Digital health interventions for cognitive function in breast cancer patients treated with chemotherapy: a network meta-analysis of subjective and objective cognitive outcomes

Purpose To systematically compare the effects of different digital health interventions on subjective and objective cognitive function in breast cancer patients treated with chemotherapy and to provide evidence for tailored supportive care and rehabilitation strategies. Methods Eight databases, including the Cochrane Library, PubMed, Web of Science, Embase, CNKI, WanFang, VIP, and SinoMed, were searched from inception to March 2026 for randomized controlled trials (RCTs) evaluating digital health interventions for cognitive function in breast cancer patients treated with chemotherapy. Two reviewers independently screened studies, extracted data, and assessed risk of bias. A frequentist network meta-analysis was conducted using RevMan 5.3 and Stata 16.0. Interventions were ranked according to the surface under the cumulative ranking curve (SUCRA). The certainty of evidence was evaluated using the GRADE approach. Results Twenty-two RCTs involving 1, 494 participants were included. Network meta-analysis (NMA) showed that digital exercise intervention (DEI) (SMD = 2.53, 95% CI 1.58 to 3.48) and digital psychological and behavioral intervention (DPBI) (SMD = 0.44, 95% CI 0.03 to 0.85) significantly improved subjective cognitive function compared with the control group (CON). DEI was also significantly more effective than digital multimodal intervention (DMI), DPBI, digital rehabilitation intervention (DRI), and digital cognitive training (DCT), and ranked highest (SUCRA = 100.0%). For objective cognitive function, DRI significantly improved cognitive function compared with CON (SMD = 2.59, 95% CI 1.17 to 4.02) and ranked highest (SUCRA = 85.5%), whereas no significant differences were observed in the remaining comparisons. The certainty of evidence was low. Conclusion Digital health interventions may improve cognitive function in breast cancer patients treated with chemotherapy, with DEI showing the greatest potential for subjective cognitive function and DRI for objective cognitive function. However, these findings should be interpreted cautiously because of the low certainty of evidence. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD420261331780.