Cleveland researchers develop calculator to predict health risks for those with diabetes, obesity
This calculator can help both physicians and patients quantify the risks and benefits of weight-loss surgery and make informed decisions.
A new web-based risk calculator can spell out the right treatment options for patients struggling with diabetes or obesity, claims the research team from Cleveland clinic, who developed the calculator. It can also predict patients' likelihood in developing other conditions such as heart disease, stroke, heart failure, and diabetic kidney disease, over the next ten years.
According to the researchers, for those considering weight-loss or bariatric surgeries, it can show how surgery could change these risks.
"Diabetes can be a devastating disease and [when] combined with obesity, patients are at a higher risk for cardiovascular complications", says Steven Nissen, chief academic officer of the Heart & Vascular Institute at the Cleveland Clinic.
To control diabetes and improve cardiovascular health, studies have shown that weight-loss surgery is an effective treatment option. It can reduce the overall risk of serious cardiovascular events and premature deaths by almost half.
Despite this, only a few eligible patients undergo the surgery. "Several reasons for underutilization [of surgery] include fear of surgery, misconception on effectiveness of medical therapy versus weight loss surgery, limited access to care, and stigma against obesity and surgical treatment of obesity", Ali Aminian, a bariatric surgeon at the Cleveland Clinic told MEA WorldWide (MEAWW).
Against this backdrop, the team says, their risk calculator finds relevance. "This calculator can help both physicians and patients quantify the risks and benefits of surgery and make the best decision for treatment", explains Nissen.
Based on a patient's current health status, it can provide personalized information for every patient, as per the study. It can help patients and their physicians better predict the health benefits of usual care versus surgical treatment, according to Dr Aminian.
It took the Cleveland Clinic about two years to develop the calculator. They performed two separate studies on patients, which was fed into the calculator to help it make future health predictions.
In the first study, they compared data from 2,300 patients who underwent weight-loss surgery and 11,500 patients who received usual medical care. The researchers saw a 40% lower risk of death and major adverse cardiovascular events for patients who had weight-loss surgery performed on them. These patients had lost more weight, had better diabetes control, and used fewer medications for treatment of their diabetes and cardiovascular disease than those undergoing usual medical care.
In their next study, the researchers used the same group of patients to predict their likelihood of developing coronary heart disease, stroke, heart failure, diabetic kidney disease, and mortality over the next 10 years. They then estimated the health risks for people with and without bariatric surgery.
The team was able to explore 26 risk factors for the different outcomes in the large group of patients, explains Dr Michael Kattan, chairman of the Department of Quantitative Health Sciences in Cleveland Clinic's Lerner Research Institute. He adds, "We then compared machine learning and traditional statistical techniques to identify the most accurate prediction models for each outcome and built those into the calculator."
According to the team, the calculator could provide accurate results. Aminian adds, "The calculators have sufficient discrimination and calibration to predict the 10-year risk."