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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 37 Research Studies DisplayedDarling KE, West C, Jelalian E
The buffering effect of family support on the association between weight-based teasing and adolescent weight management outcomes.
This study examined the buffering effect that family support on the association between weight-based victimization (WBV) and adolescent weight management options. Parents of adolescents (n = 78) completed psychosocial measures at baseline of a clinical weight management program. Objective height and weight were measured at baseline and follow-up at Visit 3. There was a significant moderating effect of family support on the association between WBV and weight change (p = .04), accounting for 5.0% of the variance in weight change.
AHRQ-funded; HS02707.
Citation: Darling KE, West C, Jelalian E .
The buffering effect of family support on the association between weight-based teasing and adolescent weight management outcomes.
J Fam Psychol 2023 Sep; 37(6):942-46. doi: 10.1037/fam0001084..
Keywords: Children/Adolescents, Obesity, Obesity: Weight Management
Warnick J, Darling KE, Topor LS
Formative development of a weight management intervention for adolescents with type 1 diabetes mellitus and obesity.
Researchers interviewed overweight or obese adolescents with type 1 diabetes mellitus (T1D), their caregivers, and pediatric endocrinologists to understand if they would be interested in a weight management intervention adapted for youth with T1D. The results provided detailed recommendations for the adaptation of a behavioral weight management intervention. Five central themes emerged: program content, programmatic messaging, program structure, social support, and risk of eating disorders.
AHRQ-funded; HS027071.
Citation: Warnick J, Darling KE, Topor LS .
Formative development of a weight management intervention for adolescents with type 1 diabetes mellitus and obesity.
Pediatr Diabetes 2023; 2023. doi: 10.1155/2023/9584419..
Keywords: Children/Adolescents, Obesity, Chronic Conditions, Obesity: Weight Management
Lucy AT, Rakestraw SL, Stringer C
Readability of patient education materials for bariatric surgery.
This paper examined readability and reading level of online bariatric surgery and standardized perioperative electronic medical record (EMR) patient education materials (PEM). National organizations recommend that PEM not exceed a sixth grade reading level. One institution was used to assess readability of PEM. Text readability was assessed by seven validated instruments and mean readability scores calculated with standard deviations and compared using unpaired t-tests. A total of 32 webpages and seven EMR education documents were assessed. Web pages were overall assessed as "difficult to read" compared to "standard/average" readability EMR materials. All web pages were at or above high school reading levels, with the highest reading levels being pages with nutrition information and the lowest reading level patient testimonials. EMR materials were found to be at sixth to ninth grade reading level.
AHRQ-funded; HS023009.
Citation: Lucy AT, Rakestraw SL, Stringer C .
Readability of patient education materials for bariatric surgery.
Surg Endosc 2023 Aug; 37(8):6519-25. doi: 10.1007/s00464-023-10153-3..
Keywords: Surgery, Education: Patient and Caregiver, Obesity: Weight Management, Obesity, Health Literacy
Zamudio J, Kanji FF, Lusk C
Identifying workflow disruptions in robotic-assisted bariatric surgery: elucidating challenges experienced by surgical teams.
The goal of this observational study was to investigate the impact of robotic bariatric surgery (RBS) on the surgical work system via the study of flow disruptions (FDs), or deviations from the natural workflow progression. Twenty-nine RBS procedures were observed at three sites; FDs were recorded in real time and subsequently classified into one of nine work system categories. FDs occurred approximately every 2.4 minutes and happened most frequently during the final patient transfer and robot docking phases of RBS. The coordination challenges that contributed most to these disruptions were associated with waiting for staff/instruments and readjusting equipment.
AHRQ-funded; HS026491.
Citation: Zamudio J, Kanji FF, Lusk C .
Identifying workflow disruptions in robotic-assisted bariatric surgery: elucidating challenges experienced by surgical teams.
Obes Surg 2023 Jul; 33(7):2083-89. doi: 10.1007/s11695-023-06620-4..
