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. 2022 Dec 30;15(1):189.
doi: 10.3390/nu15010189.

Development of the Italian Clinical Practice Guidelines on Bariatric and Metabolic Surgery: Design and Methodological Aspects

Maurizio De Luca  1 , Marco Antonio Zappa  2 , Monica Zese  1 , Ugo Bardi  3 , Maria Grazia Carbonelli  4 , Francesco Maria Carrano  5 , Giovanni Casella  6 , Marco Chianelli  7 , Sonja Chiappetta  8 , Angelo Iossa  9 , Alessandro Martinino  10 , Fausta Micanti  11 , Giuseppe Navarra  12 , Giacomo Piatto  13 , Marco Raffaelli  14 , Eugenia Romano  15 , Simone Rugolotto  1 , Roberto Serra  16 , Emanuele Soricelli  17 , Antonio Vitiello  18 , Luigi Schiavo  19 , Iris Caterina Maria Zani  20 , Giulia Bandini  21 , Edoardo Mannucci  21 , Benedetta Ragghianti  21 , Matteo Monami  21 ; Panel and Evidence Review Team for the Italian Guidelines on Surgical Treatment of Obesity
Affiliations

Development of the Italian Clinical Practice Guidelines on Bariatric and Metabolic Surgery: Design and Methodological Aspects

Maurizio De Luca et al. Nutrients. .

Abstract

Development of the Italian clinical practice guidelines on bariatric and metabolic surgery, as well as design and methodological aspects.

Background: Obesity and its complications are a growing problem in many countries. Italian Society of Bariatric and Metabolic Surgery for Obesity (Società Italiana di Chirurgia dell'Obesità e delle Malattie Metaboliche-SICOB) developed the first Italian guidelines for the treatment of obesity.

Methods: The creation of SICOB Guidelines is based on an extended work made by a panel of 24 members and a coordinator. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology has been used to decide the aims, reference population, and target health professionals. Clinical questions have been created using the PICO (Patient, Intervention, Comparison, Outcome) conceptual framework. The definition of questions used the two-step web-based Delphi method, made by repeated rounds of questionnaires and a consensus opinion from the panel.

Results: The panel proposed 37 questions. A consensus was immediately reached for 33 (89.2%), with 31 approved, two rejected and three which did not reach an immediate consensus. The further discussion allowed a consensus with one approved and two rejected.

Conclusions: The areas covered by the clinical questions included indications of metabolic/bariatric surgery, types of surgery, and surgical management. The choice of a surgical or a non-surgical approach has been debated for the determination of the therapeutic strategy and the correct indications.

Keywords: arterial hypertension (AHI); dyslipidemia (DL); gastroesophageal reflux disease (GERD); guidelines; metabolic/bariatric surgery (MBS); obesity; obstructive sleep apnea (OSA); type 2 diabetes (T2D).

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Conflict of interest statement

S.C. has received consultancy fees from Novo Nordisk, Johnson and Jhonson America for Saxenda, I.C.M.Z. received fees from Boehringer-Ingelheim, others authors have no relevant conflicts of interest to declare.

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