title: Toronto Bariatric Interprofessional Psychosocial Assessment Suitability Scale: Evaluating A New Clinical Assessment Tool for Bariatric Surgery Candidates.
abstract: BACKGROUND
  Patients who are referred for possible bariatric surgery (BS) intervention undergo a series of assessments conducted by an interdisciplinary health care team to determine suitability for surgery. Herein, we report the initial validation and reliability studies of the Bariatric Interprofessional Psychosocial Assessment Suitability Scale (BIPASS) and its relationship to interdisciplinary psychosocial assessment practices for BS.
  
  
  METHODS
  This study was conducted at the Toronto Western Hospital, a Level 1A BS center of excellence accredited by the American College of Surgeons. Phase I: a total of 4 blinded raters applied the BIPASS to 31 randomly selected BS cases referred to our program to establish interrater reliability. Phase II: in all, 3 raters with clinical experience in bariatric psychosocial care applied the BIPASS to 54 randomly selected BS cases.
  
  
  RESULTS
  In total, 46 of 54 (85.1%) patients were women. The median age of all patient cases was 49 years (range: 21-74). Raters׳ BIPASS scores ranged from 4-52 (median = 19.24, standard deviation =10.38). BIPASS scores were highly predictive of the BS psychosocial outcome (area under curve = 0.915; 95% CI: 0.844-0.985; p < 0.001). A BIPASS score of ≥16 was chosen as the cutoff score for further clinical assessment before proceeding with surgical evaluation based on a receiver operating characteristic curve analysis (sensitivity = 0.839; specificity = 0.783). The instrument has very good interrater reliability (Pearson correlation coefficient = 0.847) even among novice raters.
  
  
  CONCLUSIONS
  The findings show that the BIPASS is a comprehensive screening tool in the psychosocial assessment of BS candidates, which standardizes the evaluation process and systematically identify at-risk patients for negative outcomes after BS.
authors.affiliation: Department of Psychiatry, Bariatric Surgery Psychosocial Program, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Gurneet
authors.initials: G
authors.lastname: Thiara
authors.affiliation: Department of Psychiatry, Bariatric Surgery Psychosocial Program, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Yanofksy
authors.affiliation: Department of Psychiatry, Bariatric Surgery Psychosocial Program, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sayed
authors.initials: S
authors.lastname: Abdul-Kader
authors.affiliation: Department of Psychiatry, Bariatric Surgery Psychosocial Program, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Vincent A
authors.initials: VA
authors.lastname: Santiago
authors.affiliation: Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Cassin
authors.affiliation: Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Allan
authors.initials: A
authors.lastname: Okrainec
authors.affiliation: Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Timothy
authors.initials: T
authors.lastname: Jackson
authors.affiliation: Department of Psychiatry, Bariatric Surgery Psychosocial Program, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. Electronic address: raed.hawa@uhn.ca.
authors.forename: Raed
authors.initials: R
authors.lastname: Hawa
authors.affiliation: Department of Psychiatry, Bariatric Surgery Psychosocial Program, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sockalingam
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D050110:Bariatric Surgery / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D018579:Patient Selection; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult