Evidence map›Paper›PMID 35384575›Full record

ArticleObesity surgery2022

Advice of General Practitioner, of Surgeon, of Endocrinologist, and Self-determination: the Italian Road to Bariatric Surgery.

Antonio E Pontiroli, Geltrude Mingrone, Annamaria Colao, Luigi Barrea, Giulia Cannavale, Ferdinando Pinna, Valerio Ceriani, Stefano Maria De Carli, Giovanni Cesana, Stefano Olmi and 58 more

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Article in Obesity surgery, 2022. 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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 22% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

68 authors at 19 institutions in 1 country.

Antonio E PontiroliDipartimento Di Scienze Della Salute, Università Degli Studi Di Milano, Milan, Italy. antonio.pontiroli@unimi.it.ORCID http://orcid.org/0000-0002-8217-7672
Geltrude MingroneIRCCS-Università Cattolica S. Cuore and Policlinico A. Gemelli, Rome, Italy.
Annamaria ColaoDipartimento Di Medicina Clinica E Chirurgia, Unità Di Endocrinologia, Ospedale Universitario Federico II - Napoli, Napoli, Italy.
Luigi BarreaDipartimento Di Medicina Clinica E Chirurgia, Unità Di Endocrinologia, Ospedale Universitario Federico II - Napoli, Napoli, Italy.
Giulia CannavaleDivision of Surgery and Value-Based Healthcare Unit, IRCCS MultiMedica, Milan, Italy.
Ferdinando PinnaDivision of Surgery and Value-Based Healthcare Unit, IRCCS MultiMedica, Milan, Italy.
Valerio CerianiDivision of Surgery and Value-Based Healthcare Unit, IRCCS MultiMedica, Milan, Italy.
Stefano Maria De CarliPoliclinico San Marco - Zingonia, Bergamo, Italy.
Giovanni CesanaPoliclinico San Marco - Zingonia, Bergamo, Italy.
Stefano OlmiPoliclinico San Marco - Zingonia, Bergamo, Italy.
Gloria ScolariOspedale G. Fornaroli - Magenta, Milan, Italy.
Simonetta SarroOspedale G. Fornaroli - Magenta, Milan, Italy.
Giuliano SarroOspedale G. Fornaroli - Magenta, Milan, Italy.
Claudia ProcopioIRCCS Policlinico San Donato, Milan, Italy.
Alessandro GiovanelliIRCCS Policlinico San Donato, Milan, Italy.
Lelio MorriconeIRCCS Policlinico San Donato, Milan, Italy.
Giancarlo MichelettoIRCCS Policlinico San Donato, Milan, Italy.
Alexis MalavazosIRCCS Policlinico San Donato, Milan, Italy.
Valerio PanizzoIRCCS Policlinico San Donato, Milan, Italy.
Laura PlebaniOspedale Fatebenefratelli-Sacco, Milan, Italy.
Marco Antonio ZappaOspedale Fatebenefratelli-Sacco, Milan, Italy.
Igor TubazioOspedale Fatebenefratelli-Sacco, Milan, Italy.
Diego FoschiOspedale Fatebenefratelli-Sacco, Milan, Italy.
Silvia CapogrossiIRCCS San Raffaele, Milan, Italy.
Caterina ConteIRCCS San Raffaele, Milan, Italy.
Alessandro SaibeneIRCCS San Raffaele, Milan, Italy.
Carlo SocciIRCCS San Raffaele, Milan, Italy.
Martina GozzaIRCCS Humanitas, Rozzano, Milan, Italy.
Sara TestaIRCCS Humanitas, Rozzano, Milan, Italy.
Giuseppe MarinariIRCCS Humanitas, Rozzano, Milan, Italy.
Stefano MaccatrozzoIRCCS Auxologico, Milan, Italy.
Marina CrociIRCCS Auxologico, Milan, Italy.
Enrico MozziIRCCS Auxologico, Milan, Italy.
Ornella Verrastro, Campus Biomedico, Rome, Italy.
Esmeralda Capristo, Campus Biomedico, Rome, Italy.
Marco Raffaelli, Campus Biomedico, Rome, Italy.
Vincenzo BruniUniversità Sapienza and Policlinico Umberto I, Rome, Italy.
Andrea SoareUniversità Sapienza and Policlinico Umberto I, Rome, Italy.
Giuseppe SpagnoloUniversità Sapienza and Policlinico Umberto I, Rome, Italy.
Silvia ManfriniUniversità Sapienza and Policlinico Umberto I, Rome, Italy.
Ida GalloUniversità Sapienza and Policlinico Umberto I, Rome, Italy.
Giovanni CasellaOspedale Fatebenefratelli, Rome, Italy.
Lidia Castagneto-GisseyOspedale Fatebenefratelli, Rome, Italy.
Mikiko WatanabeOspedale Fatebenefratelli, Rome, Italy.
Simona FrontoniOspedale Fatebenefratelli, Rome, Italy.
Massimiliano Di PaolaOspedale San Camillo Forlanini, Rome, Italy.
Benedetta RussoOspedale San Camillo Forlanini, Rome, Italy.
Patrizia BigarelliOspedale San Camillo Forlanini, Rome, Italy.
James R Casella-MarioloOspedale San Camillo Forlanini, Rome, Italy.
Franca FilippiOspedale San Camillo Forlanini, Rome, Italy.
Frida LeonettiUniversità Sapienza and Ospedale S. Maria Goretti, Latina, Rome, Italy.
Alberto Di BiasioUniversità Sapienza and Ospedale S. Maria Goretti, Latina, Rome, Italy.
Gianfranco SilecchiaUniversità Sapienza and Ospedale S. Maria Goretti, Latina, Rome, Italy.
Valeria GuglielmiPoliclinico Ed Università Degli Studi Di Roma Tor Vergata, Rome, Italy.
Claudio ArcudiPoliclinico Ed Università Degli Studi Di Roma Tor Vergata, Rome, Italy.
Antonio VitielloDipartimento Di Medicina Clinica E Chirurgia, Unità Di Endocrinologia, Ospedale Universitario Federico II - Napoli, Napoli, Italy.
Mario MusellaDipartimento Di Medicina Clinica E Chirurgia, Unità Di Endocrinologia, Ospedale Universitario Federico II - Napoli, Napoli, Italy.
Rita SchianoOspedale Pineta Grande - Castel Volturno, Caserta, Italy.
Cristiano GiardielloOspedale Pineta Grande - Castel Volturno, Caserta, Italy.
Michele Giuseppe IovinoOspedale Luigi Cardarelli, Napoli, Italy.
Maurizio De PalmaOspedale Luigi Cardarelli, Napoli, Italy.
Salvatore ToloneUniversità Degli Studi Della Campania - Luigi Vanvitelli, Caserta, Italy.
Ludovico DocimoUniversità Degli Studi Della Campania - Luigi Vanvitelli, Caserta, Italy.
Michele RenzulliAOU San Giovanni Di Dio E Ruggi d'Aragona E Ospedale G. Fucito, Mercato San Severino, Salerno, Italy.
Vincenzo PiloneAOU San Giovanni Di Dio E Ruggi d'Aragona E Ospedale G. Fucito, Mercato San Severino, Salerno, Italy.
Maria PoliceOspedale San Giovanni Bosco, Salerno, Italy.
Luigi AngrisaniOspedale San Giovanni Bosco, Salerno, Italy.
Elena TagliabueDivision of Surgery and Value-Based Healthcare Unit, IRCCS MultiMedica, Milan, Italy.
IRCCS Policlinico San Donato · ITAzienda Ospedaliera San Camillo-Forlanini · ITIstituti di Ricovero e Cura a Carattere Scientifico · ITPoliclinico Umberto I · ITASST Fatebenefratelli Sacco · ITMultiMedica · ITUniversity of Naples Federico II · ITIRCCS Humanitas Research Hospital · ITIRCCS Istituto Auxologico Italiano · ITOspedale Santa Maria Goretti · ITUniversità Campus Bio-Medico · ITOspedale Antonio Cardarelli · ITOspedale San Giovanni Bosco · ITOspedali Riuniti San Giovanni di Dio e Ruggi d'Aragona · ITPoliclinico Tor Vergata · ITUniversity of Campania "Luigi Vanvitelli" · ITVilla Pineta Hospital · ITAzienda Ospedaliera di Cosenza · ITUniversity of Milan · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeBariatric surgery (BS) is considered the most efficient treatment for severe obesity. International guidelines recommend multidisciplinary approach to BS (general practitioners, endocrinologists, surgeons, psychologists, or psychiatrists), and access to BS should be the final part of a protocol of treatment of obesity. However, there are indications that general practitioners (GPs) are not fully aware of the possible benefits of BS, that specialty physicians are reluctant to refer their patients to surgeons, and that patients with obesity choose self-management of their own obesity, including internet-based choices. There are no data on the pathways chosen by physicians and patients to undergo BS in the real world in Italy.

