Table 2 Review eligibility criteria including the extended PICOTS framework for reviews of complex interventions

Patient population (P)

Adults undergoing spinal surgical procedures;

Paediatric population undergoing spinal surgical procedures;

Patients undergoing non-surgical management of spinal conditions;

Spinal trauma patients;

Intervention-treatment(I)

Twenty-two pre-defined components of an ERSS pathway (as outlined in Table 1) alone or in combination with another component;

Other proposed ERSS pathways incorporating one or more pre-defined interventions will be included;

Comparator(C)

Standard of care, no treatment or placebo;

Outcomes(O)

•Mortality from all causes;

•Morbidity including: pulmonary, cardiac and renal complication rates, surgical complication rates (including readmissions);

•Patient reported experiences and outcomes (PROMs/PREMS): pain-related outcomes (e.g. pain score rating, pain management satisfaction), quality of care (readiness for surgery, quality of care patient scores, quality of recovery after surgery);

•Health service-related outcomes: length of stay (in hospital, in ICU)and economic/financial outcome;

Timing

Perioperative process-preadmission, preoperative, intraoperative and postoperative setting;

Studies incorporating long-term (greater than 3 months) postoperative rehabilitation;

Study design

Systematic reviews, meta-analysis

Randomized controlled trials

Non-randomized studies

Observational studies (cohort studies, case-control studies, cross-sectional studies, case series);

Case reports;

Study setting

Inpatient care (including patients whose condition requires admission to a hospital same day discharge surgical);

Outpatient clinics, medical and non-surgical management of spinal conditions;