OBESITY, COMORBIDITIES, AND ECONOMIC EVALUATIONS OF SURGICAL TREATMENTS OF OBESIT

项目总结/摘要 超重和肥胖的流行率在全球范围内不断增加，这被认为是造成肥胖的主要原因。 慢性病和癌症的数量。手术治疗肥胖已被证明是有效的，在长期- 长期控制体重，为患有肥胖相关疾病的人提供额外的好处，并降低相对风险 死亡之然而，它并不是普遍适用于所有类型的肥胖人群。拟议的研究将 仔细检查减肥手术的成本和效果。最终目标是检查 目前NIH指南的适当性，并告知保险公司，患者，提供者和 最具成本效益的肥胖手术治疗。本研究的主要目的是（1） 检查肥胖、肥胖相关的合并症和死亡率之间的关系;（2）评估安全性 和减肥手术的有效性;（3）调查肥胖相关疾病的费用;（4） 进行减肥手术的成本-后果分析。研究方法包括计量经济学 建模（研究特定目标1和3），荟萃分析（研究特定目标2），微观模拟 （研究具体目标3和4）和成本效益分析（研究具体目标4）。为了 成功完成拟议的研究，该项目还将为申请人提供指导， 三名专家，结合教学培训，将使申请人成长为一个有效的， 肥胖预防和控制方面的独立卫生服务研究调查员和卫生经济学家。的 指导团队和申请人一起工作，确定了三个职业发展目标：（1） 成为一个独立的和外部资助的研究人员;（2）获得肥胖的工作知识 （3）通过获得以下领域的培训来提高研究质量： 公共卫生和定量建模。这些目标将通过各种培训战略来实现， 包括定期与三位导师（他们都是相关领域的专家）进行一对一的会谈， 教学课程，高质量的在线培训模块，并出席科学会议， 工作坊.拟议的研究将为几个R21和一个R01或 等同的应用。这些项目将扩大到研究控制肥胖的其他干预措施，例如， 运动，饮食，药物和手术，并将在强度指标内进行比较;或者，这些 项目将研究肥胖和癌症之间的关系，以及控制肥胖的干预措施如何能够 改变这种关系。

PROJECT SUMMARY/ABSTRACT The prevalence of overweight and obesity is increasing globally, which is thought to account for a substantial number of chronic diseases and cancers. Surgical treatment of obesity has been shown to be effective in long- term weight control, provide additional benefits to people with obesity-related diseases, and reduce relative risk of death. However, it is not universally available to all classes of obese people. The proposed research will closely examine the costs and effectiveness of bariatric surgery. The ultimate goal is to examine the appropriateness of current NIH guidelines and to inform insurance companies, patients, providers, and the government of the most cost-effective surgical treatment of obesity. The Research Specific Aims are to (1) examine the association between obesity, obesity-related comorbidities, and mortality; (2) evaluate the safety and effectiveness of bariatric surgery; (3) investigate the costs attributable to obesity-related diseases; and (4) conduct cost-consequence analyses of bariatric surgery. The research methodology includes econometric modeling (Research Specific Aim 1 and 3), meta-analysis (Research Specific Aim 2), microsimulation (Research Specific Aim 3 and 4), and cost-effectiveness analysis (Research Specific Aim 4). In order to successfully complete the proposed research, this project will also provide the applicant with mentoring by three experts who, in conjunction with didactic training, will enable the applicant to grow into an effective and independent health services research investigator and health economist in obesity prevention and control. The mentoring team and the applicant have worked together and identified three Career Development Aims: (1) to become an independent and externally-funded researcher; (2) to obtain working knowledge of obesity epidemiology and gastroenterology; (3) to enhance the quality of research by obtaining training in the areas of public health and quantitative modeling. These aims will be achieved through a variety of training strategies, including regular one-on-one meetings with each of three mentors who are experts in the relevant domains, didactic coursework, high-quality online training modules, and attendance at scientific conferences and workshops. The proposed research will provide preliminary data and results for several R21 and an R01 or equivalent applications. These projects will expand to examine other interventions to control obesity, e.g., exercise, diet, medications, and surgery and will be compared within a metric of intensity; alternatively, these projects will examine the relationship between obesity and cancer and how interventions to control obesity can alter this relationship.