Recommendations on the most suitable quality‐of‐life measurement instruments for bariatric and body contouring surgery: a systematic review

Vries, Claire E E de; Kalff, Marianne C.; Prinsen, Cecilia A.C.; Coulman, Karen D; Haan, Chan-Hoon; Welbourn, Richard; Blazeby, Jane M; Morton, John M.; Wagensveld, Bart A. van

doi:10.1111/obr.12710

Cited by 58 publications

(67 citation statements)

References 54 publications

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“…HRQL was one of the nine items prioritised for inclusion in the final core outcome set. Building upon the BARIACT study, work is underway to standardize measures of HRQL through the Standardizing Quality of life measures in Obesity Treatment (SQOT) initiative, an international collaboration of healthcare professionals and people living with obesity aiming to achieve global consensus on the key components of HRQL and preferred measures [ 61 , 62 ]. This may include a recommendation to include both a generic and an obesity-specific HRQL measure.…”

Section: What Are the Methodological Issues To Be Addressed With Hrqlmentioning

confidence: 99%

Health-Related Quality of Life in Bariatric and Metabolic Surgery

Coulman

Blazeby

2020

Curr Obes Rep

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Purpose of Review This review describes the latest evidence for the impact of bariatric surgery on health-related quality of life (HRQL). Recent Findings The impact of bariatric surgery on HRQL is less well-understood than its clinical effectiveness on weight and co-morbidities. Poor-quality study design and different HRQL measures challenge systematic reviews and meta-analyses. Available limited evidence suggests that physical aspects of HRQL may improve more than mental health aspects of HRQL after bariatric surgery, reaching maximal benefits 1-2 years post-surgery. Comparative HRQL analyses between bariatric procedures cannot be made due to a lack of randomised data. Qualitative research highlights the tensions patients experience after bariatric surgery, which provides insights to observed changes in HRQL. Summary Standardized HRQL measures are being developed and agreed to improve future evidence synthesis. Two multi-centre randomised trials of bariatric surgical procedures including detailed HRQL assessment are in progress. It is hoped that the combination of comparative high-quality HRQL data and information from qualitative studies will provide new insights into patient well-being and health after bariatric surgery.

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Section: What Are the Methodological Issues To Be Addressed With Hrqlmentioning

confidence: 99%

Health-Related Quality of Life in Bariatric and Metabolic Surgery

Coulman

Blazeby

2020

Curr Obes Rep

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“…For BS and BC, a recently published systematic review by de Vries et al concluded that the most rigorously developed PROM was the BODY‐Q. The review was based on the COSMIN checklist and found that the BODY‐Q had the strongest evidence for content validity . The BODY‐Q was designed in accordance with internationally accepted guidelines and methods to measure change in important PRO over the entire weight loss journey from obesity to post‐BC.…”

Section: Introductionmentioning

confidence: 99%

“…The review was based on the COSMIN checklist and found that the BODY-Q had the strongest evidence for content validity. 8 The BODY-Q was designed in accordance with internationally accepted guidelines and methods 6,7,[9][10][11][12][13] to measure change in important PRO over the entire weight loss journey from obesity to post-BC.…”

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confidence: 99%

Comparison of the Moorehead‐Ardelt quality of life questionnaire and the BODY‐Q in Danish patients undergoing weight loss and body contouring surgery

et al. 2020

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Summary This study compared the measurement properties of the Moorehead‐Ardelt quality of life questionnaire‐II (MAQOL‐II) and the BODY‐Q, to determine which was more suitable for measuring patient‐reported outcome (PRO) in Danish bariatric surgery (BS) and body contouring surgery (BC) patients. We examined content validity against the COSMIN guidelines and compared psychometric performance using Rasch measurement theory methods and criteria. MAQOL‐II data were obtained from the Danish Bariatric Surgery Database from September 2010 to November 2017, and BODY‐Q data were collected from June 2015 to March 2018. The MAQOL‐II failed to meet recommended standards for content validity, while all criteria were met for the BODY‐Q. A total of 16 965 MAQOL‐II and 2259 BODY‐Q assessments were obtained. A random sample was selected from the MAQOL‐II dataset to match the BODY‐Q sample. Psychometrically, the BODY‐Q performed better than the MAQOL‐II. For example, Cronbach's α was 0.82 for the MAQOL‐II vs ≥0.90 for all BODY‐Q scales. Fifty percent (3/6) of MAQOL‐II items had disordered thresholds, while all BODY‐Q items had ordered thresholds (123/123). Poor item fit was revealed for 17% (1/6) of MAQOL‐II and 8% (10/123) of BODY‐Q items. For scale reliability, person separation index was 0.79 for the MAQOL‐II and 0.88 (0.81‐0.93) for the BODY‐Q. In conclusion, the MAQOL‐II does not meet today's standards for a rigorously developed PRO measure. The BODY‐Q, on the other hand, gives substantial, accurate and interpretable measurement and should be recommended for use in PRO in BS and BC patients.

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“…Systematic review evidence suggests that the BODY-Q is a valid and reliable tool for measuring outcomes following weight loss and body contouring surgeries [6]. One of the features of the BODY-Q is the set of appearance scales that measure satisfaction with the body overall and for specific areas (upper arms, abdomen, back, buttocks, inner thighs, and hips and outer thighs).…”

Section: Introductionmentioning

confidence: 99%

Deriving an overall appearance domain score by applying bifactor IRT analysis to the BODY-Q appearance scales

et al. 2019

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Purpose With the BODY-Q, one can assess outcomes, such as satisfaction with appearance, in weight loss and body contouring patients using multiple scales. All scales can be used independently in any given combination or order. Currently, the BODY-Q cannot provide overall appearance scores across scales that measure a similar super-ordinate construct (i.e., overall appearance), which could improve the scales' usefulness as a benchmarking tool and improve the comprehensibility of patient feedback. We explored the possibility of establishing overall appearance scores, by applying a bifactor model to the BODY-Q appearance scales. Methods In a bifactor model, questionnaire items load onto both a primary specific factors and a general factor, such as satisfaction with appearance. The international BODY-Q validation patient sample (n = 734) was used to fit a bifactor model to the appearance domain. Factor loadings, fit indices, and correlation between bifactor appearance domain and satisfaction with body scale were assessed. Results All items loaded on the general factor of their corresponding domain. In the appearance domain, all items demonstrated adequate item fit to the model. All scales had satisfactory fit to the bifactor model (RMSEA 0.045, CFI 0.969, and TLI 0.964). The correlation between the appearance domain summary scores and satisfaction with body scale scores was found to be 0.77. Discussion We successfully applied a bifactor model to BODY-Q data with good item and model fit indices. With this method, we were able to produce reliable overall appearance scores which may improve the interpretability of the BODY-Q while increasing flexibility.

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Recommendations on the most suitable quality‐of‐life measurement instruments for bariatric and body contouring surgery: a systematic review

Abstract: The BODY-Q, developed for BS and BCS, possessed the strongest evidence for quality of measurement properties and has the potential to be recommended in future clinical trials.

Cited by 58 publications

References 54 publications

Health-Related Quality of Life in Bariatric and Metabolic Surgery

Health-Related Quality of Life in Bariatric and Metabolic Surgery

Comparison of the Moorehead‐Ardelt quality of life questionnaire and the BODY‐Q in Danish patients undergoing weight loss and body contouring surgery

Deriving an overall appearance domain score by applying bifactor IRT analysis to the BODY-Q appearance scales

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