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Health and Quality of Life Outcomes

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Open Access 01-12-2017 | Research

Further psychometric validation of the BODY-Q: ability to detect change following bariatric surgery weight gain and loss

Authors: Anne F. Klassen, Stefan J. Cano, Manraj Kaur, Trisia Breitkopf, Andrea L. Pusic

Published in: Health and Quality of Life Outcomes | Issue 1/2017

Abstract

Background

Recent systematic reviews have identified that current patient-reported outcome instruments have content limitations when used to measure change following bariatric surgery. The aim of this study was to measure change after bariatric surgery using the BODY-Q, a PRO instrument designed for weight loss and body contouring.

Methods

The BODY-Q is composed of 18 independently functioning scales and an obesity-specific symptom checklist that measure appearance, health-related quality of life (HR-QOL) and experience of health-care. The sample for this study included patients who were exploring or seeking bariatric surgery in Hamilton (Canada) at the time of the BODY-Q field-test study and who agreed to further contact from the research team. These patients were invited to complete 12 BODY-Q scales and the symptom checklist between 7 June 2016 and 29 November 2016. Data were collected online (REDCap) and via postal surveys. Clinical change was measured using paired t-tests with effect sizes and standardized response means.

Results

The survey was completed by 58 of 89 (65%) pre-bariatric participants from the original BODY-Q field-test sample. The non-participants did not differ from participants in terms of age, gender, ethnicity, BMI or initial BODY-Q scale scores. Participants who had undergone bariatric surgery had a mean BMI of 49 (SD = 7) at time 1 and 35 (SD = 7) at time 2. Time since bariatric surgery was on average 2 years (SD = 0.5) (range 0.4 to 3 years). Percentage total weight loss ranged from 12 to 51 (mean 31, SD = 9). The difference in the proportion of patients to report an obesity-specific symptom on the BODY-Q checklist was significantly lower at follow-up for 5 of 10 symptoms. Participants improved on BODY-Q scales measuring appearance (of abdomen, back, body, buttocks, hips/outer thighs, inner thigh), body image and physical function (p < 0.001 on paired t-tests) and social function (p = 0.002 on paired t-test). These changes were associated with moderate to large effect sizes (0.60 to 2.29) and standardized response means (0.47 to 1.35).

Conclusions

The BODY-Q provides a set of independently functioning scales that measure issues important to patients who undergo weight loss. BODY-Q scales were responsive to measuring clinical change associated with weight loss 2 years after bariatric surgery.

Sarwer DB, Steffen KJ. Quality of life, body image and sexual functioning in bariatric surgery patients. Eur Eat Disord Rev. 2015;23:504–8. doi:10.1002/erv.2412.CrossRefPubMed

Raaijmakers LC, Pouwels S, Thomassen SE, Nienhuijs SW. Quality of life and bariatric surgery: a systematic review of short- and long-term results and comparison with community norms. Eur J Clin Nutr. 2016 Nov 2; doi: 10.1038/ejcn.2016.198. [Epub ahead of print]

Jumber S, Bartlett C, Jumbe SL, Meyrick J. The effectiveness of bariatric surgery on long term psychosocial quality of life - a systematic review. Obes Res Clin Pract. 2016;10(3):225–42. doi:10.1016/j.orcp.2015.11.009. Epub 2016 Jan 8CrossRef

Hachem A, Brennan L. Quality of life outcomes of bariatric surgery: a systematic review. Obes Surg. 2016;26(2):395–409.CrossRefPubMed

US Food and Drug Administration Clinical Outcome Assessment Qualification Program. FDA, 2015. Available at: http://www.fda.gov/Drugs/DevelopmentApprovalProcess/DrugDevelopmentToolsQualificationProgram/ucm284077.htm. Accessed 18 Mar 2017.

Black N. Patient reported outcome measures could help transform healthcare. BMJ. 2013;346:f167.CrossRefPubMed

Basch E. Patient-reported outcomes - harnessing Patients' voices to improve clinical care. N Engl J Med. 2017;376(2):105–8.CrossRefPubMed

Nelson EC, Eftimovska E, Lind C, Hager A, Wasson JH, Lindblad S, et al. Patient reported outcome measures in practice. BMJ. 2015;350:g7818.CrossRefPubMed

Williams K, Sansoni J, Morris D, Grootemaat P, Thompson C. Patient-reported outcome measures: literature review. ACSQHC: Sydney; 2016.

