the economic evaluation, and their publication year, language or status. Initial searches were performed between 30 April and 4 May 2020.Study selection, data extraction and assessment of the included studies' risk of bias and methodological quality will initially be performed by two independent reviewers and, if agreement was sufficiently high, by one reviewer. We will extract data regarding the included studies' basic characteristics, economic evaluation methods and cost-effectiveness results.A narrative synthesis will be performed. The primary endpoint will be cost-effectiveness based on cost-utility analyses. We will discuss heterogeneity between the studies and assess the risk of publication bias. The certainty of the evidence will be determined using the Grading of Recommendations, Assessment, Development and Evaluation approach.
Ethics approval is not required as the systematic review will not involve human participants. We plan to present our findings at scientific conferences, pass them on to relevant stakeholder organisations and publish them in a peer-reviewed journal.
CRD42020182813.
术前功能能力是术后结果的重要预测指标。术前康复旨在优化患者手术前的功能能力，以改善术后结果。由于住院时间延长和术后并发症是不必要的医疗资源消耗，术前康复也可能节省成本。本系统评价的目的是调查与常规术前护理相比，等待择期手术的患者术前康复计划的成本效益。研究结果将有助于为实施术前康复计划和设计未来的术前康复计划经济评估提供信息。
我们将在 PubMed、Embase、考科蓝中心数据库、世界卫生组织国际临床试验注册平台和 ClinicalTrials.gov 中搜索针对任何人群的术前康复计划的全或部分经济评价，与常规术前护理进行比较。无论经济评价的类型、设计和观点如何，无论其出版年份、语言或状态如何，我们都将纳入研究。初步搜索于 2020 年 4 月 30 日至 5 月 4 日进行。最初将由两名独立评审员进行研究选择、数据提取以及纳入研究的偏倚风险和方法学质量评估，如果一致性足够高，则由一名评审员进行。我们将提取纳入研究的基本特征、经济评价方法和成本效益结果的数据。将进行叙述性综合。主要终点将基于成本效用分析的成本效益。我们将讨论研究之间的异质性，并评估发表偏倚的风险。证据的确定性将使用推荐、评估、制定和评估方法确定。
由于系统评价不涉及人类参与者，因此不需要伦理批准。我们计划在科学会议上展示我们的研究结果，将其传达给相关利益相关者组织，并在同行评议期刊上发表。
PROSPERO 注册号：CRD42020182813。
