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OBES SURG (2014) 24:19331939 DOI 10.1007/s11695-014-1270-6
ORIGINAL CONTRIBUTIONS
Patient Preferences and Bariatric Surgery Procedure Selection; the Need for Shared Decision-Making
Andrew L. Weinstein & Bryan J. Marascalchi &
Matthew A. Spiegel & John K. Saunders &
Angela Fagerlin & Manish Parikh
Published online: 1 May 2014# Springer Science+Business Media New York 2014
AbstractBackground Bariatric surgery is the most effective treatment for patients suffering from obesity-related comorbidities. There is little data regarding how patients choose one particular bariatric procedure over another. This study aimed to better define the relationship between preferences of patients considering bariatric surgery and the procedure patients undergo.
Methods A bilingual questionnaire was administered to all prospective patients seen between March 1 and August 31, 2012. The questionnaire assessed basic knowledge of bariatric surgery (based on the information seminar) as well as patient preferences of the various outcomes and complications for sleeve gastrectomy, gastric bypass, and gastric banding. Results One hundred seventy-two patients completed the questionnaire. Fifty-eight percent of patients chose maximum weight loss as the most important outcome, and 65 % chose
A. L. Weinstein : B. J. Marascalchi : M. A. Spiegel : J. K. Saunders :
M. Parikh (*)
Department of Surgery, New York University Langone Medical Center, Bellevue Hospital Center, 550 First Avenue, NBV 15 South 7, New York, NY 10016, USAe-mail: [email protected]
A. L. Weinsteine-mail: [email protected]
B. J. Marascalchie-mail: [email protected]
M. A. Spiegele-mail: [email protected]
J. K. Saunderse-mail: [email protected]
A. FagerlinCenter for Bioethics and Social Sciences in Medicine, VA Ann Arbor Center for Clinical Management Research, 2800 Plymouth Road, Building 16, Room# 455S, Ann Arbor, MI 48109-2800, USA e-mail: [email protected]
leak as the most concerning complication. Subgroup analysis of patients with diabetes revealed that 58 % chose curing diabetes as the most important outcome. Nineteen percent of patients were either not sure which procedure they wanted or changed their decision after consultation with the surgeon. Conclusions The decision to choose one bariatric procedure over another is complex and is based on factors beyond absolute patient preferences. Although maximum weight loss is a commonly reported preference for patients seeking bariatric surgery, patients with diabetes are more focused on diabetes remission. Most patients have already decided which procedure to undergo prior to surgeon consultation. Patients may benefit from shared decision...