10.

Tayyem R, Ali A, Atkinson J, et al. Analysis of health-related quality-of-life instruments measuring the impact of bariatric surgery. Systematic review of the instruments used and their content validity. Patient. 2011;4:73–87.CrossRefPubMed

11.

Kolotkin RL, Head S, Hamilton M, Tse CK. Assessing impact of weight on quality of life. Obes Res. 1995;3:49–56.CrossRefPubMed

12.

Kolotkin RL, Crosby RD, Kosloski KD, Williams GR. Development of a brief measure to assess quality of life in obesity. Obes Res. 2001;9:102–11.CrossRefPubMed

13.

Moorehead MK, Ardelt-Gattinger E, Lechner H, Oria HE. The validation of the Moorehead-Ardelt quality of life Questionnarie II. Obesity Surg. 2003;13:684–92.CrossRef

14.

Cano SJ, Hobart JC. The problem with health measurement. Patient Prefer Adherence. 2011;5:279–90. doi:10.2147/PPA.S14399. Epub 2011 Jun 14.CrossRefPubMedPubMedCentral

15.

Hobart J, Cano S. Improving the evaluation of therapeutic intervention in MS: the role of new psychometric methods. Health Technol Assess. 2009;13:1–200.CrossRef

16.

Klassen AF, Cano SJ, Alderman A, Soldin M, Thoma A, Robson S, Kaur M, Papas A, Van Laeken N, Taylor VH, Pusic AL. The BODY-Q: A Patient-Reported Outcome Instrument for Weight Loss and Body Contouring Treatments. Plast Reconstr Surg Glob Open. 2016; 13;4(4):e679. doi: doi:10.1097/GOX.0000000000000665.

17.

Rasch G. Probabilistic models for some intelligence and attainment tests. Copenhagen, Denmark: Danish Institute for Education Research; 1960.

18.

Reavey PL, Klassen AF, Cano S, McCarthy C, Scott A, Rubin JP, Shermak M, Pusic AL. Measuring quality-of-life and patient satisfaction after body contouring: a systematic review of patient-reported outcome measures. Aesthet Surg J. 2011;31:807–13.CrossRefPubMed

19.

Klassen AF, Cano SJ, Scott A, Tsangaris E, Johnson J. Assessing outcomes in body contouring. Clin Plast Surg. 2014;41(4):645–54. doi:10.1016/j.cps.2014.06.004.

20.

Harris PA, Taylor R, Thielke R, Rayne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81.CrossRefPubMed

21.

Kazis LE, Anderson JJ, Meenan RF. Effect sizes for interpreting changes in health status. Med Care. 1989;27(Suppl):S178–89.CrossRefPubMed

22.

Liang MH, Fossel AH, Larson MG. Comparisons of five health status instruments for orthopedic evaluation. Med Care. 1990;28:632–42.CrossRefPubMed

23.

Cohen J. Statistical power analysis for the behavioral sciences. Routledge Academic: New York, NY; 1988.

24.

Klassen AF, Cano SJ, Scott A, Johnson J, Pusic AL. Satisfaction and quality-of-life issues in body contouring surgery patients: a qualitative study. Obes Surg. 2012;10:1527–34.CrossRef

25.

Kubik JF, Gill RS, Laffin M, Karmali S. The impact of bariatric surgery on psychological health. J Obes. 2013;2013

26.

Poulsen L, Klassen A, Rose M, Roessler KK, Juhl CB, Støving RK, Sørensen JA. Patient-Reported Outcomes in Weight Loss and Body Contouring Surgery: A Cross-Sectional Analysis Using the BODY-Q. Plast Reconstr Surg. 2017;140:491–500. doi:10.1097/PRS.0000000000003605.

Title: Further psychometric validation of the BODY-Q: ability to detect change following bariatric surgery weight gain and loss
Authors: Anne F. Klassen
Stefan J. Cano
Manraj Kaur
Trisia Breitkopf
Andrea L. Pusic
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2017
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/s12955-017-0802-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Further psychometric validation of the BODY-Q: ability to detect change following bariatric surgery weight gain and loss

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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