Evidence map›Paper›PMID 28212974›Full record

ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2017

Costs and Outcomes of Increasing Access to Bariatric Surgery: Cohort Study and Cost-Effectiveness Analysis Using Electronic Health Records.

Martin C Gulliford, Judith Charlton, Toby Prevost, Helen Booth, Alison Fildes, Mark Ashworth, Peter Littlejohns, Marcus Reddy, Omar Khan, Caroline Rudisill

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 5 pooled it
11.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 5 syntheses or guidelines pooled it, 110 citations in OpenAlex.

  1. Pooled it
  2. Cost-effectiveness of metabolic surgery for the treatment of type 2 diabetes and obesity: a systematic review of economic evaluations.The European journal of health economics : HEPAC : health economics in prevention and care · 2023
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  17. COSTS FOR THE SURGICAL TREATMENT OF OBESITY THROUGH LAPAROSCOPY IN A FEDERAL TERTIARY HOSPITAL BY THE BRAZILIAN UNIFIED HEALTH SYSTEM.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024
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  19. Up-to-date literature review and issues of sedation during digestive endoscopy.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Martin C GullifordDepartment of Primary Care and Public Health Sciences, King's College London, London, UK; National Institutes for Health Research Biomedical Research Centre at Guy's and St Thomas' National Health Service Foundation Trust, London, UK. Electronic address: martin.gulliford@kcl.ac.uk.
Judith CharltonDepartment of Primary Care and Public Health Sciences, King's College London, London, UK.
Toby PrevostDepartment of Primary Care and Public Health Sciences, King's College London, London, UK; National Institutes for Health Research Biomedical Research Centre at Guy's and St Thomas' National Health Service Foundation Trust, London, UK.
Helen BoothDepartment of Primary Care and Public Health Sciences, King's College London, London, UK.
Alison FildesDepartment of Primary Care and Public Health Sciences, King's College London, London, UK.
Mark AshworthDepartment of Primary Care and Public Health Sciences, King's College London, London, UK.
Peter LittlejohnsDepartment of Primary Care and Public Health Sciences, King's College London, London, UK.
Marcus ReddyDepartment of Surgery, St George's University Hospital National Health Service Foundation Trust, London, UK.
Omar KhanDepartment of Surgery, St George's University Hospital National Health Service Foundation Trust, London, UK.
Caroline RudisillDepartment of Social Policy, London School of Economics and Political Science, London, UK.
King's College London · GBNational Health Service · GBLondon School of Economics and Political Science · GB

Funding

Department of Health 12/5005/12
6 · The paper itself

Abstract

objectivesTo estimate costs and outcomes of increasing access to bariatric surgery in obese adults and in population subgroups of age, sex, deprivation, comorbidity, and obesity category.

methodsA cohort study was conducted using primary care electronic health records, with linked hospital utilization data, for 3,045 participants who underwent bariatric surgery and 247,537 participants who did not undergo bariatric surgery. Epidemiological analyses informed a probabilistic Markov model to compare bariatric surgery, including equal proportions with adjustable gastric banding, gastric bypass, and sleeve gastrectomy, with standard nonsurgical management of obesity. Outcomes were quality-adjusted life-years (QALYs) and net monetary benefits at a threshold of £30,000 per QALY.

resultsIn a UK population of 250,000 adults, there may be 7,163 people with morbid obesity including 1,406 with diabetes. The immediate cost of 1,000 bariatric surgical procedures is £9.16 million, with incremental discounted lifetime health care costs of £15.26 million (95% confidence interval £15.18-£15.36 million). Patient-years with diabetes mellitus will decrease by 8,320 (range 8,123-8,502). Incremental QALYs will increase by 2,142 (range 2,032-2,256). The estimated cost per QALY gained is £7,129 (range £6,775-£7,506). Net monetary benefits will be £49.02 million (range £45.72-£52.41 million). Estimates are similar for subgroups of age, sex, and deprivation. Bariatric surgery remains cost-effective if the procedure is twice as costly, or if intervention effect declines over time.

conclusionsDiverse obese individuals may benefit from bariatric surgery at acceptable cost. Bariatric surgery is not cost-saving, but increased health care costs are exceeded by health benefits to obese individuals.

Indexed as

AdultAgedAge FactorsBariatric SurgeryComorbidityCost-Benefit AnalysisDepressionDiabetes MellitusElectronic Health RecordsFemaleHealth ExpendituresHealth Services AccessibilityHumansMaleMarkov ChainsMiddle Agedbariatric surgerycost-effectiveness analysisdiabetes mellitusobesity

Identifiers

PMID28212974
PMCPMC5338873
OpenAlexW2404661683

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.