Keywords: Obesity: Weight Management, Surgery, Workflow, Obesity
Barnett S, Matthews K, DeWindt L
Deaf Weight Wise: a novel randomized clinical trial with Deaf sign language users.
The purpose of this research was to address the lack of scientifically supported weight management programs specifically designed for the Deaf population. The researchers developed the Deaf Weight Wise (DWW) trial and intervention which was informed by community-based participatory research. The primary focus of DWW is promoting a healthy lifestyle and weight management through dietary adjustments and physical activity. A total of 104 Deaf adults aged 40 to 70 years, with a BMI ranging from 25 to 45, were recruited from community settings in Rochester, New York. Participants were randomized into either immediate intervention (n = 48) or a 1-year delayed intervention group (n = 56). The latter group served as a no-intervention control until the trial's midpoint. Data were collected at five time points (every six months) from baseline to 24 months. All DWW intervention leaders and participants were Deaf individuals using American Sign Language (ASL). The study found that at the 6-month mark, the average weight change difference between the immediate-intervention group and the delayed-intervention group (no intervention yet) was -3.4 kg. A majority (61.6%) of those in the immediate intervention group lost ≥5% of their baseline weight, compared to 18.1% in the no-intervention-yet group. Indicators of participant engagement included an average attendance of 11/16 sessions (69%), and 92% completed the 24-month data collection. The researchers concluded that the DWW program, which is community-engaged, culturally tailored, and provides language accessibility, successfully supported weight loss among Deaf ASL users.
AHRQ-funded; HS015700
Citation: Barnett S, Matthews K, DeWindt L .
Deaf Weight Wise: a novel randomized clinical trial with Deaf sign language users.
Obesity 2023 Apr;31(4):965-76. doi: 10.1002/oby.23702.
Keywords: Obesity: Weight Management, Disabilities, Obesity
Darling KE, Warnick J, Guthrie KM
Weight management engagement for teens from low-income backgrounds: qualitative perspectives from adolescents and caregivers.
Adolescents from low-income backgrounds are at a higher risk for obesity and obesity-related negative health outcomes. In addition, these adolescents have lower access to, and success in, weight management (WM) programs. The purpose of this qualitative study was to explore engagement in a hospital-based WM program from the adolescent and caregiver perspective at varying levels of program initiation and engagement. The researchers conducted qualitative interviews with 55 participants, including 29 adolescents and 26 caregivers. This included: a) those who were referred to WM treatment, but never initiated (non-initiators); b) those who dropped out from treatment; and c) those who that had continuous participation in treatment (engaged). The study found that participants across all groups reported that they did not have a complete understanding of the scope or goals of the WM program after initial referral. In addition, many participants identified misperceptions of the program (e.g., perceptions of a screening visit as compared to an intensive program). Both caregivers and adolescents identified caregivers as drivers of engagement, with adolescents often tentative about participation in the program. However, engaged adolescents found the program valuable and sought ongoing participation following caregiver initiation.
AHRQ-funded; HS02707.
Citation: Darling KE, Warnick J, Guthrie KM .
Weight management engagement for teens from low-income backgrounds: qualitative perspectives from adolescents and caregivers.
J Pediatr Psychol 2023 Feb 15; 48(7):593-601. doi: 10.1093/jpepsy/jsad008..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Low-Income, Patient and Family Engagement
Barlow SE, Yudkin J, Nelson V
Dynamo Kids!/¡Niños Dinámicos! A web site for pediatric primary care providers to offer parents of children 6-12 years old with overweight and obesity: web site development and protocol for pilot study.
The purpose of this study will be to determine whether a self-guided web site offered by pediatric primary care providers could assist parents with applying healthy behaviors. If successful, a large, controlled study may be conducted to further assess. The Dynamo Kids/¡Niños Dinámicos program was created with feedback from parents and health care professionals, developing a bilingual site for parents to about healthy behavior changes for their children and how to implement them. Electronic health record modifications alert providers to qualified children at well-child encounters. Parents complete online surveys before entering the site. In month 3 of the study, the practitioners will examine children in weight-focused appointments. Outcomes include change in Family Nutrition and Physical Activity parent survey score (primary) and change in child relative BMI (secondary). Additional data include time spent on site, provider surveys, and provider and parent interviews.
