Effect of Digital Health Interventions on the Nutritional Status and Quality of Life of Patients With Colorectal Cancer: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Digital health interventions may improve clinical outcomes in patients with colorectal cancer (CRC), but their impact on nutritional status (NS) and quality of life (QoL) remains unclear. This study systematically evaluated the impact of digital health interventions on the NS and QoL in patients with CRC. A systematic search was performed across PubMed, Embase, Cochrane, and Web of Science from inception to March 2026 to identify randomized controlled trials evaluating digital health interventions on NS or QoL in CRC. Two reviewers independently performed screening, data extraction, and risk of bias assessment (Cochrane Risk of Bias Assessment Tool [RoB 1.0]). Meta-analysis used a random-effects model to compute standardized mean differences (SMD) or mean differences (MD) with 95% CIs. Heterogeneity was assessed using I² and τ², and subgroup analyses (intervention duration, intervention method, and scale type) explored sources of heterogeneity. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) was used for evidence quality. Eleven RCTs from 7 countries, involving 1210 participants aged 37.7-69.0 years. The meta-analysis shows that digital health interventions have no significant effect on improving NS (MD 2.23, 95% CI -10.50 to 14.97; P=.27), with high heterogeneity (I²=81.8%). The overall analysis of QoL shows that digital health interventions significantly improve the QoL of patients (SMD 0.67, 95% CI 0.14-1.21; P=.02), with a moderate effect size, but there is high heterogeneity (I²=92.9%; τ²=0.5146; 95% prediction intervals -1.04 to 2.38). Subgroup analysis indicates in terms of intervention duration, the effect is not significant in the group with ≤1 month, while it is significant in the groups with 1-3 months and >3 months, but there is no statistical significance in the differences among subgroups (P=.67); in terms of intervention methods, the group with guided intervention has a significant effect and no heterogeneity (SMD 1.16, 95% CI 1.05-1.28; I²=0%, τ²=0, P=.97), the effect of the unsupervised intervention group is zero, and the effect of the combined intervention group is unstable, with significant differences among subgroups (P<.001); in terms of scale types, different QoL measurement tools have certain effects on the effect size, but the differences among subgroups are not significant (P=.99). Digital health interventions have a moderate effect on improving the QoL in patients with CRC, especially when guided interventions are employed, the effect is clearer and more stable. This innovatively identifies "guided intervention models" as a key moderator of efficacy, contrasting with prior reviews that focused solely on technology. Our findings provide new evidence highlighting the importance of interpersonal support in digital health applications. In practice, digital tools should integrate professional medical guidance and supervision rather than being implemented in isolation, to more effectively improve health outcomes in patients with CRC.