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Ann Surg. 2016 May;263(5):875-80. doi: 10.1097/SLA.0000000000001478.

Quality of Follow-up: Systematic Review of the Research in Bariatric Surgery.

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*Department of Surgery, University of Alberta, Edmonton, Canada †Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada ‡Department of Surgery, Jewish General Hospital, McGill University, Montreal, Canada §Center for the Advancement of Minimally Invasive Surgery, Royal Alexandra Hospital, Edmonton, Canada ¶Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada ||Department of Surgery, Peter Lougheed Center, University of Calgary, Calgary, Canada.



We aim to systematically review the bariatric surgery literature with regards to adequacy of patient follow-up, meeting the McMaster criteria of ≥80% follow-up.


Loss to follow-up is a major concern and can potentially bias the outcome and interpretation of a study. The quality of follow-up in bariatric surgery is quite variable with recent systematic reviews criticizing the field for its lack of overall follow-up.


A complete search of PubMed was performed. Literature was restricted to a range of 5 years (2007-2012), English language, and publications listed in PubMed. The McMaster Evidence-based Criteria for High Quality Studies was used to assess the follow-up data adequacy and a logistic meta-regression was performed to identify factors associated with high quality follow-up studies.


Ninety-nine published manuscripts were included. For follow-up at study end, only 40/99 (40.4%) of papers had adequate patient follow-up, 42/99 (42.4%) failed to meet the McMaster criteria and 17/99 (17.2%) failed to report any follow-up results. On average, 31% were lost to follow-up at the study's end. Only shorter study duration, and if the study was performed in the US, were associated with studies meeting the McMaster criteria.


Only 40% of studies in the bariatric surgery literature meet criteria for adequate follow-up. On average, studies have 30% of patients lost to follow-up at the stated end-point. Identified study characteristics associated with high quality follow-up included shorter study duration and studies performed in the US.

[Indexed for MEDLINE]

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