P030 Implementing the Edmonton Obesity Staging System: a cross-sectional study of the prevalence and management of obesity in a systemic therapies clinic
Notice bibliographique
Résumé
Abstract Registry studies from the UK and Ireland report the incidence of obesity among patients on systemic treatment for psoriasis as 40%. This is almost double the background population prevalence of obesity in the UK (26%) and Ireland (23%). Patients with higher body mass index (BMI) have poorer responses to systemic therapies. This study aimed to investigate the prevalence and management of obesity among consecutive patients attending dermatology systemic clinics. Weight and height were recorded, and a patient questionnaire was distributed. Patients identified as living with obesity were classified using the Edmonton Obesity Staging System (EOSS). The EOSS categorizes patients living with obesity into five stages based not solely on BMI but on the presence of obesity-related comorbidities; studies have shown the staging system correlates with clinical outcomes. The study included 113 participants. The median age was 49 years (range 19–79), and 57% (64) of participants were female. The most common diagnosis was psoriasis (77%, 88), followed by atopic dermatitis (16%, 19) and hidradenitis suppurativa (HS) (0.4%, five). Defining a BMI of ≥ 25 kg m−2 as overweight and ≥ 30 kg m−2 as obese, 38% (43) of patients were overweight and 45% (51) were living with obesity. The mean BMI was 31.4 kg m−2, with an SD of 7.3 (range 19.4–53.5). The mean BMI in patients with psoriasis was 31 kg m−2, with eczema 28 kg m−2 and HS 41 kg m−2. Of those living with obesity, 31% (16) fulfilled the requirements for EOSS stage 3, and 32% (37) met the criteria for EOSS stage 2. Hypertension at 31% (36) and mental health issues related to weight at 33% (38) were the two most common self-reported comorbidities. In total, 23% (26) of patients were being prescribed a biologic agent at an increased dose or frequency, and 92% (24) of these patients were either overweight or obese, reflecting the challenges of treating this patient cohort. Overall, 80% (41) of patients in the study classified as living with obesity expressed an interest in accessing medical management for their obesity, while 10% (n = 9) reported that a doctor had discussed obesity management options with them. This is the first study to implement an obesity staging system to examine patients with dermatological diagnoses. The results show that our patients on systemic therapies do not simply have high BMIs but also have physical and psychological consequences. New medical options for the management of obesity have the potential to help many of our patients and, in turn, improve their coexisting dermatological diseases. The EOSS is a valuable tool in time-poor environments to assess obesity and facilitate discussion of management options.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».