Posts Tagged ‘comparative effectiveness’

Bariatric Surgery for low BMI Evaluated

June 12th, 2013

The Agency for Healthcare Research and Quality has issued a Comparative Effectiveness Review on “Bariatric Surgery and Nonsurgical Therapy in Adults with Metabolic Conditions and a Body Mass Index of 30.0 to 34.9 kg/m2

Bariatric surgery is standard medical practice for patients with a BMI of 40 kg/m2 or for patients with a BMI between 35 and 40 kg/m2 who have significant comorbid conditions, such as type 2 diabetes. In recent years, there has been considerable discussion around providing bariatric surgery for patients with a BMI between 30 and 35 kg/m2 for type 2 diabetes and other metabolic conditions.

The reviewers for AHRQ concluded, “According to blood glucose outcomes, there is moderate strength evidence of efficacy for RYGB (Roux-en-Y Gastric Bypass), LAGB (Laparoscopic adjustable Gastric Banding), and SG (Sleeve Gastrectomy) as treatment for diabetes and IGT (impaired glucose tolerance) in patients with a BMI between 30 kg/m2 and 35 kg/m2 in the short term (up to 2 years). The strength of evidence for BPD (biliopancreatic diversion with duodenal switch) is rated low because there are fewer studies, and these have smaller sample size. Evidence on comparative effectiveness of surgical procedures is insufficient. Short-term adverse events are relatively minor; strength of evidence is low due to small sample size with low power to detect rare events. Strength of evidence is insufficient regarding adverse events in the long-term (2 years or more postsurgery). Longitudinal studies of bariatric surgery patients are needed to assess overall safety and comparative effectiveness regarding diabetes-related morbidity such as kidney failure and blindness.”