Timing of bariatric surgery for severely obese adolescents: A Markov decision-analysis

Andrea Stroud, Devin Parker, Daniel P. Croitoru

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose Although controversial, bariatric surgery is increasingly being performed in adolescents. We developed a model to simulate the effect of timing of gastric bypass in obese adolescents on quantity and quality of life. Methods A Markov state-transition model was constructed comparing two treatment strategies: gastric bypass surgery at age 16 versus delayed surgery in adulthood. The model simulated a hypothetical cohort of adolescents with body mass index of 45 kg/m2. Model inputs were derived from current literature. The main outcome measure was quality and quantity of life, measured using quality-adjusted life-years (QALYs). Results For females, early gastric bypass surgery was favored by 2.02 QALYs compared to delaying surgery until age 35 (48.91 vs. 46.89 QALYs). The benefit was even greater for males, where early surgery was favored by 2.9 QALYs (48.30 vs. 45.40 QALYs). The absolute benefit of surgery at age 16 increased; the later surgery was delayed into adulthood. Sensitivity analyses demonstrated that adult surgery was favored only when the values for adverse events were unrealistically high. Conclusions In our model, early gastric bypass in obese adolescents improved both quality and quantity of life. These findings are useful for surgeons and pediatricians when counseling adolescents considering weight loss surgery.

Original languageEnglish (US)
Pages (from-to)853-858
Number of pages6
JournalJournal of Pediatric Surgery
Volume51
Issue number5
DOIs
StatePublished - May 1 2016
Externally publishedYes

Fingerprint

Bariatric Surgery
Decision Support Techniques
Quality-Adjusted Life Years
Gastric Bypass
Quality of Life
Counseling
Weight Loss
Body Mass Index
Outcome Assessment (Health Care)

Keywords

  • Adolescents
  • Bariatric surgery
  • Decision analysis
  • Gastric bypass
  • Obesity

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Timing of bariatric surgery for severely obese adolescents : A Markov decision-analysis. / Stroud, Andrea; Parker, Devin; Croitoru, Daniel P.

In: Journal of Pediatric Surgery, Vol. 51, No. 5, 01.05.2016, p. 853-858.

Research output: Contribution to journalArticle

@article{d458198bd0484566bc800db8fe009bfc,
title = "Timing of bariatric surgery for severely obese adolescents: A Markov decision-analysis",
abstract = "Purpose Although controversial, bariatric surgery is increasingly being performed in adolescents. We developed a model to simulate the effect of timing of gastric bypass in obese adolescents on quantity and quality of life. Methods A Markov state-transition model was constructed comparing two treatment strategies: gastric bypass surgery at age 16 versus delayed surgery in adulthood. The model simulated a hypothetical cohort of adolescents with body mass index of 45 kg/m2. Model inputs were derived from current literature. The main outcome measure was quality and quantity of life, measured using quality-adjusted life-years (QALYs). Results For females, early gastric bypass surgery was favored by 2.02 QALYs compared to delaying surgery until age 35 (48.91 vs. 46.89 QALYs). The benefit was even greater for males, where early surgery was favored by 2.9 QALYs (48.30 vs. 45.40 QALYs). The absolute benefit of surgery at age 16 increased; the later surgery was delayed into adulthood. Sensitivity analyses demonstrated that adult surgery was favored only when the values for adverse events were unrealistically high. Conclusions In our model, early gastric bypass in obese adolescents improved both quality and quantity of life. These findings are useful for surgeons and pediatricians when counseling adolescents considering weight loss surgery.",
keywords = "Adolescents, Bariatric surgery, Decision analysis, Gastric bypass, Obesity",
author = "Andrea Stroud and Devin Parker and Croitoru, {Daniel P.}",
year = "2016",
month = "5",
day = "1",
doi = "10.1016/j.jpedsurg.2016.02.036",
language = "English (US)",
volume = "51",
pages = "853--858",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "5",

}

TY - JOUR

T1 - Timing of bariatric surgery for severely obese adolescents

T2 - A Markov decision-analysis

AU - Stroud, Andrea

AU - Parker, Devin

AU - Croitoru, Daniel P.

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Purpose Although controversial, bariatric surgery is increasingly being performed in adolescents. We developed a model to simulate the effect of timing of gastric bypass in obese adolescents on quantity and quality of life. Methods A Markov state-transition model was constructed comparing two treatment strategies: gastric bypass surgery at age 16 versus delayed surgery in adulthood. The model simulated a hypothetical cohort of adolescents with body mass index of 45 kg/m2. Model inputs were derived from current literature. The main outcome measure was quality and quantity of life, measured using quality-adjusted life-years (QALYs). Results For females, early gastric bypass surgery was favored by 2.02 QALYs compared to delaying surgery until age 35 (48.91 vs. 46.89 QALYs). The benefit was even greater for males, where early surgery was favored by 2.9 QALYs (48.30 vs. 45.40 QALYs). The absolute benefit of surgery at age 16 increased; the later surgery was delayed into adulthood. Sensitivity analyses demonstrated that adult surgery was favored only when the values for adverse events were unrealistically high. Conclusions In our model, early gastric bypass in obese adolescents improved both quality and quantity of life. These findings are useful for surgeons and pediatricians when counseling adolescents considering weight loss surgery.

AB - Purpose Although controversial, bariatric surgery is increasingly being performed in adolescents. We developed a model to simulate the effect of timing of gastric bypass in obese adolescents on quantity and quality of life. Methods A Markov state-transition model was constructed comparing two treatment strategies: gastric bypass surgery at age 16 versus delayed surgery in adulthood. The model simulated a hypothetical cohort of adolescents with body mass index of 45 kg/m2. Model inputs were derived from current literature. The main outcome measure was quality and quantity of life, measured using quality-adjusted life-years (QALYs). Results For females, early gastric bypass surgery was favored by 2.02 QALYs compared to delaying surgery until age 35 (48.91 vs. 46.89 QALYs). The benefit was even greater for males, where early surgery was favored by 2.9 QALYs (48.30 vs. 45.40 QALYs). The absolute benefit of surgery at age 16 increased; the later surgery was delayed into adulthood. Sensitivity analyses demonstrated that adult surgery was favored only when the values for adverse events were unrealistically high. Conclusions In our model, early gastric bypass in obese adolescents improved both quality and quantity of life. These findings are useful for surgeons and pediatricians when counseling adolescents considering weight loss surgery.

KW - Adolescents

KW - Bariatric surgery

KW - Decision analysis

KW - Gastric bypass

KW - Obesity

UR - http://www.scopus.com/inward/record.url?scp=84971406160&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84971406160&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2016.02.036

DO - 10.1016/j.jpedsurg.2016.02.036

M3 - Article

C2 - 27261561

AN - SCOPUS:84971406160

VL - 51

SP - 853

EP - 858

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 5

ER -