Component network meta-analysis identifies the most effective components of psychological preparation for adults undergoing surgery under general anesthesia

Journal of Clinical Epidemiology
Suzanne C FreemanNicola J Cooper

Abstract

To apply component network meta-analysis (CNMA) models to an existing Cochrane review of psychological preparation interventions for adults undergoing surgery and to extend the models to account for covariates to identify the most effective components for improving postoperative outcomes. Interventions consisted of between one and four components of psychological preparation: procedural information (P), sensory information (S), behavioral instruction (B), cognitive interventions (C), relaxation (R), and emotion-focused techniques (E). We used CNMA models to assess the effect of each component for three outcomes: length of stay, pain, and negative affect. We found evidence that the most effective component for reducing length of stay depends on the type of surgery and that R may improve pain. There was insufficient evidence that individual components contributed to the overall reduction in negative affect, but P and S emerged as the most likely beneficial components. Overall, we were unable to identify any one component as the most effective across all three outcomes. The CNMA method allowed us to address questions about the effects of specific components that could not be answered using standard Cochrane methodology.

Citations

Jan 9, 2019·The Cochrane Database of Systematic Reviews·Andrea TakedaStephanie Jc Taylor
Apr 26, 2019·Biometrical Journal. Biometrische Zeitschrift·Gerta RückerGuido Schwarzer
Sep 15, 2020·Health Technology Assessment : HTA·Hollie MeltonPeter Coventry
Feb 9, 2021·PloS One·Maria PetropoulouDimitris Mavridis
Jan 8, 2021·The Cochrane Database of Systematic Reviews·Jamie Hartmann-BoycePaul Aveyard
Mar 30, 2021·Pain Management·Sylvia H WilsonArvind Chandrakantan
Mar 31, 2021·The Cochrane Database of Systematic Reviews·Maria Corina Plaz TorresKurinchi Selvan Gurusamy
Apr 11, 2021·The Cochrane Database of Systematic Reviews·Danielle RobertsKurinchi Selvan Gurusamy
Sep 3, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Martin HübnerGregg Nelson
Jul 20, 2021·The Cochrane Database of Systematic Reviews·Jennifer K BurtonTerry J Quinn
Nov 27, 2021·The Cochrane Database of Systematic Reviews·Jennifer K BurtonTerry J Quinn

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