2023
A qualitative analysis describing attrition from bariatric surgery to identify strategies for improving retention in patients who desire treatment
Chao G, Lindquist K, Vitous C, Tolentino D, Delaney L, Alimi Y, Jafri S, Telem D. A qualitative analysis describing attrition from bariatric surgery to identify strategies for improving retention in patients who desire treatment. Surgical Endoscopy 2023, 37: 6032-6043. PMID: 37103571, PMCID: PMC10136401, DOI: 10.1007/s00464-023-10030-z.Peer-Reviewed Original ResearchConceptsBariatric surgeryBariatric surgery programFear of surgeryTheoretical Domains FrameworkSurgery programSerious chronic diseaseFuture theory-based interventionsNon-Hispanic whitesBackgroundAmong patientsResultsTwenty patientsTheory-based interventionChronic diseasesPatientsSurgeryClinical sitesConclusionsThis studyAnticipated regretTDF domainsDomains FrameworkIntervention designHealthy lifeSocial rolesDropout rateEnvironmental contextTreatmentOut-of-pocket Costs for Commercially-insured Patients in the Years Following Bariatric Surgery
Chao G, Yang J, Thumma J, Chhabra K, Arterburn D, Ryan A, Telem D, Dimick J. Out-of-pocket Costs for Commercially-insured Patients in the Years Following Bariatric Surgery. Annals Of Surgery 2023, 277: e332-e338. PMID: 35129487, PMCID: PMC9091055, DOI: 10.1097/sla.0000000000005291.Peer-Reviewed Original ResearchConceptsSleeve gastrectomyBariatric surgeryOOP costsIBM MarketScan Commercial Claims DatabasesProcedure choiceMarketScan Commercial Claims databaseLaparoscopic sleeve gastrectomyBariatric surgery proceduresPostoperative year 1Commercial claims databaseTotal OOP costsYear 1Year 2Year 3Gastric bypassRetrospective studyClaims databaseSurgical episodesInsurance typeOperative yearBACKGROUND DATASurgery proceduresPatientsPrimary analysisClinical contributors
2022
The role of preoperative toxicology screening in patients undergoing bariatric surgery
Chao G, Ying L, Chan S, Alturki N, Aravind P, Thaqi M, Mahmoud A, Morton J. The role of preoperative toxicology screening in patients undergoing bariatric surgery. Surgery For Obesity And Related Diseases 2022, 19: 187-193. PMID: 36443215, DOI: 10.1016/j.soard.2022.10.021.Peer-Reviewed Original ResearchConceptsPreoperative lengthBariatric surgeryToxicology testingWeight lossBariatric surgical populationBody mass indexImportant surgical outcomesAcademic health systemGastric bypassLack of evidenceSurgical populationPostoperative outcomesRetrospective reviewMass indexSurgical outcomesUrine testingPositivity rateMean changePositive testingPatientsNegative testingReadmissionHealth systemChi-squarePositivityBirths After Bariatric Surgery in the United States
Chao G, Yang J, Peahl A, Thumma J, Dimick J, Arterburn D, Telem D. Births After Bariatric Surgery in the United States. Annals Of Surgery 2022, 277: e801-e807. PMID: 35762610, PMCID: PMC9794635, DOI: 10.1097/sla.0000000000005438.Peer-Reviewed Original ResearchConceptsRisk of reinterventionAdverse obstetric outcomesBariatric surgery patientsObstetric outcomesBariatric surgerySurgery patientsFemale patients ages 18Multivariable logistic regression analysisEvent ratesNational US cohortSevere maternal morbidityLaparoscopic sleeve gastrectomyPatients age 18Retrospective cohort studyIBM MarketScan databasesMultivariable logistic regressionKaplan-Meier estimatesLogistic regression analysisIncidence of birthsMaternal safetyDelivery complicationsGastric bypassGestational diabetesHypertensive disordersMaternal morbidityExpectations and experiences following bariatric surgery: Perceptions of female patients across Michigan
Vitous C, Ehlers A, Chao G, Stricklen A, Ross R, Kullgren J, Ghaferi A. Expectations and experiences following bariatric surgery: Perceptions of female patients across Michigan. The American Journal Of Surgery 2022, 224: 1182-1184. PMID: 35595572, DOI: 10.1016/j.amjsurg.2022.05.010.Peer-Reviewed Original ResearchVariation in pre-operative insurance requirements for bariatric surgery
