Summary of findings 1. Summary of findings table ‐ Preoperative exercise training compared to no exercise training for people scheduled to undergo lung resection for non‐small cell lung cancer.

Preoperative exercise training compared to no exercise training for people scheduled to undergo lung resection for non‐small cell lung cancer
Patient or population: people scheduled to undergo lung resection for non‐small cell lung cancer Setting: USA, China, Brazil, Turkey, Italy, Spain and Switzerland Intervention: preoperative exercise training Comparison: no exercise training
Outcomes	Anticipated absolute effects* (95% CI)		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with no exercise training	Risk with preoperative exercise training
Risk of developing a postoperative pulmonary complication – total	35 per 100	16 per 100 (12 to 21)	RR 0.45 (0.33 to 0.61)	573 (9 RCTs)	⊕⊕⊕⊕ Higha,b	Preoperative exercise training results in large reduction in risk of developing a postoperative pulmonary complication.
Postoperative intercostal catheter duration	The mean postoperative intercostal catheter duration ranged from 3.33 to 8.8 days	MD 2.07 days lower (4.64 lower to 0.49 higher)	‐	111 (3 RCTs)	⊕⊝⊝⊝ Very lowa,c,d	The evidence is very uncertain about the effect of preoperative exercise training on postoperative intercostal catheter duration.
Safety of the intervention assessed with: number of adverse events related to the intervention assessed postintervention (preoperative)	No adverse events reported in all 3 studies			188 (3 RCTs)	⊕⊕⊕⊝ Moderatea,b,e	Preoperative exercise training is likely safe.
Postoperative length of hospital stay	The mean postoperative length of hospital stay ranged from 3.75 to 12.2 days	MD 2.24 days lower (3.64 lower to 0.85 lower)	‐	573 (9 RCTs)	⊕⊕⊕⊝ Moderatea,b,f	Preoperative exercise training likely results in a reduction in postoperative length of hospital stay.
Postintervention (preoperative) exercise capacity assessed with peak oxygen consumption	The mean postintervention (preoperative) exercise capacity assessed with peak oxygen consumption ranged from 14.5 to 19.0 mL/kg/minute	MD 3.36 mL/kg/minute higher (2.7 higher to 4.02 higher)	‐	191 (2 RCTs)	⊕⊕⊕⊝ Moderatea,b,g	Preoperative exercise training likely increases postintervention (preoperative) exercise capacity (peak oxygen consumption).
Postintervention (preoperative) exercise capacity assessed with 6‐minute walk distance	The mean postintervention (preoperative) exercise capacity assessed with 6‐minute walk distance ranged from 335 to 557 metres	MD 29.55 metres higher (12.05 higher to 47.04 higher)	‐	474 (6 RCTs)	⊕⊝⊝⊝ Very lowa,h,i	The evidence is very uncertain about the effect of preoperative exercise training on postintervention (preoperative) exercise capacity (6‐minute walk distance).
Postintervention (preoperative) forced expiratory volume in 1 second	The mean postintervention (preoperative) forced expiratory volume in 1 second ranged from 57.5 to 90.5 % predicted	MD 5.87 % predicted higher (4.46 higher to 7.28 higher)	‐	197 (4 RCTs)	⊕⊕⊝⊝ Lowa,j	Preoperative exercise training may result in little to no difference in postintervention (preoperative) lung function (forced expiratory volume in 1 second).
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference; RR: risk ratio
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.
See interactive version of this table: https://gdt.gradepro.org/presentations/#/isof/isof_question_revman_web_429907492607292218.

^a Serious risk of bias: the proportion of information from studies at high risk of bias was sufficient to affect the interpretation of results – downgraded one level.
^b Large magnitude of effect – upgraded one level.
^c Some inconsistency exists: there was little overlap of confidence intervals associated with the effect estimates and statistical tests suggest there was substantial heterogeneity (I2 = 77%) – downgraded one level.
^d Some imprecision exists: sample size (n = 111) was not large enough to calculate a precise effect estimate; and the 95% confidence interval around the estimate of effect included both appreciable benefit and harm – downgraded one level.
^e Some imprecision exists: sample size (n = 188) was not large enough to calculate a precise effect estimate – downgraded one level.
^f Some inconsistency exists: statistical tests suggest there was considerable heterogeneity (I2 = 85%) – downgraded one level.
^g Some imprecision exists: sample size (n = 191) was not large enough to calculate a precise effect estimate – downgraded one level.
^h Some inconsistency exists: statistical tests suggest there was considerable heterogeneity (I2 = 90%) – downgraded one level.
ⁱ Some imprecision exists: the 95% confidence interval around the estimate of effect included both little or no effect and appreciable benefit based on the minimal important difference of 22 to 42 metres – downgraded one level.
^j Some imprecision existed: sample size (n = 197) was not large enough to calculate a precise effect estimate – downgraded one level.