Digital health interventions for perioperative patient-reported outcomes: a network meta-analysis.

Summary

Across 56 randomized trials, extended reality most reduced perioperative anxiety, mobile apps and XR reduced postoperative pain, and 2D video best improved quality of life. Evidence certainty ranged from moderate to high and was appraised with RoB 2 and GRADE.

Key Findings

• Extended reality reduced perioperative anxiety (SMD 0.60; MD 8.05), meeting MID thresholds.
• Mobile apps (SMD 0.64; MD 1.36) and XR (SMD 0.51; MD 1.09) probably reduced postoperative pain.
• 2D video achieved the largest quality-of-life improvement (SMD 0.99), and XR improved satisfaction (SMD 1.27).

Clinical Implications

Hospitals can prioritize XR for anxiety reduction, mobile apps or XR for pain control, and simple 2D videos for quality-of-life gains, aligning DHI selection with targeted perioperative outcomes.

Limitations

• Heterogeneity across interventions, outcomes, and measurement time points
• Potential variability in standard perioperative care and DHI implementation fidelity

Future Directions

Prospective head-to-head trials comparing high-performing DHIs, cost-effectiveness analyses, and implementation studies in diverse surgical populations.