Comparative effectiveness of non-pharmacological therapies for postoperative cognitive dysfunction: Protocol for a systematic review and network meta-analysis

PLoS One. 2024 Dec 19;19(12):e0309605. doi: 10.1371/journal.pone.0309605. eCollection 2024.

Abstract

Introduction: Postoperative cognitive dysfunction (POCD) is a common complication following surgery. Electroacupuncture (EA), manual acupuncture (MA), transcutaneous electrical acupoint stimulation (TEAS), and cognitive training (CT) can effectively maintain or improve the postoperative cognitive function of patients. However, it remains unclear which therapy is the most effective. Therefore, this network meta-analysis aims to compare and rank the efficacy of these non-pharmacological therapies for POCD to identify the optimal therapy.

Methods and analysis: A systematic search will be conducted across seven databases (PubMed, Cochrane Library, EMBASE, Web of Science, CINAHL, AMED, and PsycINFO) for articles published between January 2000 and November 2023. Two reviewers will independently conduct study selection and data extraction. The primary outcome will be the changes in the overall cognitive function before and after the intervention. The secondary outcome will be the incidence of POCD. The risk of bias will be assessed using the revised Risk of Bias Assessment Tool. Pairwise and Bayesian network meta-analyses will be performed using RevMan, STATA, and Aggregate Data Drug Information System statistical software. Additionally, the quality of evidence will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation guidelines. Ethics and dissemination: The results will be disseminated to peer-reviewed journals or conferences.

Trial registration: PROSPERO registration number: CRD42023454028.

MeSH terms

  • Acupuncture Therapy / methods
  • Bayes Theorem
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / therapy
  • Electroacupuncture / methods
  • Humans
  • Meta-Analysis as Topic
  • Network Meta-Analysis*
  • Postoperative Cognitive Complications* / etiology
  • Postoperative Cognitive Complications* / therapy
  • Systematic Reviews as Topic*
  • Treatment Outcome

Grants and funding

This study received financial support from the State Administration of Traditional Chinese Medicine, under the National Key Research and Development Program of China (Grant No. 2019YFC1709700), the National Natural Science Foundation of China (Grants Nos. 81973961, 82004486), and the Project of the Science and Technology Department of Sichuan Province (Grant No. 2021YFS0087). Fanrong Liang acknowledges support from these organizations as a grantee. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.