Currently submitted to: JMIR Perioperative Medicine
Date Submitted: Jul 24, 2026
Open Peer Review Period: Jul 31, 2026 - Sep 25, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Digital health intervention in perioperative lung cancer care: A systematic review and meta-analysis
ABSTRACT
Background:
Background:
Patients undergoing lung cancer surgery treatment experience substantial physical and psychological burden. Digital health interventions (DHIs) offer scalable solutions for supportive cancer care, yet their effects on quality of life (QOL) and psychological outcomes in the perioperative lung cancer population remain inconclusive.
Objective:
Objective:
To systematically review and meta-analyze the effects of DHIs on QOL, anxiety, and depression in patients undergoing lung cancer surgery.
Methods:
Methods:
We searched PubMed, Embase, Web of Science, Cochrane Library, and CINAHL from inception to January 31, 2026. Randomized controlled trials (RCTs) involving adults (≥18 years) with lung cancer in the perioperative period who received digital health interventions (mobile apps, telemedicine, virtual reality, wearable devices, or web-based platforms et al.) compared with usual care were involved. The outcomes were QOL, anxiety, and depression. Where applicable, recruitment and withdrawal rates were also assessed. A combination of meta-analysis and descriptive analysis was used to evaluate outcomes. Risk of bias was assessed using the Cochrane RoB 2.0 tool.
Results:
Results:
A total of 14 RCTs involving 2,930 patients were included. For QOL, meta-analysis of 3 studies using EORTC QLQ-C30 global health scale at ≥12 months follow-up showed a significant improvement (SMD = 0.39, 95% CI: 0.21 to 0.56, P < 0.001, I² = 0%). For anxiety, sensitivity analysis of 4 studies (≤3 months) demonstrated a moderate reduction after excluding one outlier (SMD = −0.58, 95% CI: −0.92 to −0.24, P < 0.001, I² = 50%). For depression, meta-analysis of 5 studies (≤3 months) showed a small but significant effect (SMD = −0.32, 95% CI: -0.53 to -0.19, I² = 14%). VR-guided relaxation and gain-framed messaging showed the largest effects on anxiety. Most studies (50%) were at high risk of bias, primarily due to lack of blinding.
Conclusions:
Conclusions:
Digital health interventions significantly improve long-term quality of life and alleviate short-term anxiety and depression in patients undergoing lung cancer surgery. Multicomponent interventions lasting ≥12 months and those integrating real-time symptom monitoring with clinical feedback appear most effective. However, the evidence is limited by high risk of bias, substantial heterogeneity, and predominance of WeChat-based studies from China. Future high-quality RCTs with standardized outcomes and longer follow-up are warranted. Clinical Trial: Trial Registration: PROSPERO CRD420251270726
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