AHRQ-funded; HS022418.
Citation: Barlow SE, Yudkin J, Nelson V .
Dynamo Kids!/¡Niños Dinámicos! A web site for pediatric primary care providers to offer parents of children 6-12 years old with overweight and obesity: web site development and protocol for pilot study.
J Pediatr Health Care 2023 Jan-Feb; 37(1):17-24. doi: 10.1016/j.pedhc.2022.09.003..
Keywords: Children/Adolescents, Primary Care, Obesity, Obesity: Weight Management, Education: Patient and Caregiver, Family Health and History
Cedillo M, Kukhareva PV, Larsen SM
Impact of electronic health record-coaching features in weight change: a secondary analysis from the MAINTAIN-pc randomized trial.
This study evaluated whether coaching features were successfully transmitted via electronic health record (EHR) communication and to evaluate their relationship with weight change in a previously tested EHR-based coaching intervention. The authors conducted a secondary analysis from the Maintaining Activity and Nutrition through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) study randomized clinical trial in nine primary care practices and one specialty practice (endocrinology) affiliated with the University of Pittsburgh Medical Center. Eligible participants were aged 18 to 75 years, had intentional 5% weight loss in the previous 2 years, had access to an internet-connected computer, and had receipt of care from a University of Pittsburgh Medical Center primary care provider. Participants content with intervention delivery via the EHR and those who felt a strong connection to their coach had significantly less weight regain. Participants who had needs unmet by the intervention (e.g., "in-person" support in a group setting or individual settings) regained more weight. The results suggest heterogeneity in the patient population regarding preference for in-person versus EHR-based coaching formats.
AHRQ-funded; HS021162.
Citation: Cedillo M, Kukhareva PV, Larsen SM .
Impact of electronic health record-coaching features in weight change: a secondary analysis from the MAINTAIN-pc randomized trial.
Obesity 2023 Jan;31(1):31-36. doi: 10.1002/oby.23595..
Keywords: Electronic Health Records (EHRs), Obesity, Obesity: Weight Management, Lifestyle Changes
Shen MR, Jiang S, Millis MA
Racial variation in baseline characteristics and wait times among patients undergoing bariatric surgery.
The purpose of this study was to examine whether differences exist in baseline characteristics or access to care between white and non-white patients of bariatric surgery. The researchers utilized a statewide bariatric-specific data registry and assessed all patients of bariatric surgery who completed a baseline questionnaire prior to the operation and compared data among racial groups. A total of 73,141 patients were included with 25.5% self-identifying as non-white. Non-white males were the least represented group with 4% of all bariatric surgery cases performed. Despite having higher rates of college education, when compared to white patients non-white patients were more likely to be younger, disabled, and have Medicaid. Despite having higher rates of patients with a body mass index above 50 kg/m the median time from the first evaluation to surgery was longer among non-white patients (157 days vs. 127 days.) The study concluded that despite presenting with higher rates of severe obesity, when compared with white patients non-white patients of bariatric surgery are an extremely diverse group with greater socioeconomic disadvantages and longer wait times.
AHRQ-funded; HS000053.
Citation: Shen MR, Jiang S, Millis MA .
Racial variation in baseline characteristics and wait times among patients undergoing bariatric surgery.
Surg Endosc 2023 Jan; 37(1):564-70. doi: 10.1007/s00464-022-09292-w..
Keywords: Racial and Ethnic Minorities, Surgery, Obesity: Weight Management, Obesity, Disparities
Rosas LG, Lv N, Xiao L
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
Identifying effective weight loss interventions for Latino adults at risk of diabetes is of critical public health importance. The purpose of this study was to determine whether a culturally adapted behavioral intervention for Latino adults was more effective than usual care for weight loss over 24 months. The investigators concluded that among Latino adults with high diabetes risk, a culturally adapted behavioral lifestyle intervention was effective for weight loss over 12 months but not 24 months.
