Applicability of obesity clinical practice guidelines in low- and middle-income countries
Notice bibliographique
Résumé
Obesity is a chronic disease and its impact on individuals and society is a major global health problem, with a high prevalence across all socio-economic strata. Some specialty societies include obesity management related recommendations in clinical practice guidelines, but relatively few guidelines are specifically designed to fully address its diagnosis and management. We sought to understand clinicians' use of obesity clinical practice guidelines in their practice, the perceived deficiencies and implementation barriers, and differences between those practicing in high-income countries (HIC) and those in low-/middle-income countries (LMIC). An email survey of physicians in the Translational Medicine Academy database was offered from August 26 to December 26, 2024 to inquire about participants' demographic information, experience, and views of obesity guidelines as related to their practice. Of 1,412 participating clinicians from 129 countries, 741 partially completed, and an additional 671 fully completed the survey: 281 practiced in HIC; 1,130 in LMIC. Obesity was recognized as a disease (93.5% of respondents) as was its impact on other disorders: cardiovascular disease ranked as the most important, and hepatic disorders the least, with no differences between HIC and LMIC. Only 13.1% regarded the guidelines as equally applicable across different economic strata and geography, and just 29% thought the guidelines to be applicable in their country, with no difference between HIC and LMIC. The most frequently indicated reason given for hindering implementation of obesity guidelines was that they were primarily relevant for HIC; the most common local factor hindering implementation was cost, with no difference in views between HIC and LMIC. There was broad agreement (83.4%) for the importance/need for specific recommendations for patients of differing socio-economic status, with no difference between HIC (79.4%) and LMIC (84.3%; p=0.191), and for guideline authors to include those from LMIC (68.7%), with those from LMIC agreeing more strongly (73.1%) than did those from HIC (50.4%; p<0.00001). Most clinicians from both HIC and LMIC do not consider obesity guidelines to be applicable in their country, and appear to have minimal recognition of obesity’s impact on hepatic disorders, suggesting a need for improved clinician education and awareness. It was widely recognized that guidelines should have specific recommendations directed at differing socio-economic environments, and writing committees including authors from those settings.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,052 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
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 tête enseignante, 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 ».