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Does the National Bariatric Prioritization Tool predict health outcomes?

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Summary:

A study of patients undergoing elective bariatric surgery at Middlemore Hospital found that while National Bariatric Prioritization Tool (NBPT) score is not correlated with percentage total weight loss after 18 months, it is associated with improvement of comorbidities. Correlation coefficients for the association of NBPT score with reduction in glycosylated haemoglobin, resolution of obstructive sleep apnoea and resolution of hypertension were 0.28 (p < 0.0001), 0.20 (p < 0.001) and 0.20 (p < 0.001), respectively. NBPT scores were significantly higher for Māori and Pacific than New Zealand European patients (p = 0.0023). The study authors concluded that the NBPT could be used to achieve equity of access, but that further modifications should be considered to optimise outcomes.

Comment:
Interesting paper given the recent outcry of using prioritisation tools at Auckland-based hospitals last year. I’d add though that, in my experience: (1) GPs, the main referrers to surgery, don’t necessarily have access to the priority criteria and; (2) arbitrary exclusion criteria can undermine equity aspirations.
Reference: ANZ J Surg. 2023;93(12):2851-2856.
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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