AHRQ-funded; HS022702.
Citation: Rosas LG, Lv N, Xiao L .
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
JAMA Netw Open 2020 Dec;3(12):e2027744. doi: 10.1001/jamanetworkopen.2020.27744..
Keywords: Racial and Ethnic Minorities, Obesity: Weight Management, Obesity, Cultural Competence, Diabetes, Primary Care, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Ferguson MC, O'Shea KJ, Hammer LD
Can following formula-feeding recommendations still result in infants who are overweight or have obesity?
This study compares guidelines for formula feeding and whether current recommendations still result in infants who are overweight or have obesity. The researchers used their “Virtual Infant” agent-based model representing infant-caregiver pairs that allowed caregivers to feed infants each day according to guidelines from Johns Hopkins Medicine (JHM), Children’s Hospital of Philadelphia (CHOP), Children’s Hospital of the King’s Daughters (CHKD), and Women, Infants, and Children (WIC). The WIC guidelines were found to be the best as opposed to JHM/CHOP/CHKD where infants still became overweight/obese by 6 months. The study recommended the minimum recommended amount of daily formula feeding should be made lower for JHM/CHOP/CHKD guidelines and that WIC guidelines may be a good starting point for caregivers.
AHRQ-funded; HS023317.
Citation: Ferguson MC, O'Shea KJ, Hammer LD .
Can following formula-feeding recommendations still result in infants who are overweight or have obesity?
Pediatr Res 2020 Oct;88(4):661-67. doi: 10.1038/s41390-020-0844-3..
Keywords: Newborns/Infants, Obesity: Weight Management, Obesity, Guidelines, Caregiving, Evidence-Based Practice
Varban OA, Thumma JR, Carlin AM
Peer assessment of operative videos with sleeve gastrectomy to determine optimal operative technique.
Global assessments of technical skill have been associated with surgical outcomes. More detailed understanding of which specific aspects of technique combine to make the "optimal" sleeve gastrectomy are necessary to help surgeons improve their practice. In this article, the investigators described their study in which the review of de-identified videos of practicing bariatric surgeons was conducted by a minimum of 10 peer surgeons. The videos were assessed on the technical quality of 9 operative maneuvers (ie mobilization of the fundus, stapler location, and sleeve width).
AHRQ-funded; HS017765.
Citation: Varban OA, Thumma JR, Carlin AM .
Peer assessment of operative videos with sleeve gastrectomy to determine optimal operative technique.
J Am Coll Surg 2020 Oct;231(4):470-77. doi: 10.1016/j.jamcollsurg.2020.06.016..
Keywords: Surgery, Obesity: Weight Management, Obesity, Adverse Events, Provider: Physician, Provider
Li X, Lewis KH, Callaway K
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
The authors assessed the availability and validity of claims-based weight-related diagnosis codes among bariatric surgery patients who underwent adjusted gastric banding, Roux-en-Y gastric bypass, or sleeve gastrectomy. They found that claims-based weight-related diagnosis codes had excellent validity before and after bariatric surgical operation but suboptimal availability after operation. Claims databases can be used for bariatric surgery studies of non-weight-related effectiveness and safety outcomes that are well-captured.
AHRQ-funded; HS026214.
Citation: Li X, Lewis KH, Callaway K .
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
BMC Med Res Methodol 2020 Sep 7;20(1):225. doi: 10.1186/s12874-020-01106-8..
Keywords: Obesity: Weight Management, Obesity, Surgery, Health Services Research (HSR), Research Methodologies
Darling KE, Ranzenhofer LM, Hadley W
Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms.
This cross-sectional study examined the association between stressful life events and weight-related outcomes including weight status, disordered eating behaviors, and insulin sensitivity in treatment-seeking adolescents with overweight and obesity. The authors were also looking at the potential mediating role of depression. The study included 170 adolescents (mean age 14.8, 62% female) enrolled in an interdisciplinary weight management program. Findings were that stressful childhood experiences were significantly related to weight status and disordered eating but not insulin sensitivity. Depressive symptoms were related to stressful experiences and disordered eating patterns but not weight status or insulin sensitivity.