Gomez-Rexrode A, Chhabra K, Telem D, Chao G. Variation in pre-operative insurance requirements for bariatric surgery. Surgical Endoscopy 2022, 36: 8358-8363. PMID: 35513536, DOI: 10.1007/s00464-022-09293-9.Peer-Reviewed Original ResearchConceptsBariatric surgeryInsurance typePoisson regressionInsurance plan typeBariatric surgery programLife-saving interventionsCross-sectional assessmentPlan typeBackgroundFor patientsSecondary outcomesPrimary outcomeU.S. Census regionSurgery programMedicaid plansPatientsSurgeryWeight lossMedicaidNumber of monthsInsurance plansCommercial plansCensus regionGreater frequencyInsurance requirementsGreater numberLong-term comparative effectiveness of gastric bypass and sleeve gastrectomy on use of antireflux medication: a difference-in-differences analysis
Howard R, Yang J, Thumma J, Arterburn D, Ryan A, Chao G, Telem D, Dimick J. Long-term comparative effectiveness of gastric bypass and sleeve gastrectomy on use of antireflux medication: a difference-in-differences analysis. Surgery For Obesity And Related Diseases 2022, 18: 1033-1041. PMID: 35649735, DOI: 10.1016/j.soard.2022.04.016.Peer-Reviewed Original ResearchConceptsLong-term comparative effectivenessGERD medication useCommon bariatric operationGastric bypassMedication useSleeve gastrectomyAntireflux medicationComparative effectivenessBariatric surgeryBariatric operationsAntireflux medication useInpatient bariatric surgeryLong-term effectivenessGastroesophageal refluxRetrospective studyNational cohortGastrectomyTreatment decisionsMedicare beneficiariesPatientsSurgeryBypassMedicationsGreater reductionDifferential changesFemale Patient Perceptions on Financial Incentives to Promote Follow-Up After Bariatric Surgery
Ehlers A, Vitous C, Chao G, Stricklen A, Ross R, Kullgren J, Ghaferi A. Female Patient Perceptions on Financial Incentives to Promote Follow-Up After Bariatric Surgery. Journal Of Surgical Research 2022, 276: 195-202. PMID: 35366424, DOI: 10.1016/j.jss.2022.02.027.Peer-Reviewed Original ResearchMedication Use for Obesity-Related Comorbidities After Sleeve Gastrectomy or Gastric Bypass
Howard R, Chao G, Yang J, Thumma J, Arterburn D, Telem D, Dimick J. Medication Use for Obesity-Related Comorbidities After Sleeve Gastrectomy or Gastric Bypass. JAMA Surgery 2022, 157: 248-256. PMID: 35019988, PMCID: PMC8756362, DOI: 10.1001/jamasurg.2021.6898.Peer-Reviewed Original ResearchConceptsTime of surgeryGastric bypassMedication discontinuationSleeve gastrectomyCumulative incidenceMedication useHyperlipidemia medicationsComorbidity resolutionLower incidenceCommon bariatric surgical proceduresLipid-lowering medication useComparative effectiveness research studyAdult Medicare beneficiariesDiabetes medication useAntihypertensive medication useLipid-lowering medicationsBariatric surgical proceduresSubset of patientsLong-term trialsAntihypertensive medicationsDiabetes medicationsLaparoscopic RouxBariatric surgeryPrimary outcomeMean ageComparative effectiveness of sleeve gastrectomy vs Roux-en-Y gastric bypass in patients giving birth after bariatric surgery: reinterventions and obstetric outcomes
Chao G, Yang J, Peahl A, Thumma J, Dimick J, Arterburn D, Telem D. Comparative effectiveness of sleeve gastrectomy vs Roux-en-Y gastric bypass in patients giving birth after bariatric surgery: reinterventions and obstetric outcomes. Surgical Endoscopy 2022, 36: 6954-6968. PMID: 35099628, DOI: 10.1007/s00464-022-09063-7.Peer-Reviewed Original ResearchConceptsAdverse obstetric outcomesGastric bypassObstetric outcomesBariatric surgerySleeve gastrectomyComparative effectivenessRisk of reinterventionLaparoscopic sleeve gastrectomyRetrospective cohort studyMultivariable logistic regressionSignificant differencesCommon procedure todayResultsFrom 2011Reintervention rateBariatric proceduresCohort studyIBM MarketScanNational cohortInverse probability weightingGastrectomyReinterventionRouxSurgeryPatientsBypassQuestioning the legitimacy of bariatric surgery: a qualitative analysis of individuals from the community who qualify for bariatric surgery
