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Trial registered on ANZCTR
Registration number
ACTRN12622000784718
Ethics application status
Approved
Date submitted
24/05/2022
Date registered
2/06/2022
Date last updated
16/11/2023
Date data sharing statement initially provided
2/06/2022
Type of registration
Retrospectively registered
Titles & IDs
Public title
Understanding real-world health, wellbeing and dietary outcomes after metabolic and obesity surgery
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Scientific title
Understanding real-world health, wellbeing and dietary outcomes after metabolic and obesity surgery
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Secondary ID [1]
307206
0
nil
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Universal Trial Number (UTN)
NA
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Trial acronym
Nil
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Linked study record
Nil
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Health condition
Health condition(s) or problem(s) studied:
metabolic and obesity surgery
326431
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Obesity
326432
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weight stigma
326435
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mental health
326436
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Condition category
Condition code
Diet and Nutrition
323714
323714
0
0
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Obesity
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Mental Health
323715
323715
0
0
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Anxiety
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Metabolic and Endocrine
323716
323716
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0
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Metabolic disorders
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
People undergoing metabolic and obesity surgery will be observed for 2 years following surgery and asked to complete a series of validated questionnaires prior to surgery and at 3,6,12 and 24 months following surgery. They will undergo care as usual. Questionnaires will be emailed to participants via a secure REDCap database. Outcomes to be reported on and evaluated include: demographics, anthropometry (weight change and BMI), medical conditions, mental health status using the DASS questionnaire and medical assessment, quality of life (QoL) using the AQoL-8D questionnaire, dietary intake using a dietitians assessment tool and disorder eating behaviour using the EDE-q tool, physical activity using the international Physical Activity Questionnaire (IPAQ), weight stigma using the Weight Bias Internalization Scale (WBIS), reflux using the GastroEsphogeal Reflux Disease (GERD) questionnaire, use of social networks, patient beliefs and attendance at clinical appointments will be recorded as part of usual care.
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Intervention code [1]
323652
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Early Detection / Screening
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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The primary outcome measure is weight and weight change across time-points.
Assessment of this outcome will be weight in kilograms to the nearest one decimal place using digital scales. Weight change will also be recorded as percentage weight loss (%WL) and change in BMI (kg/m2). A stadiometer will be used to assess height in metres to 2 decimal places.
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Assessment method [1]
331461
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Timepoint [1]
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Timepoints for data collection will be at baseline, pre-surgery, then at 3 months, 6 months, 12 months and 24 months post surgery.
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Secondary outcome [1]
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Quality of life will be measured by the AQoL-8D
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Assessment method [1]
409985
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Timepoint [1]
409985
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The AQoL-8D will be sent to participants pre-surgery and then sent at 6 months, 12 months and 24 months post surgery.
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Secondary outcome [2]
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Mental health changes from pre to post surgery will be assessed by measuring changes in the DASS (Depression, Anxiety, Stress Scales) questionnaire.
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Assessment method [2]
409986
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Timepoint [2]
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The DASS will be sent to participants to complete prior to surgery and then sent at 6 months, 12 months and 24 months post surgery.
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Secondary outcome [3]
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Change in demographics and patient characteristics including education, employment, marital status, living situation, postcode, support networks and family life. These changes will be documented on a participant initial and follow-up questionnaire which was developed for this project by the research team who are familiar with bariatric cohorts.
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Assessment method [3]
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Timepoint [3]
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The participant initial questionnaire will be sent prior to surgery and the follow-up questionnaire sent at 3 months, 6 months, 12 months and 24 months post surgery.
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Secondary outcome [4]
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Changes in metabolic risk profile including changes in
• HbA1c*
• Fasting glucose (mmol/L) and insulin (mlU/L)
• Fasting lipid profile (total cholesterol, HDLc, LDLc, triglycerides)
• liver enzymes
• hsCRP
Using data collected from standard usual care pathology results, and
• Blood pressure will be measured using an Oscillometric Sphygmomanometer
The BP measure will be recorded into the database using data from a doctor's assessment form.
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Assessment method [4]
410102
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Timepoint [4]
410102
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The metabolic profile data will be collected by the researcher from the surgeon's clinical notes and pathology reports pre-surgery and then at 3 months, 6 months, 12 months and 24 months post surgery.
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Secondary outcome [5]
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Change in use and need for medications. This will be documented in the database from information provided from the surgeon's clinical notes.
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Assessment method [5]
410103
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Timepoint [5]
410103
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The medication change will be collected from the surgeon's clinical notes at pre-surgery and then at 3 months, 6 months, 12 months and 24 months post surgery.
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Secondary outcome [6]
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Change in medical conditions from pre to post surgery. This will be documented in the research database based on from information provided from the surgeon's clinical notes. This may include change in diabetes status, sleep disorders, gastrointestinal symptoms, pain status and cardiovascular health.
