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.
To assess agreement between PROs and clinical registry data at 1 year after bariatric
Not-for-profit organization, bariatric surgery data registry, PROs platform.
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
difference 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.
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 ∼2 lb, on average. Percent agreement and kappa coefficients were highest
for diabetes (n = 999; binary: 94%, κ = .72; 4-level: 86%, κ = .71) and lowest for
gastroesophageal reflux disease (n = 1032; binary: 75%, κ = .40; 4-level: 57%, κ =
.35). Of patients eligible for both PROs and registry 1-year follow-up, 21% had PROs
One-year patient- and clinic-reported weights and disease status for patients with
diabetes 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.