Bariatric treatments for adult obesity - Institute of Health Economics

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Quality subsection 5a:Study quality used in analysis or discussion of study resultsYes: Results of the included studies were discussed or analyzed in terms of theirquality.Unclear:No:Study quality was assessed, but was either not used at all or was onlyused to analyze some of the included studies.The review mentions selective inclusion of ‘quality’ studies, but withoutfurther assessment of their quality (for example, only RCTs were includedbut the robustness of their execution was not assessed).The results of the included studies were not discussed or analyzed interms of their quality.Study quality was not assessed.Semi-quantitative review:Incorporates a statistical analysis of individual studies without pooling the results (for example,relative risks calculated for individual study outcomes) or includes pooling of results using onlydescriptive statistics (for example, median, mean, mode, frequency).Quality subsection 5b: Confidence interval/measures of dispersion reportedYes: Confidence intervals or measures of dispersion (range, standard deviation,standard error of the mean) were reported for all relevant analyses.Unclear:Confidence intervals or measures of dispersion were only reported forsome of the relevant analyses.Confidence intervals were reported for all relevant analyses, but the levelof confidence was not specified (for example, it is unclear whether 95% or99% confidence intervals were calculated). Measures of dispersion were reported for all relevant analyses but thetype was not specified (for example, standard deviation or standard error).No: Confidence intervals or measures of dispersion were not reported.Meta-analysis:A pooled effect estimate is calculated for at least two studies. Reviews that contain a meta-analysis ofsome studies and a qualitative analysis of the remaining studies are considered a ‘meta-analysis.’Quality subsection 5c: Precision of results reportedYes: Confidence intervals were reported for all pooled effect estimates.Unclear:Confidence intervals were reported for some but not all pooled effectestimates. Confidence intervals were reported for all pooled effect estimates but thelevel of confidence was not specified (for example, it is unclear whether95% or 99% confidence intervals were calculated).No: Confidence intervals were not reported.Bariatric treatments for adult obesity 116
Quality subsection 5d: Test of study heterogeneity conductedYes: A statistical analysis of study heterogeneity was reported for all pooledstudies.Unclear:A statistical analysis of study heterogeneity was reported for some but notall pooled studies. Heterogeneity was examined visually or a statistical analysis of studyheterogeneity was reported for all pooled studies, but the type of modelused was not specified (for example, fixed-effect or random-effect).No: A statistical analysis of study heterogeneity was not conducted.Test for publication biasReported: Publication bias was analyzed or a reason provided for why it was not.Partially reported:The review mentions analyzing publication bias but does not present the results. The review states that publication bias was not analyzed but does not explain why.Not reported: There was no mention of analyzing publication bias.Concluding SectionPotential methodological limitationsReported: The methodological limitations or advantages of the review are described in a separatesection or paragraph.Partially reported: The description of the methodological limitations or advantages of the review iscursory (for example, a single sentence or no separate paragraph or section).Not reported: There is no mention of the potential methodological limitations or advantages of thereview.Clinical application of resultsThe clinical application of results is considered adequate if all of the following four elements arepresent in the concluding section (includes discussion) or statement of the review: treatment,treatment effect, patient group, and comparator.Reported: All four elements are present.Partially reported: Only three of the four elements are present.Not reported: Less than three of the four elements are present.Incorporation of methodological qualityThe review should take into account the methodological quality of the included studies whenformulating the conclusions.Reported: The methodological quality of the included studies is mentioned in the concludingsection (includes discussion) or statement of the review.Bariatric treatments for adult obesity 117
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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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This section will address a set of
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dietary therapy is to reduce total
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
Page 96 and 97: Long-term complications are specifi
Page 98 and 99: Devices used for bariatric surgeryH
Page 100 and 101: Description of the Included Systema
Page 102 and 103: AEs for sibutramineAs compared to a
Page 104 and 105: Evidence on Efficacy/EffectivenessW
Page 106 and 107: Table T.7: Effects of behavioural t
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Page 110 and 111: follow-up time was 3 years. Results
Page 112 and 113: group as compared to the VBG group.
Page 114 and 115: The authors identified many methodo
Page 116 and 117: The investigators pointed out that
Page 118 and 119: approximately 3 to 5 kilograms. For
Page 120 and 121: for studies with a mean age of part
Page 122 and 123: Examining whether use of any of the
Page 124 and 125: Evidence from placebo-controlled cl
Page 126 and 127: colorectal or gastroesophageal or f
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
Page 136 and 137: Padwal R, Li SK, Lau DC. Long-term
Page 138 and 139: Quality subsection 1: At least MEDL
Page 142 and 143: Partially reported: The study types
Page 144 and 145: Table T.C.1: Results of quality ass
Page 146 and 147: Table T.C.1: Results of quality ass
Page 148 and 149: APPENDIX T.D: CHARACTERISTICS OF SY
Page 150 and 151: Table T.D.1: Characteristics of the
Page 156 and 157: APPENDIX T.E: EVIDENCE TABLE ON SAF
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Page 160 and 161: LSGmMAMDNAnssORQoLRCTRDRRRYGBSBPTGV
Page 162 and 163: Table T.F.1-2: Weight loss - Behavi
Page 164 and 165: Table T.F.1-4: Weight loss - Surger
Page 166 and 167: Table T.F.2: Quality of life (QoL)
Page 168 and 169: Curioni & Lourenco 2005 58Cholester
Page 170 and 171: Table T.F.3-3: Risk factors/comorbi
Page 172 and 173: Table T.F.3-5: Long-term effects of
Page 174 and 175: Maciejewski et al., 2005 65Avenell
Page 176 and 177: Table T.G.2: Effects of bariatric s
Page 178 and 179: Table T.G.4: Effects of bariatric s
Page 180 and 181: 18. Cerulli J, Lomaestro BM, Malone
Page 182 and 183: 50. Health Canada Drug Product Data
Page 184 and 185: SECTION THREE: ECONOMIC EVALUATIONC
Page 186 and 187: Definition of bariatric surgical pa
Page 188 and 189: 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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