Bariatric treatments for adult obesity - Institute of Health Economics

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Padwal R, Li SK, Lau DC. Long-term pharmacotherapy for overweight andobesity: a systematic review and meta-analysis of randomized controlled trials.International Journal of Obesity & Related Metabolic Disorders: Journal of the InternationalAssociation for the Study of Obesity 3002;27(12):1437-46.Pichon RA, et al. Usefulness of surgical treatments for obesity. Ciudad de Buenos Aires:Institute for Clinical Effectiveness and Health Policy (IECS), 2004.Picot J. The clinical effectiveness and cost-effectiveness of bariatric (weight loss)surgery for obesity: a systematic review and economic evaluation. HealthTechnology Assessment 2009;13(41):ix-214Poobalan A, et al. Effects of weight loss in overweight/obese individuals andlong-term lipid outcomes--a systematic review. Obesity Reviews 2004;5(1):43-50.Rucker D, Padwal R, Li SK, et al. Long term pharmacotherapy for obesity andoverweight updated meta-analysis. BMJ 2007;335(7631):1194-99Salem L, et al. Are bariatric surgical outcomes worth their cost? A systematicreview. Journal of the American College of Surgeons 2005;200(2):270-8.Shekelle PG, et al. Pharmacological and surgical treatment of obesity. Evidence Report.Technology Assessment (Summary) 2004;(103):1-6.Slevin E. High intensity counselling or behavioural interventions can result inmoderate weight loss. Evidence-Based Healthcare 2004;8(3):136-8.Sodlerlund A, et al. Physical activity, diet and behaviour modification in thetreatment of overweight and obese adults: a systematic review. Perspect PublicHealth 2009;129(3):132-42.Tice JA. Laparoscopic adjustable silicone gastric banding for obesity. Availableat: www medscape com/viewarticle/717883_print 2010 (accessed 31 May 2010).van Hout G. Psychosocial effects of bariatric surgery. Acta chirurgica Belgica2005;105(1):40-3.Vocks S, et al. Meta-Analysis of the effectiveness of psychological andpharmacological treatments for binge eating disorder. International Journal ofEating Disorders 2010;43(3):205-17.Wu T, et al. Long-term effectiveness of diet-plus-exercise interventions vs. dietonlyinterventions for weight loss: a meta-analysis. Obesity Reviews 2009;10(3):313-23.Obesity: weight loss without drugs: a balanced diet avoiding high-calorie foods,plus exercise. Prescrire International 2007;16(90):162-7.Orlistat: a second look. At best, a minor adjunct to dietary measures. PrescrireInternational 2002;11(57):10-2.Weight loss medications for obesity in adults, 3-24-2010, DynaMed.Abbreviations: RCT = randomized controlled trial; SR = systematic reviewEarlier publication of Padwal et al. 20Non-English publicationDuplicate publication of Colquitt et al. 62Multiple publication of Avenell et al. 2Journal publication of Padwal et al. 20 with lessdetailsFocused on economic evaluationFor medication part, an older version of(60);for surgery part, most included studies are notRCTsAbstractDid not meet Cook’s criteria for SRMost included studies are not RCTsDid not meet Cook’s criteria for SR; not areview of RCTsFocused on binge eating disorderDid not meet Cook’s criteria for SRNot an SRNot an SRNot an SRBariatric treatments for adult obesity 112
APPENDIX T.C: METHODOLOGICAL QUALITY ASSESSMENTQuality assessment checklist for systematic reviews(Adapted from various sources a-d ) (Updated on June 29, 2009)This checklist contains six quality subsections (grey sections) that, according to the literature, reflectaspects considered essential for a good quality systematic review. If desired, the scores obtained forthese six subsections can be used to categorize the review as good quality, average quality, or poorquality, according to the number of criteria met. This additional categorization is optional. TheRating System is flexible in that other criteria can be substituted for some or all of the six criteria inaccordance with the priorities and opinions of the assessors.,Study QuestionThe research question should be established a priori.Reported: The objectives of the review are clearly stated in the abstract, introduction, or methods.Partially reported: The objectives of the review are stated in:the abstract, introduction, or methods but are vague or unclear a section of the report other than the abstract, introduction, or methodsNot reported: The objectives are not stated in any section of the review.Inclusion/Exclusion CriteriaThe participants, interventions, outcome measures, and types of studies considered for analysisshould be established a priori.Reported: All four elements (participants, interventions, outcome measures, types of studies) arereported in the abstract, introduction, or methods section of the review.Partially reported: Only three of the four elements are reported in the abstract, introduction, ormethods section.Not reported:Fewer than three of the four elements are reported in the abstract, introduction, ormethods section. The first mention of any of these elements occurs in the results section.Search StrategyElectronic databasesReported: At least one electronic database was searched and the name(s) of the database(s) is/areprovided.Partially reported: At least one electronic database was searched but the name(s) of the database(s)is/are not provided.Not reported: Electronic databases were not searched or are not mentioned in the review.Bariatric treatments for adult obesity 113
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Alberta STE ReportBariatric treatme
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Alberta STE ReportBariatric treatme
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EXECUTIVE SUMMARYSocial and System
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Three surgical procedures—adjusta
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Costs of Bariatric Surgery and Pote
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Regulatory status .................
