Original Patient perspectives on the usefulness of the MBSAQIP Bariatric Surgical Risk/Benefit Calculator: a randomized controlled trial

Background: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Bariatric Surgical Risk/Benefit Calculator uses procedure-specific prediction models to generate individualized surgical risk/outcome estimates. This tool helps guide informed consent and operative selection. We hypothesized that calculator use would influence patient procedure choice. Objective: To assess patient perspectives on the bariatric surgical calculator. Setting: A randomized controlled trial at an MBSAQIP-accredited center. Methods: During the preoperative bariatric surgical office consultation, patients were randomized into 2 groups: the control group received conventional surgeon-led counseling, whereas surgeons used the risk/benefit calculator to guide decision making for the calculator group. Surveys were completed by patients following consultations to evaluate satisfaction and perceived impact of the risk/benefit calculator on operative selection. Results: Between 2020 and 2022, 61 patients were randomized to the calculator group and 68 pa-tients to the control group. The percentage of patients whose procedure of choice changed following consultation was similar in the calculator versus control group (44.3% versus 41.2%; P =.723). How-ever, calculator group patients were less likely to perceive surgeon counseling as very important for their decision making (43.3% versus 76.5%; P , .001). Eighty-five percent of calculator group pa-tients rated the calculator as useful or very useful, and only 1.7% found it not very important. The reasons patients changed procedure choice were similar between the groups (P = .091); the most common cause was to improve their anticipated outcome (48.7% versus 54.8%). Conclusions: While the risk/benefit calculator was perceived as a helpful tool by most patients, its use did not influence their procedure choice. However, the patient-reported usefulness and importance of the calculator during surgeon counseling suggest that the information provided has weight in pa-tient decision making. (Surg Obes Relat Dis 2023;19:604-610.) (c) 2022 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Automated summary

In a randomized controlled trial, patients undergoing bariatric surgery were divided into two groups, with one group guided by a risk/benefit calculator and the other group receiving traditional surgeon-led counseling. The study found that while most patients found the calculator useful, its use did not influence their procedure choice.