AHRQ-funded; HS027071.
Citation: Darling KE, Ranzenhofer LM, Hadley W .
Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms.
Eat Behav 2020 Aug;38:101402. doi: 10.1016/j.eatbeh.2020.101402..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Stress, Depression, Behavioral Health, Trauma
Haynes SC, Tancredi DJ, Tong K
Association of adherence to weight telemonitoring with health care use and death: a secondary analysis of a randomized clinical trial.
This study examined if heart failure patients who had lower adherence to weight telemonitoring had higher hospitalization and death rates. This study was a post hoc secondary analysis of the Better Effectiveness After Transition-Heart Failure randomized clinical trial which included patients from 6 academic medical centers in California. Criteria for eligibility was if they were hospitalized for decompensated heart failure. Exclusion criteria included if they were discharged to a skilled nursing facility, were expected to improve because of a medical procedure, or did not have the cognitive or physical ability to participate. The trial compared a telemonitoring intervention with usual care for patients with heart failure after hospital discharge from October 12, 2011 to September 30, 2013. The cohort of 538 eligible participants had a mean age of 70.9, was 53.8% male and 50.7% white. Adherence got better from week to week, and they found that every increase in adherence by 1 day was associated with a 19% decrease in the rate of death the following week and an 11% decrease in the rate of hospitalization. However, weight adherence is unlikely to be a result of the telemonitoring intervention.
AHRQ-funded; HS019311.
Citation: Haynes SC, Tancredi DJ, Tong K .
Association of adherence to weight telemonitoring with health care use and death: a secondary analysis of a randomized clinical trial.
JAMA Netw Open 2020 Jul;3(7):e2010174. doi: 10.1001/jamanetworkopen.2020.10174..
Keywords: Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance, Obesity: Weight Management, Obesity, Heart Disease and Health, Cardiovascular Conditions, Hospitalization
Atkins M, Castro I, Sharifi M
Unmet social needs and adherence to pediatric weight management interventions: Massachusetts, 2017-2019.
This study examined the effects of housing insecurity and unmet social needs on adherence to pediatric weight management intervention (PWMI) programs. The authors used data from children enrolled in a 2017-2019 comparative effectiveness trial for 2 high-intensive PWMIs in Massachusetts. Families with housing security had higher contact hours with the program than families without. Children with 3 to 4 unmet social needs (parental stress, parental depression, food insecurity, and housing insecurity) also attended less hours of the program than those without.
AHRQ-funded; HS024332.
Citation: Atkins M, Castro I, Sharifi M .
Unmet social needs and adherence to pediatric weight management interventions: Massachusetts, 2017-2019.
Am J Public Health 2020 Jul;110(S2):S251-s57. doi: 10.2105/ajph.2020.305772..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Patient Adherence/Compliance, Social Determinants of Health, Family Health and History
Ferguson MC, Morgan MJ, O'Shea KJ
Using simulation modeling to guide the design of the Girl Scouts Fierce & Fit Program.
The goal of this study was to see if computational modeling would help to revise the design of the Girl Scouts Fierce & Fit Program. The Girl Scouts of Central Maryland worked with the researchers to develop a computational simulation model representing the 250 adolescent girls who were participating in the program to determine how their diets and physical activity affected their BMI and subsequent outcomes, including costs. As a result, the program changed from 6 weeks meeting twice a week with 5 minutes of physical activity each session to meeting 12 weeks with 30 minutes of physical activity each session. Cost savings were estimated at an additional $84,828 in lifetime direct medical costs, $81,365 in lifetime productivity losses, and 7.85 quality-adjusted life-years.
AHRQ-funded; HS023317.
Citation: Ferguson MC, Morgan MJ, O'Shea KJ .