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Assessment method [6]
410104
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Timepoint [6]
410104
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The medical condition changes will be collected from the surgeon's clinical notes at pre-surgery and then at 3 months, 6 months, 12 months and 24 months post surgery.
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Secondary outcome [7]
410105
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Nutritional deficiencies and dietary quality will be assessed by conducting:
i) a dietitian assessment via a purpose built dietary survey tool,
ii) participants completing the Eating Disorder Examination questionnaire (EDE-q)
iii) usual care pathology including blood measures of vitamins D and c, Iron studies, Vitamin B1, B12 and serum folate, zinc, copper and selenium. Urine measure include 24-hour collection for creatinine, Na, K, Ca(paired with serum EUC/CMP)
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Assessment method [7]
410105
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Timepoint [7]
410105
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The dietary intake outcomes will be collected at 3 months, 6 months, 12 months and 24 months post surgery. No pre-surgery dietary intake data will be collected.
Dietary behaviour, using the EDE-q will be collected pre-surgery and then at 6,12 and 24 months post surgery.
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Secondary outcome [8]
410106
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Physical activity measures and changes will be ssessed by the IPAQ - International Physical Activity Questionnaire.
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Assessment method [8]
410106
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Timepoint [8]
410106
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The IPAQ will be sent to participants to complete prior to surgery and then sent at 6 months, 12 months and 24 months post surgery.
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Secondary outcome [9]
410107
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Weight stigma will be measured by using the Weight Bias Internalization Scale (WBIS) questionnaire to be complete by participants.
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Assessment method [9]
410107
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Timepoint [9]
410107
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The WBIS will be sent to participants to complete prior to surgery and then sent at 6 months, 12 months and 24 months post surge
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Secondary outcome [10]
410108
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Patient attendance at appointments, attrition, and reasons for attrition, collected from administration records at clinics and recorded on the database in the appointments record form.
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Assessment method [10]
410108
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Timepoint [10]
410108
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Appointments will be collected from the surgeon's office annually- at 12 months and 24 months post surgery.
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Secondary outcome [11]
410320
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Mental health will be assessed by the surgeon and recorded in the medical assessment form. Details of mental health will include use of addictive substance usage including alcohol, smoking, drugs, and addictive behaviours including gambling, sex addiction and gaming.
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Assessment method [11]
410320
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Timepoint [11]
410320
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Mental health assessments will be made at presurgery and then at 3, 6 12 and 24 months post surgery
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Eligibility
Key inclusion criteria
To be included in this research, participants must meet these requirements:
• Planning bariatric surgery
• older than 16 years
• able to understand the study protocol and/or give written consent to participate
• agreeable to participate in all usual clinical data collection and to complete additional questionnaires, surveys and recording of usual food intake supplementary to normal clinical procedure
• willing to allow the use of a translator or family member to assist in completion of these assessments and surveys, questionnaires and usual food intake records, if English is the second language, or if they have poor literacy levels.
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Minimum age
16
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Younger than 16 years
inability to understand and give consent
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Data will be analysed using SPSS v25 after developing a detailed Statistical Analysis Plan. Descriptive statistics will be used to outline the baseline characteristics and linear and generalised linear mixed models and survival models will be used for the longitudinal data analysis. This model uses all available data therefore participants with missing data or who are lost to follow-up are still included in the analysis. Relevant covariates will be included.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
18/04/2022
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Date of last participant enrolment
Anticipated
30/12/2023
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Actual
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Date of last data collection
Anticipated
10/01/2026
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Actual
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Sample size
Target
250
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Accrual to date
225
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
22430
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Norwest Private Hospital - Bella Vista
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Recruitment hospital [2]
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Nepean Private Hospital - Kingswood
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Recruitment hospital [3]
23357
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Calvary Private Hospital - Wagga Wagga
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Recruitment hospital [4]
23358
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Nepean Hospital - Kingswood
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Recruitment hospital [5]
23359
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Wagga Wagga Base Hospital - Wagga Wagga
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Recruitment postcode(s) [1]
37626
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2153 - Bella Vista
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Recruitment postcode(s) [2]
37629
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2153 - Baulkham Hills
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Recruitment postcode(s) [3]
38735
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2650 - Wagga Wagga
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Recruitment postcode(s) [4]
38736
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2747 - Kingswood
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Recruitment postcode(s) [5]
38737
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2650 - Wagga Wagga
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Funding & Sponsors
Funding source category [1]
311505
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University
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Name [1]
311505
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The University of Sydney
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Address [1]
311505
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The University of Sydney
Charles Perkins Centre
John Hopkins Dr,
Camperdown NSW 2006
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Country [1]
311505
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Australia
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Primary sponsor type
Individual
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Name
Dr Kathryn Williams
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Address
Nepean Family Metabolic Health Service
Nepean hospital,
Derby Street
Kingswood, NSW 2747
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Country
Australia
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Secondary sponsor category [1]
312993
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None
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Name [1]
312993
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Address [1]
312993
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Country [1]
312993
