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Record W2529537828

INCREASING PATIENT OBESITY: DO I OR DON'T I OPERATE?

2013· article· en· W2529537828 on OpenAlexaff
Robert B. Bourne

Bibliographic record

VenueJournal of Bone and Joint Surgery-british Volume · 2013
Typearticle
Languageen
FieldMedicine
TopicTotal Knee Arthroplasty Outcomes
Canadian institutionsWestern University
Fundersnot available
KeywordsMedicineObesityDeep veinBody mass indexSurvivorship curveQuality of life (healthcare)ThrombosisPhysical therapySurgeryInternal medicineCancer
DOInot available

Abstract

fetched live from OpenAlex

Obesity is a growing worldwide health issue! In my home country, the percentage of obese Canadians grew from 13.8% in 1979 to 23.1% in 2004. Interestingly, TKA rates have grown substantially during this time frame and obesity seems to have been a major contributor. In a large study, we found that increasing obesity had an exponential effect on TKA rates (i.e. patients with a body mass index >40 having a 33X greater relative risk of receiving a TKA compared to a normal weight patients). This is an important issue, as obese TKA patients have been shown to have greater pre-operative disability, have longer waits for surgery, be associated with greater technical difficulties (i.e. wound healing, infection, ligamentous injury, deep vein thrombosis and medical issues) and have more peri-operative complications. As a result, some countries have advocated deferring TKAs in obese patients until they have lost a substantial amount of weight despite the fact that many studies have demonstrated that the required weight reduction is seldom achieved. In an effort to understand this issue, we have conducted several studies. In a multicentre study, we could find no link between patient obesity and the level of patient satisfaction following a primary TKA. In another mid-term study, we found that obese patients had equal implant survivorship, but did note that obese patients had lower pre-operative and post-operative health-related quality of life outcome scores. However, in this manuscript we advocated determining the ‘improvement or delta score’ (i.e. difference between the pre-operative and post-operative scores) and found that when this was done, obese TKA patients actually demonstrated more improvement than normal and overweight patients! Based on our research, we would make the following recommendations: (1) the public should be educated on the effect of obesity on TKA rates, (2) weight management should be an important part of non-operative knee arthritis management and (3) TKA should ‘not’ be withheld from obese patients with end-stage knee arthritis.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.116
Threshold uncertainty score0.999

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.001
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.014
GPT teacher head0.214
Teacher spread0.200 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2013
Admission routes1
Has abstractyes

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