Chao G, Diaz A, Ghaferi A, Dimick J, Byrnes M. Questioning the legitimacy of bariatric surgery: a qualitative analysis of individuals from the community who qualify for bariatric surgery. Surgical Endoscopy 2022, 36: 6733-6741. PMID: 34981224, PMCID: PMC8722749, DOI: 10.1007/s00464-021-08949-2.Peer-Reviewed Original ResearchConceptsBariatric surgeryMedical treatmentWeight loss requirementsInterpretive description frameworkNIH criteriaMajority of participantsDurable therapySurgeryMajority of individualsHealthcare providersDiverse cohortDescriptive studyWeight lossFirst qualitative studyPacific IslandersTreatmentQualitative studyParticipantsDoctorsImportant contributorFinal themeIndividualsObesityPatientsMajor themes
2021
Comparative Safety of Sleeve Gastrectomy and Gastric Bypass Up to 5 Years After Surgery in Patients With Severe Obesity
Howard R, Chao G, Yang J, Thumma J, Chhabra K, Arterburn D, Ryan A, Telem D, Dimick J. Comparative Safety of Sleeve Gastrectomy and Gastric Bypass Up to 5 Years After Surgery in Patients With Severe Obesity. JAMA Surgery 2021, 156: 1160-1169. PMID: 34613354, PMCID: PMC8495604, DOI: 10.1001/jamasurg.2021.4981.Peer-Reviewed Original ResearchConceptsAdjusted hazard ratioSleeve gastrectomyGastric bypassRisk of mortalityCumulative incidenceLong-term riskBariatric surgerySurgical revisionComparative safetyMAIN OUTCOMEUnknown raceLower long-term riskHigher long-term riskUnderwent sleeve gastrectomyRetrospective cohort studyEmergency department useHealth care useLong-term safetyMedicare claims databaseTotal health care spendingCause hospitalizationLaparoscopic RouxCohort studyHazard ratioSecondary outcomesVenous thromboembolism: risk factors in the sleeve gastrectomy era
Chao G, Montgomery J, Abou Azar S, Telem D. Venous thromboembolism: risk factors in the sleeve gastrectomy era. Surgery For Obesity And Related Diseases 2021, 17: 1905-1911. PMID: 34389247, DOI: 10.1016/j.soard.2021.06.022.Peer-Reviewed Original ResearchConceptsHistory of VTEPostoperative venous thromboembolismBody mass indexVenous thromboembolismRisk factorsBlack patientsPreoperative body mass indexHigh-risk patientsBariatric Surgery AccreditationMultivariable logistic regressionVenous stasis diseaseQuality Improvement ProgramProlonged prophylaxisBariatric surgeryMultivariable analysisOperative timeMass indexOperative lengthProcedure typeWhite racePrevious historyPatientsSurgery dataLogistic regressionHealth equityFinancial Incentives to Improve Patient Follow-up and Weight Loss After Bariatric Surgery
Chao G, Kullgren J, Ross R, Bonham A, Ghaferi A. Financial Incentives to Improve Patient Follow-up and Weight Loss After Bariatric Surgery. Annals Of Surgery 2021, 277: e70-e77. PMID: 34171878, DOI: 10.1097/sla.0000000000005013.Peer-Reviewed Original ResearchConceptsExcess weight lossBariatric surgeryWeight lossSurgery datePercent excess weight lossPostoperative months 1Financial incentive programsBody mass indexGreater weight lossPostintervention patientsPractice patientsPostoperative appointmentsContemporary patientsMass indexMonths 1Control practicesHistoric patientsPatientsSurgeryControl groupHealth outcomesHistoric groupPrior visitMonthsSignificant differencesPatient-reported Comorbidity Assessment After Bariatric Surgery
Chao G, Bonham A, Ross R, Stricklen A, Ghaferi A. Patient-reported Comorbidity Assessment After Bariatric Surgery. Annals Of Surgery 2021, 276: e792-e797. PMID: 33914479, DOI: 10.1097/sla.0000000000004841.Peer-Reviewed Original ResearchConceptsGastroesophageal reflux diseaseObstructive sleep apneaComorbidity assessmentPostoperative questionnaireBariatric surgerySleep apneaBariatric surgery patientsMedical chart auditLong-term outcomesLong-term efficacyCross-sectional studyPostoperative comorbiditiesGastric bypassReflux diseasePatient comorbiditiesSurgery patientsSurgical patientsChart auditPatient reportsBACKGROUND DATAComorbiditiesPatientsResponse rateΚ statisticMean difference