methodsAn exploratory exam was performed for 6 months in three pilot regions (Lombardy, Lazio, Campania) in twenty-three tertiary centers for the treatment of morbid obesity, to describe the real pathways to BS in Italy.

resultsCharts of 2686 patients (788 men and 1895 women, 75.5% in the age range 30-59 years) were evaluated by physicians and surgeons of the participating centers. A chronic condition of obesity was evident for the majority of patients, as indicated by duration of obesity, by presence of several associated medical problems, and by frequency of previous dietary attempts to weight loss. The vast majority (75.8%) patients were self-presenting or referred by bariatric surgeons, 24.2% patients referred by GPs and other specialists. Self-presenting patients were younger, more educated, more professional, and more mobile than patients referred by other physicians. Patients above the age of 40 years or with a duration of obesity greater than 10 years had a higher prevalence of all associated medical problems.

conclusionsThe majority of patients referred to a tertiary center for the treatment of morbid obesity have a valid indication for BS. Most patients self-refer to the centers, with a minority referred by a GP or by specialists. Self-presenting patients are younger, more educated, more professional, and more mobile than patients referred by other physicians. Older patients and with a longer duration of obesity are probably representative of the conservative approach to BS, often regarded as the last resort in an endless story.

Indexed as

Bariatric SurgeryGeneral PractitionersObesity, MorbidSurgeonsAdultEndocrinologistsFemaleHumansMaleMiddle AgedBariatric surgeonsBariatric surgeryEndocrinologistsGeneral practitionersObesitySanitary tourismSelf-referral

Identifiers

PMID35384575
OpenAlexW4225693864

What OpenQuestion holds

Textmetadata
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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.