The Effect of Attrition on Reported Diabetes Remission Rates Following Roux-en-Y Gastric Bypass: a Sensitivity Analysis

Obesity Surgery
Deanna J M IsamanWilliam H Herman

Abstract

Attrition, or loss to follow-up, is a common problem in studies of type 2 diabetes remission following roux-en-Y gastric bypass (RYGB) and is often correlated with weight loss. Thus, reported rates of remission may be inflated by attrition bias. We investigate the effect of attrition bias on reported diabetes remission rates following RYGB. Using sensitivity analyses, we identified sets of attrition and remission rates that produced simulated outcomes within 95% confidence intervals of the reported outcomes from five studies of diabetes remission following RYGB. Potential attrition bias varied greatly, yielding possible remission rates of diabetes ranging from 20 to 40% at 1 year. For studies with the attrition greater than ~ 20%, estimates that ignored attrition overestimated diabetes remission rates. Kaplan-Meier estimates were less affected by attrition. Potential for bias was most evident in the study with the largest sample size. Researchers, clinicians, and policymakers can measure potential attrition bias in clinical studies. In the case of remission of diabetes following RYGB, the potential bias in reported remission rates is generally less than 10%, varies considerably among studies, and is primarily driven by attritio...Continue Reading

References

Jun 23, 2012·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Robin BlackstoneHarvey J Sugerman
Oct 5, 2012·The New England Journal of Medicine·Roderick J LittleHal Stern
Sep 27, 2014·Journal of the American College of Surgeons·Adam DiamantFayez A Quereshy
Nov 2, 2014·Obesity Surgery·Gianluca IacobellisNestor F De La Cruz-Munoz
Jul 15, 2015·Bariatric Surgical Practice and Patient Care·Zhamak KhorgamiNestor de la Cruz-Muñoz
Dec 15, 2015·Surgical Endoscopy·Ninh T NguyenMichael J Phelan
Jan 24, 2016·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·William F GourashDavid Nolfi
Feb 29, 2016·Obesity Surgery·Martin C GullifordUNKNOWN King’s Bariatric Surgery Study Group
May 26, 2016·Diabetes Care·Francesco RubinoUNKNOWN Delegates of the 2nd Diabetes Surgery Summit
Oct 16, 2016·Diabetes Care·Deanna J M IsamanWilliam H Herman

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