2 research outputs found
Development and validation of an interpretable machine learning-based calculator for predicting 5-year weight trajectories after bariatric surgery: a multinational retrospective cohort SOPHIA study
Background Weight loss trajectories after bariatric surgery vary widely
between individuals, and predicting weight loss before the operation remains
challenging. We aimed to develop a model using machine learning to provide
individual preoperative prediction of 5-year weight loss trajectories after
surgery. Methods In this multinational retrospective observational study we
enrolled adult participants (aged 18 years) from ten prospective cohorts
(including ABOS [NCT01129297], BAREVAL [NCT02310178], the Swedish Obese
Subjects study, and a large cohort from the Dutch Obesity Clinic [Nederlandse
Obesitas Kliniek]) and two randomised trials (SleevePass [NCT00793143] and
SM-BOSS [NCT00356213]) in Europe, the Americas, and Asia, with a 5 year
followup after Roux-en-Y gastric bypass, sleeve gastrectomy, or gastric band.
Patients with a previous history of bariatric surgery or large delays between
scheduled and actual visits were excluded. The training cohort comprised
patients from two centres in France (ABOS and BAREVAL). The primary outcome was
BMI at 5 years. A model was developed using least absolute shrinkage and
selection operator to select variables and the classification and regression
trees algorithm to build interpretable regression trees. The performances of
the model were assessed through the median absolute deviation (MAD) and root
mean squared error (RMSE) of BMI. Findings10 231 patients from 12 centres in
ten countries were included in the analysis, corresponding to 30 602
patient-years. Among participants in all 12 cohorts, 7701 (753%) were
female, 2530 (247%) were male. Among 434 baseline attributes available
in the training cohort, seven variables were selected: height, weight,
intervention type, age, diabetes status, diabetes duration, and smoking status.
At 5 years, across external testing cohorts the overall mean MAD BMI was
28 kg/m (95% CI 26-30) and mean RMSE BMI was
47 kg/m (44-50), and the mean difference
between predicted and observed BMI was-03 kg/m (SD 47).
This model is incorporated in an easy to use and interpretable web-based
prediction tool to help inform clinical decision before surgery.
InterpretationWe developed a machine learning-based model, which is
internationally validated, for predicting individual 5-year weight loss
trajectories after three common bariatric interventions.Comment: The Lancet Digital Health, 202
Rationale and design of ePPOP-ID: a multicenter randomized controlled trial using an electronic-personalized program for obesity in pregnancy to improve delivery.
International audienceBackgroundPre-pregnancy obesity and excessive gestational weight gain (GWG) are established risk factors for adverse pregnancy, delivery and birth outcomes. Pregnancy is an ideal moment for nutritional interventions in order to establish healthier lifestyle behaviors in women at high risk of obstetric and neonatal complications.MethodsElectronic-Personalized Program for Obesity during Pregnancy to Improve Delivery (ePPOP-ID) is an open multicenter randomized controlled trial which will assess the efficacy of an e-health web-based platform offering a personalized lifestyle program to obese pregnant women in order to reduce the rate of labor procedures and delivery interventions in comparison to standard care. A total of 860 eligible pregnant women will be recruited in 18 centers in France between 12 and 22 weeks of gestation, randomized into the intervention or the control arm and followed until 10 weeks of postpartum.The intervention is based on nutrition, eating behavior, physical activity, motivation and well-being advices in which personalization is central, as well as the use of a mobile/tablet application. Inputs includes data from the medical record of participants (medical history, anthropometric data), from the web platform (questionnaires on dietary habits, eating behavior, physical activity and motivation in both groups), and adherence to the program (time of connection for the intervention group only). Data are collected at inclusion, 32 weeks, delivery and 10 weeks postpartum. As primary outcome, we will use a composite endpoint score of obstetrical interventions during labor and delivery, defined as caesarean section and instrumental delivery (forceps and vacuum extractor). Secondary outcomes will consist of data routinely collected as part of usual antenatal and perinatal care, such as GWG, hypertension, preeclampsia, as well as fetal and neonatal outcomes including premature birth, gestational age at birth, birth weight, macrosomia, Apgar score, arterial umbilical cord pH, neonatal traumatism, hyperbilirubinemia, respiratory distress syndrome, transfer in neonatal intensive care unit, and neonatal adiposity. Post-natal outcomes will be duration of breastfeeding, maternal weight retention and child weight at postnatal visit.DiscussionThe findings of the ePPOP-ID trial will help design e-health intervention program for obese women in pregnancy.Trial registrationClinicalTrials.gov Identifier: NCT02924636 / October 5th 2016