Evidence map›Paper›PMID 34088970›Full record

ArticleInternational journal of obesity (2005)2021

Cost-effectiveness of bariatric surgery and non-surgical weight management programmes for adults with severe obesity: a decision analysis model.

D Boyers, L Retat, E Jacobsen, A Avenell, P Aveyard, E Corbould, A Jaccard, D Cooper, C Robertson, M Aceves-Martins and 4 more

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

Article in International journal of obesity (2005), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 4 pooled it
6.7field-weighted citation impact, top 2% 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

23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 45 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 2 countries.

D BoyersHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK. d.boyers@abdn.ac.uk.ORCID http://orcid.org/0000-0002-9786-8118
L RetatUK Health Forum, London, UK.
E JacobsenHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK.
A AvenellHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
P AveyardNuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK.ORCID http://orcid.org/0000-0002-1802-4217
E CorbouldUK Health Forum, London, UK.
A JaccardUK Health Forum, London, UK.ORCID http://orcid.org/0000-0002-7903-5956
D CooperHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
C RobertsonHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
M Aceves-MartinsHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
B XuUK Health Forum, London, UK.
Z SkeaHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
M de BruinHealth Psychology, University of Aberdeen, Aberdeen, UK.
and the REBALANCE team
University of Aberdeen · GBUK Health Forum · GBRadboud University Nijmegen · NLUniversity of Oxford · GB

Funding

Chief Scientist Office HERU1Chief Scientist Office HSRU1
6 · The paper itself

Abstract

objectivesTo determine the most cost-effective weight management programmes (WMPs) for adults, in England with severe obesity (BMI ≥ 35 kg/m

methodsAn economic evaluation of five different WMPs: 1) low intensity (WMP1); 2) very low calorie diets (VLCD) added to WMP1; 3) moderate intensity (WMP2); 4) high intensity (Look AHEAD); and 5) Roux-en-Y gastric bypass (RYGB) surgery, all compared to a baseline scenario representing no WMP. We also compare a VLCD added to WMP1 vs. WMP1 alone. A microsimulation decision analysis model was used to extrapolate the impact of changes in BMI, obtained from a systematic review and meta-analysis of randomised controlled trials (RCTs) of WMPs and bariatric surgery, on long-term risks of obesity related disease, costs, quality adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) measured as incremental cost per QALY gained over a 30-year time horizon from a UK National Health Service (NHS) perspective. Sensitivity analyses explored the impact of long-term weight regain assumptions on results.

resultsRYGB was the most costly intervention but also generated the lowest incidence of obesity related disease and hence the highest QALY gains. Base case ICERs for WMP1, a VLCD added to WMP1, WMP2, Look AHEAD, and RYGB compared to no WMP were £557, £6628, £1540, £23,725 and £10,126 per QALY gained respectively. Adding a VLCD to WMP1 generated an ICER of over £121,000 per QALY compared to WMP1 alone. Sensitivity analysis found that all ICERs were sensitive to the modelled base case, five year post intervention cessation, weight regain assumption.

conclusionsRYGB surgery was the most effective and cost-effective use of scarce NHS funding resources. However, where fixed healthcare budgets or patient preferences exclude surgery as an option, a standard 12 week behavioural WMP (WMP1) was the next most cost-effective intervention.

Indexed as

Bariatric SurgeryBody Weight MaintenanceCost-Benefit AnalysisDecision Support TechniquesEnglandHumansObesity, Morbid

Identifiers

PMID34088970
PMCPMC8455321
OpenAlexW3152117021

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.