Background

The MBSAQIP Bariatric Risk/Benefit Calculator uses procedure-specific prediction models based on patient demographics to generate individualized surgical risk and outcome estimates. This tool can help guide informed consent discussions and operative selection. We hypothesized that calculator use would influence patient procedure choice.

Methods

During the preoperative bariatric surgical consultation process, patients were randomized into two groups: the calculator group utilized the Risk/Benefit Calculator to guide discussion-making while the control group relied on conventional surgeon-led counseling. Surveys were administered following consultations to evaluate patient satisfaction and perceived impact of risk calculator on operative selection.

Results

Between 2019-2021, 114 patients enrolled and 55 randomized to the calculator and 59 to the non-calculator group. Groups had similar demographics. The percentage of patients whose procedure of choice changed following consultation was similar between groups (43.6% vs. 42.4%;p=0.892). However, calculator group patients were less likely to perceive surgeon counseling as very important for their decision-making regarding procedure choice (38.9% vs 76.3%; p<0.001; Figure 1). 81.4% of calculator group patients rated the calculator as useful/very useful, and only 1.9% found it not important. Patients who did not change their opinion on procedure of choice following surgical consultation reported an inherent belief that their selection would result in better outcomes (44.4% vs. 55.3%; p=0.352).

Conclusions

While the MBSAQIP Bariatric Risk/Benefit Calculator was perceived as a helpful tool by the majority of patients, its use did not influence their procedure choice. However, the identified difference in surgeon counseling importance suggests that the information provided by the calculator weighs into patient decision-making.