2020
Evidence-Based Medicine and Decision Making
Chao G, Dimick J. Evidence-Based Medicine and Decision Making. Difficult Decisions In Surgery: An Evidence-Based Approach 2020, 5-14. DOI: 10.1007/978-3-030-55329-6_2.Peer-Reviewed Original ResearchBariatric Surgery in Medicare Patients
Chao G, Chhabra K, Yang J, Thumma J, Arterburn D, Ryan A, Telem D, Dimick J. Bariatric Surgery in Medicare Patients. Annals Of Surgery 2020, 276: 133-139. PMID: 33214440, PMCID: PMC8126578, DOI: 10.1097/sla.0000000000004526.Peer-Reviewed Original ResearchConceptsBariatric surgeryED utilizationHealthcare utilizationClinical safety outcomesMedicare Evidence DevelopmentBariatric surgery patientsTreatment effectsGastric bypassSurgery patientsMedicare cohortBariatric outcomesMedicare patientsHernia repairMedicare claimsSafety outcomesMedicare beneficiariesComparative effectivenessBypassSurgeryInstrumental variable analysisEvidence developmentReinterventionRehospitalizationComplicationsPatientsComparative Safety of Sleeve Gastrectomy and Gastric Bypass
Chhabra K, Telem D, Chao G, Arterburn D, Yang J, Thumma J, Ryan A, Blumenthal B, Dimick J. Comparative Safety of Sleeve Gastrectomy and Gastric Bypass. Annals Of Surgery 2020, 275: 539-545. PMID: 33201113, DOI: 10.1097/sla.0000000000004297.Peer-Reviewed Original ResearchConceptsSleeve gastrectomyGastric bypassBariatric surgeryIBM MarketScanLarge cohortCommon bariatric operationBariatric surgery patientsSelection biasSuperior safety profileLong-term safetyOverall healthcare spendingGastroesophageal refluxSurgery patientsBariatric operationsSafety profileComparative safetyGastrectomyBACKGROUND DATAHigh riskInternational ClassificationPatientsSurgeryPayer decisionsBypassProcedural TerminologyConvergent Mixed Methods Exploration of Telehealth in Bariatric Surgery: Maximizing Provider Resources and Access
Chao GF, Ehlers AP, Ellimoottil C, Varban OA, Dimick JB, Telem DA. Convergent Mixed Methods Exploration of Telehealth in Bariatric Surgery: Maximizing Provider Resources and Access. Obesity Surgery 2020, 31: 1877-1881. PMID: 33111249, PMCID: PMC7591243, DOI: 10.1007/s11695-020-05059-1.Peer-Reviewed Original ResearchConceptsBariatric surgery processBariatric surgery programHealthcare resource utilizationCare delivery modalitiesSelf-reported weightSurgery processSurgery visitsUS healthcare systemBariatric surgeryTelehealth visitsTelehealth useSurgery programTelehealth implementationShow ratesProvider perspectivesHealthcare systemTelehealthDelivery modalitiesPrior yearVisitsInsurance providersCoverage decisionsMixed methods explorationPatientsSurgeryPerioperative risks of bariatric surgery among patients with and without history of solid organ transplant
Montgomery JR, Cohen JA, Brown CS, Sheetz KH, Chao GF, Waits SA, Telem DA. Perioperative risks of bariatric surgery among patients with and without history of solid organ transplant. American Journal Of Transplantation 2020, 20: 2530-2539. PMID: 32243667, PMCID: PMC7838764, DOI: 10.1111/ajt.15883.Peer-Reviewed Original ResearchConceptsGlomerular filtration rateBariatric surgeryPrevious transplantSurgical complicationsPrimary outcomeMedical complicationsPatient populationFiltration rateLaparoscopic sleeve gastrectomySolid organ transplantsGastric bypass proceduresIncidence of deathLimited case seriesMultivariable logistic regressionIntraabdominal leakUnplanned reoperationDay readmissionInfectious complicationsPerioperative riskSleeve gastrectomyTransplant patientsBariatric proceduresPerioperative safetyIndividual complicationsCase series