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Other collaborator category [1]
282321
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Individual
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Name [1]
282321
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Dr Michael Devadas
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Address [1]
282321
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Norwest Private Hospital:
Suite C202 C Block
9 Norbrik Drive Bella Vista
PO BOX 6551 Baulkham Hills,
NSW, 1755
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Country [1]
282321
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Australia
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Other collaborator category [2]
282322
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Individual
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Name [2]
282322
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Sally Badorrek
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Address [2]
282322
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Nepean Family Metabolic Health Service
Nepean hospital,
Derby Street
Kingswood, NSW 2747
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Country [2]
282322
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Australia
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Other collaborator category [3]
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Individual
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Name [3]
282449
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Rachel Russell
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Address [3]
282449
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c/o Metabolic Obesity Service
Health Services Hub, Wagga Wagga Base Hospital
260-280 Edward Street, PO Box 159
Wagga Wagga NSW 2650
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Country [3]
282449
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Australia
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Other collaborator category [4]
282450
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Individual
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Name [4]
282450
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Associate Professor Nicholas Williams
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Address [4]
282450
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Harrison Williams Consulting
18/2 Docker St
Wagga Wagga NSW 2650
Australia
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Country [4]
282450
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
310967
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Nepean Blue Mountains Local Health District Ethics Committee HREC
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Ethics committee address [1]
310967
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Human Research Ethics Committee Research Office Level 5, South Block Nepean Hospital Kingswood NSW 2747 PO Box 63 Penrith NSW 2750
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Ethics committee country [1]
310967
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Australia
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Date submitted for ethics approval [1]
310967
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03/12/2020
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Approval date [1]
310967
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15/12/2020
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Ethics approval number [1]
310967
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2020/ETH02984
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Summary
Brief summary
AIM Metabolic and obesity surgery (MOS) is currently the most effective, durable strategy for weight management. Comprehensive outcome data following metabolic and obesity surgery is missing from the Australian bariatric population. This prospective long term cohort study aims to document and evaluate medical, psychosocial and behavioural factors linked to outcome measures. METHODS Recruitment will commence from April 2021 and continue until November 2023 or until 250 participants are recruited. The study will observe participants for 2 years with data collection commencing 1-2 months pre-MOS and at timepoints 3,6,12 and 24 months post-surgery. Participants include those undergoing surgery over 16 years of age, able to read and write English and give consent. All participants will receive usual care during the study period. Data collection will include demographics and family traits; medical history, mental health via the Depression, Anxiety and Stress Scale (DASS); Quality of Life via the Assessment of Quality of Life (AQoL-8D); dietary intake (via a dietitian assessment survey and a participant-completed food frequency questionnaire); dietary behaviour via the Eating Disorder Examination questionnaire (EDE-Q); social factors; weight stigma using the Weight Bias Stigmatisation Scale (WBIS); use of social support networks and beliefs using patient-completed surveys; and attendance at clinical appointments. The primary outcome of weight change will be reported in kilogram (kg) weight change, BMI (kg/m2) and percentage weight loss (%WL), secondary outcome measures will include health and psychosocial variables evaluated in the study. STATISTICAL ANALYSIS Descriptive statistics will be used to profile the baseline characteristics of the participants. Linear and generalised linear mixed models and survival models will be used for the longitudinal data analysis. The investigators plan to present and publish the findings of this study at scientific meetings, both nationally and internationally and in peer reviewed journals. Participants will be unidentifiable with results being anonymised. SUMMARY Obesity effects a third of Australians and MOS in Australia has become a popular tool for obesity management. This surgery is mainly performed in the private setting with minimal data available reporting on outcomes including that of health, psychosocial wellbeing, and dietary changes. This prospective observational study will add to the limited literature from the Australian setting, important real-world data on the long-term comprehensive outcomes following MOS. Results may assist clinicians in providing best practice individualised care.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Kathryn Williams
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Address
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Nepean Family Metabolic Health Service
Nepean Hospital
Derby Street
Level 5, South Block
Kingswood, NSW 2747
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Country
119526
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Australia
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Phone
119526
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+61 2 4734 3594
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Fax
119526
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+61 2 47341920
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Email
119526
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[email protected]
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Contact person for public queries
Name
119527
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Sally Badorrek
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Address
119527
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Nepean Family Metabolic Health Service
Nepean Hospital
Derby Street
Level 5, South Block
Kingswood, NSW 2747
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Country
119527
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Australia
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Phone
119527
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+61 2 4734 3594
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Fax
119527
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+61 2 47341920
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Email
119527
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[email protected]
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Contact person for scientific queries
Name
119528
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Kathryn Williams
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Address
119528
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Nepean Family Metabolic Health Service
Nepean Hospital
Derby Street
Level 5, South Block
Kingswood, NSW 2747
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Country
119528
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Australia
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Phone
119528
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+61 2 4734 3594
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Fax
119528
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+61 2 47341920
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Email
119528
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF