Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
Alpert Medical School of Brown University, Providence, Rhode Island.
Surg Obes Relat Dis. 2023 Aug;19(8):897-906. doi: 10.1016/j.soard.2023.01.031. Epub 2023 Feb 9.
The Metabolic and Bariatric Surgery Accreditation Quality Improvement Program (MBSAQIP) assesses safety after metabolic and bariatric surgery and the impact on weight and obesity-related diseases. However, changes in quality of life are likely what matters most to patients, and these are not currently assessed. The best way to measure health-related quality of life (HRQoL) is to use validated patient-reported outcomes measures (PROMs), which capture patients' perspectives of their quality of life both before and after surgery.
Identify the outcomes most important to bariatric surgery patients and identify the most appropriate validated PROMs to implement in a national program for the MBSAQIP.
Five hospitals from a single healthcare system in New England.
A series of 18 focus groups and/or interviews conducted with patients, patients' family members, and bariatric health providers determined the outcomes most important to bariatric patients and which validated PROMs would accurately measure those outcomes. Immersion crystallization was used to analyze focus group data and identify appropriate PROMs.
Focus group participants ranked health as the most important outcome for metabolic and bariatric surgery. Self-confidence, mobility, and everyday activities were the next highest ranked HRQoL domains. The Patient-Reported Outcomes Measurement Information System 10-Item Global Health Survey was selected as the general health measure. The Obesity-Related Problems scale and the Obesity and Weight-Loss Quality of Life Instrument were the disease-specific measures selected for inclusion in the MBSAQIP PROMs program.
The addition of PROMs to the MBSAQIP provides a unique opportunity to monitor HRQoL at the national level, which can foster improved shared decision-making before surgery.
代谢和减重手术认证质量改进计划（MBSAQIP）评估代谢和减重手术后的安全性，以及对体重和肥胖相关疾病的影响。然而，生活质量的变化可能是患者最关心的，而目前并没有对此进行评估。衡量健康相关生活质量（HRQoL）的最佳方法是使用经过验证的患者报告结局测量工具（PROMs），这些工具可以捕捉患者在手术前后对生活质量的看法。
确定对减重手术患者最重要的结果，并确定最适合在 MBSAQIP 国家计划中实施的经过验证的 PROMs。
新英格兰单一医疗系统的五家医院。
对患者、患者家属和减重保健提供者进行了一系列 18 次焦点小组和/或访谈，以确定对减重患者最重要的结果，以及哪些经过验证的 PROMs 将准确测量这些结果。沉浸式结晶法用于分析焦点小组数据并确定合适的 PROMs。
焦点小组参与者将健康列为代谢和减重手术最重要的结果。自信、活动能力和日常活动是下一个最重要的 HRQoL 领域。患者报告的结果测量信息系统 10 项全球健康调查被选为一般健康测量工具。肥胖相关问题量表和肥胖与减重生活质量量表被选为纳入 MBSAQIP PROMs 计划的疾病特异性测量工具。
在 MBSAQIP 中添加 PROMs 为在全国范围内监测 HRQoL 提供了一个独特的机会，这可以促进手术前更好的共同决策。
