Comparing the Benefits and Harms of Three Types of Weight Loss Surgery: The PCORnet Bariatric Study


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dc.contributorPatient-Centered Outcomes Research Institute
dc.contributor.authorArterburn, David
dc.contributor.otherKaiser Permanente
dc.date.accessioned2024-09-26T19:55:36Z
dc.descriptionThe use of bariatric surgery as a treatment for severe obesity has increased dramatically over the past two decades, but there have been few high-quality, long-term studies comparing the outcomes of different procedures. Prior studies have also not been large enough to examine differences in outcomes across important patient subgroups, including older adults (>65 years of age) and racial/ethnic minorities. Research on the outcomes of adolescent bariatric surgery is even more limited and mostly consists of studies of short duration. More studies are needed in larger, more broadly representative samples to help inform patient and provider decisions about the optimal choice of bariatric surgical procedure in various populations. The goal of the study is to provide accurate estimates of the one-, three-, and five-year benefits and risks of the three most common bariatric procedures - Roux-en-y gastric bypass, adjustable gastric banding, and sleeve gastrectomy - with a focus on outcomes that are important to adults and adolescents with severe obesity: 1) changes in weight, 2) rates of remission and relapse of diabetes, and 3) risk of major adverse events. The study also had two additional goals: 1) the development of infrastructure - in the form of study processes and procedures - to support future comparative effectiveness studies using the PCORnet distributed research network, and 2) the identification of patient preferences and opinions about (a) whether to undergo bariatric surgery; (b) which bariatric procedure to utilize; and (c) the delivery of follow-up care after bariatric surgery through a series of focus groups involving adults and children with severe obesity. Patients and other stakeholders have been fully engaged in the development of this proposal and engaged in all stages of the protocol development, including formulating the research questions, selecting outcomes that are of interest to the study population, identifying methods to address these outcomes, monitoring study conduct, and designing and implementing dissemination plans. #### Cohort Description Bariatric procedures were identified from over 100 million patient records in 41 health systems from the 11 clinical data research networks DRNs. For each patient, their first observed bariatric procedure in the data set was considered the index procedure; index procedures had to occur in inpatient or ambulatory care encounters. The following were excluded: 1. Patients aged less than 12 years and those aged greater than or equal to 80 years at the index procedure. 2. Individuals with different bariatric procedure codes on the same day. 3. Individuals with any revision bariatric procedure code, gastrointestinal cancer diagnosis code, or fundoplasty procedure in the year before the index procedure. 4. Individuals with any emergency department encounter on the day of the index procedure. 5. Patients without BMI data and those without a BMI of greater than or equal to 35 in the year before their procedure.
dc.description.abstractStudy to provide accurate estimates of the one-, three-, and five-year benefits and risks of the three most common bariatric procedures (roux-en-y gastric bypass, adjustable gastric banding, and sleeve gastrectomy) with a focus on outcomes that are important to adults and adolescents with severe obesity.
dc.identifier.urihttps://hdl.handle.net/20.500.14642/797
dc.publisherPEDSnet
dc.relation.isreferencedbyToh S, Rasmussen-Torvik LJ, Harmata EE, Pardee R, Saizan R, et al. December 2017. "PCORnet Bariatric Surgery Collaborative. The National Patient-Centered Clinical Research Network (PCORnet) Bariatric Study Cohort: Rationale,Methods, and Baseline Characteristics." _JMIR Res Protoc_. 6(12):e222. DOI: [10.2196/resprot.8323](doi.org/10.2196/resprot.8323)
