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    "key": "carli-2020",
    "id": "TAP-RDN-0066",
    "locale": "en",
    "path": "/research/carli-2020/",
    "title": "TAP reading note: Effect of Multimodal Prehabilitation vs Postoperative Rehabilitation on 30-Day Postoperative Complications for Frail Patients Undergoing Resection of Colorectal Cancer: A Randomized Clinical Trial",
    "description": "Among frail or prefrail older colorectal-cancer patients, preoperative prehabilitation showed no clear advantage over postoperative rehabilitation for 30-day complication burden: adjusted CCI difference −3.2 (95% CI −11.8 to 5.3). The four-week walk-distance difference of 18.5 m (−20.2 to 57.3) was also nonsignificant. The intervals still allow meaningful benefit and do not demonstrate equivalence or no effect.",
    "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",
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      "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 the trial in frail older patients, retaining uncertainty intervals and linking its affiliation correction."
        }
      ]
    },
    "original": {
      "id": "carli-2020",
      "title": "Effect of Multimodal Prehabilitation vs Postoperative Rehabilitation on 30-Day Postoperative Complications for Frail Patients Undergoing Resection of Colorectal Cancer: A Randomized Clinical Trial",
      "authors": "Carli F · Bousquet-Dion G · Awasthi R · Elsherbini N · Liberman S · Boutros M · Stein B · Charlebois P · Ghitulescu G · Morin N · Jagoe T · Scheede-Bergdahl C · Minnella EM · Fiore JF",
      "journal": "JAMA Surgery",
      "year": "2020",
      "url": "https://doi.org/10.1001/jamasurg.2019.5474",
      "doi": "10.1001/jamasurg.2019.5474",
      "pmid": "31968063"
    },
    "references": [
      {
        "id": "carli-2020",
        "title": "Effect of Multimodal Prehabilitation vs Postoperative Rehabilitation on 30-Day Postoperative Complications for Frail Patients Undergoing Resection of Colorectal Cancer: A Randomized Clinical Trial",
        "authors": "Carli F · Bousquet-Dion G · Awasthi R · Elsherbini N · Liberman S · Boutros M · Stein B · Charlebois P · Ghitulescu G · Morin N · Jagoe T · Scheede-Bergdahl C · Minnella EM · Fiore JF",
        "journal": "JAMA Surgery",
        "year": "2020",
        "url": "https://doi.org/10.1001/jamasurg.2019.5474",
        "doi": "10.1001/jamasurg.2019.5474",
        "pmid": "31968063"
      }
    ],
    "sections": [
      {
        "id": "finding",
        "title": "What the study found",
        "paragraphs": [
          "Among frail or prefrail older colorectal-cancer patients, preoperative prehabilitation showed no clear advantage over postoperative rehabilitation for 30-day complication burden: adjusted CCI difference −3.2 (95% CI −11.8 to 5.3). The four-week walk-distance difference of 18.5 m (−20.2 to 57.3) was also nonsignificant. The intervals still allow meaningful benefit and do not demonstrate equivalence or no effect."
        ]
      },
      {
        "id": "limits",
        "title": "Scope & limitations",
        "paragraphs": [
          "Two centres; patients aged ≥65 with Fried scores ≥2. Of 120 randomized, 110 entered the authors' intention-to-treat analysis.",
          "Ten post-randomization exclusions, substantial secondary-outcome missingness, age/ASA imbalance and the missing-at-random imputation assumption matter. Population, comparator and implementation differ from PREHAB, so the trials are not simply opposing positive/negative results. A formal correction concerns author affiliations, not result values."
        ]
      },
      {
        "id": "sample",
        "title": "Population & sample",
        "paragraphs": [
          "Two centres; patients aged ≥65 with Fried scores ≥2. Of 120 randomized, 110 entered the authors' intention-to-treat analysis."
        ]
      },
      {
        "id": "exposure",
        "title": "Exposure or intervention",
        "paragraphs": [
          "Four weeks of preoperative multimodal prehabilitation versus similar postoperative rehabilitation; both received standard enhanced recovery, with blinded assessors."
        ]
      },
      {
        "id": "outcomes",
        "title": "Outcomes",
        "paragraphs": [
          "30-day CCI and functional outcomes, interpreted with uncertainty intervals and missingness."
        ]
      },
      {
        "id": "duration",
        "title": "Time frame",
        "paragraphs": [
          "Four preoperative weeks, 30-day complication assessment and postoperative functional follow-up."
        ]
      },
      {
        "id": "funding",
        "title": "Research funding",
        "paragraphs": [
          "Rossy Cancer Network and the Peri Operative Program; Immunotec supplied protein supplements."
        ]
      },
      {
        "id": "conflicts",
        "title": "Research conflicts of interest",
        "paragraphs": [
          "Liberman disclosed other company relationships; consult the article. Complete author-by-author disclosures remain to be checked."
        ]
      },
      {
        "id": "basis",
        "title": "Reading scope",
        "paragraphs": [
          "JAMA web full-text methods/results, Tables 2–4 and article information, paired with the 2020 affiliation correction. Protocol, missingness and adherence supplements remain to be examined."
        ],
        "links": [
          {
            "label": "Full text in PubMed Central",
            "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6990653/"
          },
          {
            "label": "Formal correction: Error in Author Affiliations",
            "url": "https://jamanetwork.com/journals/jamasurgery/fullarticle/2763142"
          },
          {
            "label": "Compare the related original study and its methods",
            "url": "https://doi.org/10.1001/jamasurg.2023.0198"
          }
        ]
      }
    ]
  }
}