دورية أكاديمية
Developing a Decision Aid for Clinical Obesity Services in the Real World: the DACOS Nationwide Pilot Study.
العنوان: | Developing a Decision Aid for Clinical Obesity Services in the Real World: the DACOS Nationwide Pilot Study. |
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المؤلفون: | Atlantis E; School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, Australia. e.atlantis@westernsydney.edu.au., Kormas N; Department of Endocrinology, Concord Hospital, Concord, New South Wales, Australia.; South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden and Campbelltown Hospitals, Campbelltown, New South Wales, Australia., Piya M; South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden and Campbelltown Hospitals, Campbelltown, New South Wales, Australia.; School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia., Sahebol-Amri M; Ryde Hospital, Northern Sydney Local Health District, Ryde, New South Wales, Australia., Williams K; Department of Endocrinology, Nepean Hospital, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia.; Charles Perkins Centre-Nepean, The University of Sydney, Kingswood, New South Wales, Australia., Huang HC; Respiratory & Sleep Medicine, Canberra Hospital, Garran, Canberra, Australian Capital Territory, Australia.; Canberra Obesity Management Service, Canberra Health Services, Belconnen, Canberra, Australian Capital Territory, Australia.; College of Health and Medicine, Australian National University, Acton, Australian Capital Territory, Australia., Bishay R; School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia.; Metabolic & Weight Loss Clinic, University Clinics, Western Sydney University, Blacktown Hospital, Blacktown, New South Wales, Australia., Chikani V; Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia., Girolamo T; Re:You Health, Adelaide Weight Management and Wellness, Adelaide, South Australia, Australia., Prodan A; School of Computer, Data and Mathematical Sciences, Western Sydney University, Sydney, Australia., Fahey P; School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, Australia. |
المصدر: | Obesity surgery [Obes Surg] 2024 Jun; Vol. 34 (6), pp. 2073-2083. Date of Electronic Publication: 2024 Mar 11. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Science + Business Media Country of Publication: United States NLM ID: 9106714 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1708-0428 (Electronic) Linking ISSN: 09608923 NLM ISO Abbreviation: Obes Surg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2006- : New York : Springer Science + Business Media Original Publication: Oxford, OX, UK : Rapid Communications of Oxford, [1991- |
مواضيع طبية MeSH: | Bariatric Surgery* , Weight Loss* , Decision Support Techniques*, Humans ; Pilot Projects ; Female ; Male ; Middle Aged ; Adult ; Australia ; Obesity, Morbid/surgery ; Obesity, Morbid/therapy ; Obesity/therapy ; Obesity/surgery ; Adolescent ; Young Adult |
مستخلص: | Purpose: The purpose of this study is to develop a decision aid tool using "real-world" data within the Australian health system to predict weight loss after bariatric surgery and non-surgical care. Materials and Methods: We analyzed patient record data (aged 16+years) from initial review between 2015 and 2020 with 6-month (n=219) and 9-/12-month (n=153) follow-ups at eight clinical obesity services. Primary outcome was percentage total weight loss (%TWL) at 6 months and 9/12 months. Predictors were selected by statistical evidence (p<0.20), effect size (±2%), and clinical judgment. Multiple linear regression and bariatric surgery were used to create simple predictive models. Accuracy was measured using percentage of predictions within 5% of the observed value, and sensitivity and specificity for predicting target weight loss of 5% (non-surgical care) and 15% (bariatric surgery). Results: Observed %TWL with bariatric surgery vs. non-surgical care was 19% vs. 5% at 6 months and 22% vs. 5% at 9/12 months. Predictors at 6 months with intercept (non-surgical care) of 6% include bariatric surgery (+11%), BMI>60 (-3%), depression (-2%), anxiety (-2%), and eating disorder (-2%). Accuracy, sensitivity, and specificity were 58%, 69%, and 56%. Predictors at 9/12 months with intercept of 5% include bariatric surgery (+15%), type 2 diabetes (+5%), eating disorder (+4%), fatty liver (+2%), atrial fibrillation (-4%), osteoarthritis (-3%), sleep/mental disorders (-2-3%), and ≥10 alcohol drinks/week (-2%). Accuracy, sensitivity, and specificity were 55%, 86%, and 53%. Conclusion: Clinicians may use DACOS to discuss potential weight loss predictors with patients after surgery or non-surgical care. (© 2024. The Author(s).) |
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فهرسة مساهمة: | Keywords: Decision support model; Management; Obesity; Weight loss |
تواريخ الأحداث: | Date Created: 20240312 Date Completed: 20240525 Latest Revision: 20240528 |
رمز التحديث: | 20240528 |
مُعرف محوري في PubMed: | PMC11127827 |
DOI: | 10.1007/s11695-024-07123-6 |
PMID: | 38467898 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1708-0428 |
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DOI: | 10.1007/s11695-024-07123-6 |