dc.relation.isreferencedbyInge TH, Coley RY, Bazzano LA, Xanthakos SA, McTigue K, et al. September 2018. "PCORnet Bariatric Study Collaborative. Comparative effectiveness of bariatric procedures among adolescents: the PCORnet bariatric study." _Surg Obes Relat Dis_. 14(9):1374-1386. <br>DOI: [10.1016/j.soard.2018.04.002](doi.org/10.1016/j.soard.2018.04.002)
dc.relation.isreferencedbyArterburn D, Wellman R, Emiliano A, Smith SR, Odegaard AO, et al. December 2018. "PCORnet Bariatric Study Collaborative. Comparative Effectiveness and Safety of Bariatric Procedures for Weight Loss: A PCORnet Cohort Study." _Ann Intern Med_. 169(11):741-750. <br>DOI: [10.7326/M17-2786](doi.org/10.7326/M17-2786)
dc.relation.isreferencedbyColeman, K.J., Schlundt, D.G., Bonnet, K.R. et al. 2020. "Correction to: Understanding the Bariatric Patient Perspective in the National Patient-Centered Clinical Research Network (PCORnet) Bariatric Study." *OBES SURG* 30, 1848. <br>DOI: [10.1007/s11695-020-04475-7](doi.org/10.1007/s11695-020-04475-7)
dc.relation.isreferencedbyColeman, K.J., Schlundt, D.G., Bonnet, K.R. et al. 2020. "Understanding the Bariatric Patient Perspective in the National Patient-Centered Clinical Research Network (PCORnet) Bariatric Study." *OBES SURG* 30, 1837-1847. <br>DOI: [10.1007/s11695-020-04404-8](doi.org/10.1007/s11695-020-04404-8)
dc.relation.isreferencedbyAnau J, Arterburn D, Coleman KJ, et al. 2020. "Comparing Three Types of Weight Loss Surgery -The PCORnet Bariatric Study." Patient-Centered Outcomes Research Institute (PCORI). <br>DOI: [10.25302/11.2020.OBS.150530683](doi.org/10.25302/11.2020.OBS.150530683)
dc.relation.isreferencedbyBuszkiewicz JH, Bobb JF, Kapos F, Hurvitz PM, Arterburn D, et al. December 2021. "Differential associations of the built environment on weight gain by sex and race/ethnicity but not age." _Int J Obes (Lond)_. 45(12):2648-2656. <br>DOI: [10.1038/s41366-021-00937-9](doi.org/10.1038/s41366-021-00937-9)
dc.relation.isreferencedbyColeman KJ, Wellman R, Fitzpatrick SL, Conroy MB, Hlavin C, et al. October 2022. "PCORnet Bariatric Study Collaborative. Comparative Safety and Effectiveness of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy for Weight Loss and Type 2 Diabetes Across Race and Ethnicity in the PCORnet Bariatric Study Cohort." _JAMA Surg_. 157(10):897-906. <br>DOI: [10.1001/jamasurg.2022.3714](doi.org/10.1001/jamasurg.2022.3714)
dc.relation.isreferencedbyCoughlin JW, Nauman E, Wellman R, Coley RY, McTigue KM, et al. April 2023. "PCORnet Bariatric Study Collaborative. Preoperative Depression Status and 5 Year Metabolic and Bariatric Surgery Outcomes in the PCORnet Bariatric Study Cohort." _Ann Surg_. 277(4):637-646. <br>DOI: [10.1097/SLA.0000000000005364](doi.org/10.1097/SLA.0000000000005364)
dc.rightsa CC-BY 4.0 Attribution license.
dc.rights.urihttps://creativecommons.org/licenses/by-sa/4.0/
dc.subjectRetrospective Study
dc.subjectCohort Study
dc.subjectObservational Study
dc.subjectClinical Study
dc.subjectADVANCE Data Source
dc.subjectGPC Data Source
dc.subjectINSIGHT Data Source
dc.subjectPaTH Data Source
dc.subjectPEDSnet Data Source
dc.subjectREACHnet Data Source
dc.subjectPCORI-Funded Research
dc.subject.meshBypass of stomach
dc.subject.meshAnastomosis of stomach
dc.subject.meshBypass gastroenterostomy
dc.subject.meshNutritional and Metabolic Diseases
dc.titleComparing the Benefits and Harms of Three Types of Weight Loss Surgery: The PCORnet Bariatric Study
dc.title.alternative2016.ARTD.PCORI.DCC
dspace.entity.typeStudy
local.admin.noteStudy PM: Rahul, Study Analysts:
local.contributor.siteLeadPEDSnet Data Coordinating Center
local.contributor.sitesCincinnati Children�s Hospital Medical Center
local.contributor.sitesNationwide Children�s Hospital
local.contributor.sitesNemours Children�s Health
project.endDate2018
project.startDate2016
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relation.isPublicationOfStudy.latestForDiscovery3e6d9a51-bbea-4946-8d09-d4f9695ef04d

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