Restriction of range effects in post-metabolic and bariatric surgery outcomes research: considerations for clinical decision making.
Surg Obes Relat Dis
; 18(3): 425-432, 2022 Mar.
Article
em En
| MEDLINE
| ID: mdl-34973926
ABSTRACT
BACKGROUND:
Preoperative psychopathology does not consistently predict postoperative outcomes in patients who undergo metabolic and bariatric surgery (MBS). Individuals with elevated pre-MBS psychopathology may be less likely to undergo surgery, which may create a floor effect given the limited range of scores on measures of psychopathology included in postoperative analyses, thereby decreasing the power to detect clinically significant differences between groups.OBJECTIVES:
Our objective was to compare rates of clinically significant pre-MBS psychopathology across domains of functioning in patients who did and did not undergo MBS surgical completers (SCs, n = 286) and nonsurgical completers (NSCs, n = 125).SETTING:
Academic medical center, United States.METHODS:
Participants (n = 411) were a racially diverse sample of MBS candidates who completed a preoperative psychosocial evaluation including measures of disordered eating, alcohol and tobacco use, pain catastrophizing, anxiety, and depressive symptomatology.RESULTS:
Compared with SCs, NSCs had larger scale score variance on measures of psychopathology and were more likely to be Black; to report clinically significant scores on measures of binge eating, depression, anxiety, and pain catastrophizing; and to use tobacco.CONCLUSION:
Results support the presence of a restriction-of-range effect but do not demonstrate a floor effect. These data suggest that current outcome data for MBS patients may not generalize to those who report clinically significant psychopathology at the pre-MBS psychosocial evaluation and may warrant caution when using the current literature to inform clinical decision making for this group. Findings also suggest a need for interventions that will better engage Black patients.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Obesidade Mórbida
/
Cirurgia Bariátrica
/
Transtorno da Compulsão Alimentar
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article