Evidence map›Paper›PMID 31214966›Full record

ArticleObesity surgery2019

Cost-Utility of Gastric Bypass Surgery Compared to Clinical Treatment for Severely Obese With and Without Diabetes in the Perspective of the Brazilian Public Health System.

Roberto Pereira Assumpção, Luciana Ribeiro Bahia, Michelle Quarti Machado da Rosa, Marcelo Goulart Correia, Everton Nunes da Silva, Paula Rosales Zubiaurre, Claudio Corá Mottin, Denizar Araujo Vianna

Abstract readComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in Obesity surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. 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
    Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Cardiovascular Statistics - Brazil 2021.Arquivos brasileiros de cardiologia · 2022
    Article
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

8 authors.

Roberto Pereira AssumpçãoDepartment of Internal Medicine, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77, 3° andar, Rio de Janeiro, Rio de Janeiro, 20551-030, Brazil. rpassumpcao@gmail.com.ORCID 0000-0001-8642-5410
Luciana Ribeiro BahiaDepartment of Internal Medicine, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77, 3° andar, Rio de Janeiro, Rio de Janeiro, 20551-030, Brazil.
Michelle Quarti Machado da RosaDepartment of Internal Medicine, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77, 3° andar, Rio de Janeiro, Rio de Janeiro, 20551-030, Brazil.
Marcelo Goulart CorreiaBiostatistics and Bioinformatics Department, National Institute of Cardiology, Rio de Janeiro, Brazil.
Everton Nunes da SilvaDepartment of Public Health, University of Brasilia,, Centro Metropolitano, conjunto A, lote 01, Brasília, Distrito Federal, 72.220-275, Brazil.
Paula Rosales ZubiaurreCenter of Morbid Obesity, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga 6690/302, Porto Alegre, Rio Grande do Sul, 90610-000, Brazil.
Claudio Corá MottinCenter of Morbid Obesity, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga 6690/302, Porto Alegre, Rio Grande do Sul, 90610-000, Brazil.
Denizar Araujo ViannaDepartment of Internal Medicine, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77, 3° andar, Rio de Janeiro, Rio de Janeiro, 20551-030, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeObesity is associated with increased morbidity and mortality. Weight loss due to gastric bypass (GBP) surgery improves clinical outcomes and may be a cost-effective intervention. To estimate the cost-effectiveness of GBP compared to clinical treatment in severely obese individuals with and without diabetes in the perspective of the Brazilian public health system. MATERIALS AND

methodsA Markov model was developed to compare costs and outcomes of gastric bypass in an open approach to clinical treatment. Health states were living with diabetes, remission of diabetes, non-fatal and fatal myocardial infarction, and death. We also included the occurrence of complications related to surgery and plastic surgery after the gastric bypass surgery. The direct costs were obtained from primary data collection performed in three public reference centers for obesity treatment. Utility values also derived from this cohort, while transition probabilities came from the international literature. A sensitivity analysis was performed to evaluate uncertainties. The model considered a 10-year time horizon and a 5% discount rate.

resultsOver 10 years, GBP increased quality-adjusted life years (QALY) and costs compared to clinical treatment, resulting in an incremental cost-effectiveness ratio (ICER) of Int$1820.17/QALY and Int$1937.73/QALY in individuals with and without diabetes, respectively. Sensitivity analysis showed that utility values and direct costs of treatments were the parameters that affected the most the ICERs.

conclusionThe study demonstrated that GBP is a cost-effective intervention for severely obese individuals in the Brazilian public health system perspective, with a better result in individuals with diabetes.

Indexed as

Body Mass IndexBrazilCost-Benefit AnalysisCross-Sectional StudiesDiabetes Mellitus, Type 2FemaleGastric BypassHealth Care CostsHumansMaleMarkov ChainsObesityObesity, MorbidPublic HealthQuality-Adjusted Life YearsWeight LossCost-utilityGastric bypass surgeryObesity

Identifiers

PMID31214966

What OpenQuestion holds

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Registered trials

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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.