{
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  "capturedAt": "2026-10-29T10:31:13.632Z",
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  "work": {
    "type": "RDN",
    "kind": "note",
    "key": "molenaar-2023",
    "id": "TAP-RDN-0065",
    "locale": "en",
    "path": "/research/molenaar-2023/",
    "title": "TAP reading note: Effect of Multimodal Prehabilitation on Reducing Postoperative Complications and Enhancing Functional Capacity Following Colorectal Cancer Surgery: The PREHAB Randomized Clinical Trial",
    "description": "In PREHAB, four weeks of multimodal prehabilitation was associated with fewer severe complications, defined as CCI>20: 21/123 versus 38/128, adjusted OR=.47 (95% CI .26–.87). The other coprimary outcome, six-minute walk distance four weeks after surgery, differed by 15.6 m (−1.4 to 32.6), which was not significant. These outcomes require separate interpretation.",
    "rights": "© The Allostasis Project. All rights reserved. Reproduction or adaptation requires separate permission, subject to applicable legal exceptions.",
    "version": "1.0",
    "updatedAt": "2026-10-29",
    "editorial": {
      "contentType": "evidence-review",
      "reviewState": "draft",
      "reviewedAt": null,
      "reviewedVersion": null,
      "updatedAt": "2026-10-29",
      "version": "1.0",
      "byline": "team",
      "author": null,
      "reviewer": null,
      "workflow": {
        "ai": {
          "usage": "used",
          "system": "OpenAI Codex",
          "scope": "Assisted source comparison, evidence extraction and bilingual research-note preparation. The materials consulted and unresolved scientific issues are specified in each note.",
          "version": "1.0",
          "tasks": [
            "Source comparison and evidence extraction",
            "Bilingual research-note drafting and editorial comparison"
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      },
      "revisions": [
        {
          "date": "2026-10-29",
          "version": "1.0",
          "description": "Added PREHAB with separate coprimary results and the Figure 3D correction."
        }
      ]
    },
    "original": {
      "id": "molenaar-2023",
      "title": "Effect of Multimodal Prehabilitation on Reducing Postoperative Complications and Enhancing Functional Capacity Following Colorectal Cancer Surgery: The PREHAB Randomized Clinical Trial",
      "authors": "Molenaar CJL · Minnella EM · Coca-Martinez M · Ten Cate DWG · Regis M · Awasthi R · Martínez-Palli G · López-Baamonde M · Sebio-Garcia R · Feo CV · van Rooijen SJ · Schreinemakers JMJ · Bojesen RD · Gögenur I · van den Heuvel ER · Carli F · Slooter GD · PREHAB Study Group",
      "journal": "JAMA Surgery",
      "year": "2023",
      "url": "https://doi.org/10.1001/jamasurg.2023.0198",
      "doi": "10.1001/jamasurg.2023.0198",
      "pmid": "36988937"
    },
    "references": [
      {
        "id": "molenaar-2023",
        "title": "Effect of Multimodal Prehabilitation on Reducing Postoperative Complications and Enhancing Functional Capacity Following Colorectal Cancer Surgery: The PREHAB Randomized Clinical Trial",
        "authors": "Molenaar CJL · Minnella EM · Coca-Martinez M · Ten Cate DWG · Regis M · Awasthi R · Martínez-Palli G · López-Baamonde M · Sebio-Garcia R · Feo CV · van Rooijen SJ · Schreinemakers JMJ · Bojesen RD · Gögenur I · van den Heuvel ER · Carli F · Slooter GD · PREHAB Study Group",
        "journal": "JAMA Surgery",
        "year": "2023",
        "url": "https://doi.org/10.1001/jamasurg.2023.0198",
        "doi": "10.1001/jamasurg.2023.0198",
        "pmid": "36988937"
      }
    ],
    "sections": [
      {
        "id": "finding",
        "title": "What the study found",
        "paragraphs": [
          "In PREHAB, four weeks of multimodal prehabilitation was associated with fewer severe complications, defined as CCI>20: 21/123 versus 38/128, adjusted OR=.47 (95% CI .26–.87). The other coprimary outcome, six-minute walk distance four weeks after surgery, differed by 15.6 m (−1.4 to 32.6), which was not significant. These outcomes require separate interpretation."
        ]
      },
      {
        "id": "limits",
        "title": "Scope & limitations",
        "paragraphs": [
          "Seven centres and nonmetastatic colorectal-cancer surgery patients; 269 randomized, 18 excluded after randomization and 251 in the authors' intention-to-treat analysis. Median age was 69.",
          "The planned sample was 714, but COVID-19 stopped recruitment early. CCI was analysed dichotomously because of skew, and about one-third of four-week walking data were missing. A 2023 correction added significance superscripts to the prehabilitation group's preoperative and four-week Figure 3D data. Eight-week secondary results do not replace the four-week coprimary endpoint."
        ]
      },
      {
        "id": "sample",
        "title": "Population & sample",
        "paragraphs": [
          "Seven centres and nonmetastatic colorectal-cancer surgery patients; 269 randomized, 18 excluded after randomization and 251 in the authors' intention-to-treat analysis. Median age was 69."
        ]
      },
      {
        "id": "exposure",
        "title": "Exposure or intervention",
        "paragraphs": [
          "Four weeks of supervised exercise, nutrition and psychological support with standard enhanced recovery, versus standard care."
        ]
      },
      {
        "id": "outcomes",
        "title": "Outcomes",
        "paragraphs": [
          "Coprimary 30-day CCI and four-week walk distance; continuous CCI comparison P=.06. Seven minor and no serious intervention-related adverse events were reported."
        ]
      },
      {
        "id": "duration",
        "title": "Time frame",
        "paragraphs": [
          "Four preoperative weeks; primary postoperative assessments at 30 days and four weeks, with later measurements."
        ]
      },
      {
        "id": "funding",
        "title": "Research funding",
        "paragraphs": [
          "Dutch Cancer Society and Johnson & Johnson, among others; protein supplied by FrieslandCampina and Immunotec, equipment loaned by Philips."
        ]
      },
      {
        "id": "conflicts",
        "title": "Research conflicts of interest",
        "paragraphs": [
          "Some authors disclosed relationships with Dompé, Pharmacosmos, Intuitive and Ethicon, among others. Funders reportedly had no role in research decisions."
        ]
      },
      {
        "id": "basis",
        "title": "Reading scope",
        "paragraphs": [
          "Original PDF body and formal correction of 3 May 2023. The consulted PDF predates the correction, so Figure 3D must be read with the notice. Protocol, statistical analysis plan and all missing-data sensitivity supplements remain to be checked."
        ],
        "links": [
          {
            "label": "Full text in PubMed Central",
            "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10061316/"
          },
          {
            "label": "Formal correction: Error in Figure",
            "url": "https://jamanetwork.com/journals/jamasurgery/fullarticle/2804492"
          },
          {
            "label": "Compare the related original study and its methods",
            "url": "https://doi.org/10.1001/jamasurg.2019.5474"
          }
        ]
      }
    ]
  }
}