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TABLES AND FIGURESSection One: Soci
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ABBREVIATIONSAll abbreviations that
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LYMmMAMDMUHCNANHLBINHSNICENIHNNHNPH
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Bariatric physician: a licensed Doc
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High-density lipoprotein (HDL): a f
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Very-low-calorie diet (VLCD): a die
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Additional Internet searches were c
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This report addresses obesity in ad
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Many systemic factors have been ide
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Severe obesity is associated with d
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eport their height and under-report
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Also using self-reported data from
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An examination of overall obesity d
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Table S.2 presents the associationa
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• have multiple focal points and
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The main problem in any weight mana
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food, and a negative body image. As
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directly causes death. 61 To the ex
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The addition of a selected pharmaco
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lack of formal training in nutritio
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slightly more likely to have prescr
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selection criteria, have facilities
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Barriers to using appropriate baria
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Overview of adult obesityOver the p
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the need for regular physical activ
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phenylpropanolamine/25. Sibutramine
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Complianceand AdherenceDemand andut
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Aetna Clinical PolicyBulletinswww.a
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Overweight 123,821 172,971 157,623
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REFERENCES1. 2006 Canadian clinical
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34. Gostin LO. Fast and supersized:
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69. Klarenbach S, Padwal R, Wiebe N
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105. Hill JO, Thompson H, Wyatt H.
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141. Ross R, Bradshaw AJ. The futur
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172. Arkinson J, Ji H, Fallah S, Pe
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Page 90 and 91: Additional benefits of exercise ove
Page 92 and 93: medications that inhibit intestinal
Page 94 and 95: Rimonabant may be considered for pa
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Page 100 and 101: Description of the Included Systema
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Page 106 and 107: Table T.7: Effects of behavioural t
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Page 122 and 123: Examining whether use of any of the
Page 124 and 125: Evidence from placebo-controlled cl
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Page 128 and 129: Web of ScienceISI Interface License
Page 130 and 131: AMA Clinical PracticeGuidelineswww.
Page 132 and 133: critical appraisal of the included
Page 134 and 135: APPENDIX T.B: EXCLUDED STUDIESTable
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Page 140 and 141: Quality subsection 5a:Study quality
Page 142 and 143: Partially reported: The study types
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Page 184 and 185: SECTION THREE: ECONOMIC EVALUATIONC
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Definition of bariatric surgical pa
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etween surgical interventions, the
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concluded that adding orlistat to L
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Weight management program (WMP) ver
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groups. Compared with standard care
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Results from Analysis of Provincial
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DiscussionThe objectives of the eco
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surgical suites, and so on. The bud
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APPENDIX E.A: LITERATURE SEARCH SUM
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CRD Databases(DARE, HTA & NHS EED)h
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Web of ScienceISI Interface License
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NEOS Librarywww.library.ualberta.ca
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Table E.A.2: Evidence table of revi
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ResultHealth outcomesCostsMarginal
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CostsMarginal analysisThe cost anal
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Time Horizon/discount rateCurrency/
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Objectivestudy perspective: society
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S4Economic burden of obesityMean co
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15. Lacey LA, Wolf A, O'shea D, Ern
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Author Contribution StatementsPaula
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