Evaluating agreement between clinic- and patient-reported outcomes for weight and co-morbidities at 1 year after bariatric surgery

Background: Development of patient-reported outcomes (PROs) to include traditionally clinic -reported data has the potential to decrease the data-collection burden for patients and clinicians and increase follow-up rates. However, replacing clinic report by patient report requires that the data reasonably agree.Objective: To assess agreement between PROs and clinical registry data at 1 year after bariatric surgery. Setting: Not-for-profit organization, bariatric surgery data registry, PROs platform.Methods: Patient-and clinic-reported 1-year postoperative weight and co-morbidities were compared for matched PROs and registry records. The co-morbidities evaluated were diabetes, sleep apnea, hypertension, gastroesophageal reflux disease, and hyperlipidemia. Weight differ-ence in pounds and nominal groupings (binary, 4-level) for co-morbidities were assessed for agreement between data sources using descriptive statistics, Bland-Altman plots, multiple regression, and kappa coefficients. Sensitivity analyses and follow-up by response method were examined.Results: Among 1130 patients with both 1-year PROs and registry weights, 95% of patient-reported weights were within 13 lb of the registry-recorded weight, and patients underreported their weight by w2 lb, on average. Percent agreement and kappa coefficients were highest for diabetes (n = 999; bi-nary: 94%, K = .72; 4-level: 86%, K = .71) and lowest for gastroesophageal reflux disease (n = 1032; binary: 75%, K = .40; 4-level: 57%, K = .35). Of patients eligible for both PROs and registry 1-year follow-up, 21% had PROs only.Conclusions: One-year patient-and clinic-reported weights and disease status for patients with dia-betes and hypertension showed high agreement. The degree of bias from patient report was low. Patient report is a viable alternative to clinic report for certain objective measurements and may increase follow-up. (Surg Obes Relat Dis 2023;19:309-317.)(c) 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.