title: A Comparison of Health Professionals' and Patients' Views of the Importance of Outcomes of Bariatric Surgery.
abstract: A comprehensive evaluation of bariatric surgery is required to inform decision-making. This will include measures of benefit and risk. It is possible that stakeholders involved with surgery value these outcomes differently, although this has not previously been explored. This study aimed to investigate and compare how professionals and patients prioritise outcomes of bariatric surgery.
  
  
  
  Systematic reviews and qualitative interviews created an exhaustive list of outcomes. This informed the development of a 130-item questionnaire, structured in four sections (complications of surgery; clinical effectiveness; signs, symptoms, and other measures; quality of life). Health professionals and patients rated the importance of each item on a 1-9 scale. Items rated 8-9 by at least 70 % of the participants were considered prioritised. Items prioritised in each section were compared between professionals and patients and interrater agreement assessed using kappa statistics (ĸ).
  
  
  
  One hundred sixty-eight out of four hundred fifty-nine professionals (36.6 %) and 90/465 patients (19.4 %) completed the questionnaire. Professionals and patients prioritised 18 and 25 items, respectively, with 10 overlapping items and 23 discordant items (ĸ 0.363). Examples of items prioritised by both included 'diabetes' and 'leakage from bowel joins'. Examples of discordant items included 're-admission rates' (professionals only) and 'excess skin' (patients only). Poor agreement was seen in the 'quality of life' section (0 overlapping items, 8 discordant, ĸ -0.036).
  
  
  
  Although there was some overlap of outcomes prioritised by professionals and patients, there were important differences. We recommend that the views of all relevant health professionals and patients are considered when deciding on outcomes to evaluate bariatric surgery.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. karen.coulman@bristol.ac.uk.
authors.forename: Karen D
authors.initials: KD
authors.lastname: Coulman
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.|Department of Upper GI and Bariatric Surgery, Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, TA1 5DA, UK.
authors.forename: Noah
authors.initials: N
authors.lastname: Howes
authors.affiliation: Department of Upper GI and Bariatric Surgery, Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, TA1 5DA, UK.
authors.forename: James
authors.initials: J
authors.lastname: Hopkins
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: Katie
authors.initials: K
authors.lastname: Whale
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: Katy
authors.initials: K
authors.lastname: Chalmers
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: Sara
authors.initials: S
authors.lastname: Brookes
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Nicholson
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.|The National Institute For Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation Trust, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
authors.forename: Jelena
authors.initials: J
authors.lastname: Savovic
authors.affiliation: Department of Upper GI and Bariatric Surgery, Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, TA1 5DA, UK.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Ferguson
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: Amanda
authors.initials: A
authors.lastname: Owen-Smith
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.|Division of Surgery, Head & Neck, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8HW, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Blazeby
authors.forename: Jane
authors.initials: J
authors.lastname: Blazeby
authors.forename: Richard
authors.initials: R
authors.lastname: Welbourn
authors.forename: James
authors.initials: J
authors.lastname: Byrne
authors.forename: Jenny
authors.initials: J
authors.lastname: Donovan
authors.forename: Barnaby C
authors.initials: BC
authors.lastname: Reeves
authors.forename: Sarah
authors.initials: S
authors.lastname: Wordsworth
authors.forename: Robert
authors.initials: R
authors.lastname: Andrews
authors.forename: Janice L
authors.initials: JL
authors.lastname: Thompson
authors.forename: Graziella
authors.initials: G
authors.lastname: Mazza
authors.forename: Chris A
authors.initials: CA
authors.lastname: Rogers
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D050110:Bariatric Surgery / Q000523:psychology*; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Core outcome sets; Health professional views; Outcomes; Patient views; Quality of life; Survey