Restriction of Range Effects in Post-Metabolic and Bariatric Surgery Outcomes Research: Considerations for Clinical Decision-Making

Author(s):  
Colleen C. Schreyer ◽  
Jessica K. Salwen-Deremer ◽  
Amanda Montanari ◽  
Janelle W. Coughlin
1999 ◽  
Vol 15 (4) ◽  
pp. 385-393 ◽  
Author(s):  
Edward C.Y. Wang ◽  
Thaddeus H. Grasela ◽  
Cynthia A. Walawander

2017 ◽  
Vol 31 (4) ◽  
pp. 393-401
Author(s):  
Susan M. S. Carlson

Background and Purpose: Currently, there is no guideline or standard of practice for performing the psychiatric/psychological evaluation that is a requirement for approval for bariatric surgery. The Readiness to Change for Bariatric Surgery Assessment Tool (RCB-SAT) establishes a means for psychiatric evaluators to objectively assess the patient’s cognition, beliefs, and motivation around the bariatric diet and lifestyle changes. Development of a clinical decision-making tool for assessing readiness to change in bariatric patients will be useful regarding The Strategic Plan for NIH Obesity Research. The strategic plan outlines 6 overarching themes, with the last 3 centering around creation of such a clinical decision-making tool to assess a bariatric patient’s readiness to change: evaluate promising strategies for obesity prevention and treatment in real-world settings and diverse populations, harness technology and tools to advance obesity research and improve health care delivery, and facilitate integration of research results into community programs and medical practice (National Institutes of Health, 2011). Methods: The pilot tool was administered to 153 potential bariatric patients, with 61 patients completing the survey a second time. Face and content validity of the items were established through an expert review process. Results: Principle axis factoring by means of varimax rotation with Kaiser normalization identified 15 items loading on 3 factors associated with Prochaska and DiClemente’s transtheoretical model of health behavior change: precontemplation, contemplation, and action (DiClemente & Prochaska, 1998). Test–retest reliability was also established for the tool. Implications for Practice: The proposed RCB-SAT demonstrates potential for assessing a patient’s readiness to change regarding the bariatric diet and lifestyle.


2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.


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