Using simulation modeling to guide the design of the Girl Scouts Fierce & Fit Program.
Using simulation modeling to guide the design of the Girl Scouts Fierce & Fit Program.
Obesity 2020 Jul;28(7):1317-24. doi: 10.1002/oby.22827..
Obesity 2020 Jul;28(7):1317-24. doi: 10.1002/oby.22827..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Lifestyle Changes
Simione M, Sharifi M, Gerber MW
Family-centeredness of childhood obesity interventions: psychometrics & outcomes of the family-centered care assessment tool.
The purpose of this study was to evaluate the psychometric properties of a modified version of the Family Centered-Care Assessment (mFCCA) tool and to assess the family-centeredness of two clinical-community childhood obesity interventions. Using the mFCCA which demonstrated good psychometric properties for the assessment of family-centered care among parents of children with obesity, the investigators found that individualized health coaching is a family-centered approach to pediatric weight management.
AHRQ-funded; HS024332; HS022986.
Citation: Simione M, Sharifi M, Gerber MW .
Family-centeredness of childhood obesity interventions: psychometrics & outcomes of the family-centered care assessment tool.
Health Qual Life Outcomes 2020 Jun 11;18(1):179. doi: 10.1186/s12955-020-01431-y..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Patient-Centered Healthcare, Family Health and History
Flórez KR, Payán DD, Palar K
Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review.
This systematic literature review examined the impact of multilevel church-based interventions to address racial/ethnic disparities in obesity in the US. The review identified 43 relevant articles using systematic review methods developed by the CDC’s Task Force on Community Preventive Services. Although 81% of the studies reported significant results, effective size was reported or could only be calculated in 56% of the cases. A lack of diversity among the samples was also found with few studies involving Latinos, men, young adults, or children. Few interventions were actually multilevel in nature or incorporated strategies at the church or community. Greater diversity is needed in future church-based interventions.
AHRQ-funded; HS000046.
Citation: Flórez KR, Payán DD, Palar K .
Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review.
Nutr Rev 2020 Apr;78(4):304-22. doi: 10.1093/nutrit/nuz046..
Keywords: Racial and Ethnic Minorities, Obesity, Obesity: Weight Management, Disparities, Health Promotion, Prevention
Bourgi K, Jenkins CA, Rebeiro PF
Weight gain among treatment-naive persons with HIV starting integrase inhibitors compared to non-nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada.
This study compared weight gain among persons with HIV (PWH) following different antiretroviral therapy (ART) drug classes. The cohort was part of the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). The 22,972 participants were 87% male and 41% white. Twenty percent started strand transfer inhibitor (INSTI), 31% started protease inhibitor (PI), and 49% started non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based ART. Average weight gain was higher with INSTI-based regimens compared to NNRTI-based regimens or PI-based regimens.
AHRQ-funded; 90047713.
Citation: Bourgi K, Jenkins CA, Rebeiro PF .
Weight gain among treatment-naive persons with HIV starting integrase inhibitors compared to non-nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada.
J Int AIDS Soc 2020 Apr;23(4):e25484. doi: 10.1002/jia2.25484.
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Keywords: Human Immunodeficiency Virus (HIV), Obesity: Weight Management, Obesity, Medication
Yuce TK, Khorfan R, Soper NJ
Post-operative complications and readmissions associated with smoking following bariatric surgery.
The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. In this study, the investigators describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers. The investigators concluded that smokers undergoing bariatric surgery experienced significantly worse 30-day outcomes when compared with non-smokers.
AHRQ-funded; HS000078.
Citation: Yuce TK, Khorfan R, Soper NJ .
Post-operative complications and readmissions associated with smoking following bariatric surgery.
J Gastrointest Surg 2020 Mar;24(3):525-30. doi: 10.1007/s11605-019-04488-3..
Keywords: Surgery, Tobacco Use, Adverse Events, Hospital Readmissions, Obesity: Weight Management, Obesity, Risk, Outcomes
de Meireles A, Carlin AM, Cain-Nielsen A
Association between surgeon practice knowledge and venous thromboembolism.
