{
  "schemaVersion": 1,
  "capturedAt": "2026-10-29T10:31:13.711Z",
  "sha256": "26ee76359905347c57b3b8cb8661a61511348b4c136fff94a12693eeacb32a4b",
  "work": {
    "type": "RDN",
    "kind": "note",
    "key": "carli-2020",
    "id": "TAP-RDN-0066",
    "locale": "zh",
    "path": "/zh/research/carli-2020/",
    "title": "TAP 导读: 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": "在衰弱或前衰弱的老年结直肠癌患者中，术前预康复与术后康复相比，未显示30日并发症负担的明确优势：调整CCI差−3.2（95%CI −11.8—5.3）。四周步行距离差18.5米（−20.2—57.3）也不显著；区间仍容许有意义获益，不能解释成等效或已证明无效。",
    "rights": "© The Allostasis Project。保留所有权利。除法律允许的例外外，转载或改编需另行授权。",
    "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"
          ]
        }
      },
      "revisions": [
        {
          "date": "2026-10-29",
          "version": "1.0",
          "description": "新增老年衰弱人群试验，保留估计区间并配对作者单位更正。"
        }
      ]
    },
    "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": "研究发现",
        "paragraphs": [
          "在衰弱或前衰弱的老年结直肠癌患者中，术前预康复与术后康复相比，未显示30日并发症负担的明确优势：调整CCI差−3.2（95%CI −11.8—5.3）。四周步行距离差18.5米（−20.2—57.3）也不显著；区间仍容许有意义获益，不能解释成等效或已证明无效。"
        ]
      },
      {
        "id": "limits",
        "title": "范围与局限",
        "paragraphs": [
          "两中心、≥65岁且Fried评分≥2的患者；120人随机，110人纳入作者称为意向治疗的分析。",
          "10人随机后排除，次要结局缺失较多，年龄与ASA分级存在不平衡；插补依赖随机缺失假设。与PREHAB的人群、比较组和实施方案不同，不宜只按阳性或阴性对立。正式更正涉及作者单位，不涉及结果数值。"
        ]
      },
      {
        "id": "sample",
        "title": "研究人群与样本",
        "paragraphs": [
          "两中心、≥65岁且Fried评分≥2的患者；120人随机，110人纳入作者称为意向治疗的分析。"
        ]
      },
      {
        "id": "exposure",
        "title": "暴露或干预",
        "paragraphs": [
          "术前四周多模式预康复，对比术后同类康复；两组均接受标准增强恢复路径，评估者盲。"
        ]
      },
      {
        "id": "outcomes",
        "title": "观察结局",
        "paragraphs": [
          "30日CCI及功能表现等结局，分别考虑估计区间与缺失资料。"
        ]
      },
      {
        "id": "duration",
        "title": "时间范围",
        "paragraphs": [
          "四周术前干预，30日并发症与术后功能随访。"
        ]
      },
      {
        "id": "funding",
        "title": "研究资金来源",
        "paragraphs": [
          "Rossy Cancer Network和Peri Operative Program支持；Immunotec供应蛋白补充品。"
        ]
      },
      {
        "id": "conflicts",
        "title": "研究利益关系",
        "paragraphs": [
          "Liberman披露其他企业关系，详见原文；完整逐作者披露仍待核全。"
        ]
      },
      {
        "id": "basis",
        "title": "导读范围",
        "paragraphs": [
          "JAMA网页全文方法、结果、表2—4和文章信息，配对2020年作者单位更正；方案、缺失机制和依从性附件尚待核。"
        ],
        "links": [
          {
            "label": "PubMed Central全文",
            "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6990653/"
          },
          {
            "label": "正式更正：作者单位",
            "url": "https://jamanetwork.com/journals/jamasurgery/fullarticle/2763142"
          },
          {
            "label": "对照阅读相关原始研究及其方法",
            "url": "https://doi.org/10.1001/jamasurg.2023.0198"
          }
        ]
      }
    ]
  }
}