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

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 (Societa Italiana di Chirurgia dell'Obesita 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.

Automated summary

Development and methodological aspects of Italian clinical practice guidelines on bariatric and metabolic surgery. The guidelines were developed by the Italian Society of Bariatric and Metabolic Surgery for Obesity, using the GRADE methodology and the PICO framework. A panel of experts proposed 37 questions and reached consensus on most of them, covering indications, types of surgery, and management. The choice between surgical and non-surgical approaches was discussed for determining the therapeutic strategy and indications.