Venous thromboembolism (VTE) is the most common cause of mortality following bariatric surgery. This study aimed to determine practice patterns of VTE chemoprophylaxis among bariatric surgeons participating in a large statewide quality collaborative and compare the results of surgeon self-reported chemoprophylaxis prescription practices versus actual data from abstracted charts. They administered a 13-question survey to 66 surgeons to reveal VTE practice patterns such as medication type, dosage, timing, duration, and level of trainee involvement. They also examined the charts of all patients who had developed VTE during the study period and 15 other randomly selected patient charts per site. There was found to be a greater discordance between surgeon self-reported and actual perioperative VTE prophylaxis, but there was no significant discordance postoperatively. Greater perioperative discordance is associated with significantly increased risk of VTE.
AHRQ-funded; HS02362; HS024403.
Citation: de Meireles A, Carlin AM, Cain-Nielsen A .
Association between surgeon practice knowledge and venous thromboembolism.
Obes Surg 2020 Feb 16;30(6):2274-79. doi: 10.1007/s11695-020-04468-6..
Keywords: Surgery, Obesity: Weight Management, Obesity, Blood Clots, Practice Patterns, Provider: Physician, Provider
Kanters AE, Shubeck SP, Varban OA
Incidence and efficacy of stent placement in leak management after bariatric surgery: an MBSAQIP analysis.
The goal of this study was to evaluate the rates of use and efficacy of stent placement for postoperative leak following bariatric surgery. Using data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, findings showed that the use of stents can be effective; however, such use does not prevent reoperation and is associated with an increased likelihood of readmission. Recommendations included consideration of both technique and resource utilization when choosing a management pathway for leaks.
AHRQ-funded; HS000053; HS023597.
Citation: Kanters AE, Shubeck SP, Varban OA .
Incidence and efficacy of stent placement in leak management after bariatric surgery: an MBSAQIP analysis.
Ann Surg 2020 Jan;271(1):134-39. doi: 10.1097/sla.0000000000003023..
Keywords: Surgery, Obesity: Weight Management, Obesity, Adverse Events, Patient Safety, Outcomes
Danilack VA, Brousseau EC, Phipps MG
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
Weight retention after pregnancy is a concern for adolescents who may be entering adulthood at unhealthy weights. In this article, the investigators studied associations between each of three measures: pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and post-pregnancy BMI in a longitudinal follow-up of an adolescent pregnancy study cohort. They concluded that teens experienced an increase in BMI from pre-pregnancy to within 4 years after their first delivery, and this increase was related to GWG.
AHRQ-funded; HS025013.
Citation: Danilack VA, Brousseau EC, Phipps MG .
The effect of gestational weight gain on persistent increase in body mass index in adolescents: a longitudinal study.
J Womens Health 2018 Dec;27(12):1456-58. doi: 10.1089/jwh.2017.6635..
Keywords: Children/Adolescents, Pregnancy, Obesity: Weight Management, Obesity, Women
Kelsall AC, Cassidy R, Ghaferi AA
Variation in bariatric surgery episode costs in the commercially insured: implications for bundled payments in the private sector.
The authors described hospital-level variation in roux-en-Y gastric bypass and sleeve gastrectomy in Michigan. Their findings suggested that there are previously underappreciated differences in episode payment variation between bariatric surgery procedures. The authors also suggested that sleeve gastrectomy may be more amenable to cost containment under bundled payment initiatives by virtue of the greater share of variation explained by readmission and post-discharge payments.
AHRQ-funded; HS023621; HS024403.
Citation: Kelsall AC, Cassidy R, Ghaferi AA .
Variation in bariatric surgery episode costs in the commercially insured: implications for bundled payments in the private sector.
Ann Surg 2018 Dec;268(6):1014-18. doi: 10.1097/sla.0000000000002462..
Keywords: Surgery, Obesity: Weight Management, Obesity, Payment, Health Insurance, Healthcare Costs