Study Compares Roux Duodenal Switch With SADI-S

What in the hell is the Roux Duodenal Switch.
Plus Cottam is involved, I suspect a badly slanted approach to justify all the SADI-S he’s done even when coding them as a DS.
 
What in the hell is the Roux Duodenal Switch.
Plus Cottam is involved, I suspect a badly slanted approach to justify all the SADI-S he’s done even when coding them as a DS.
I know. I loved that - Roux Duodenal Switch.

I didn’t know Cottam did that. :oops: That’s really upsetting
 
Hmmm … they call this data mining (I call it cherry picking):

Data were used for a retrospective matched cohort from 815 patients who underwent a primary laparoscopic traditional DS or primary laparoscopic SADI-S from September 2011 through November 2019 by four surgeons. Data were obtained by matching DS patients to SADI-S patients of the same age, sex and body mass index. In addition, only patients who were out at least five years and had a minimum five-year follow-up were included in the study. There were 30 patients in each group.
 
I’m not a data specialist but I do know data can be adjusted to fit the criteria you want to prove.
Agreed

I thought of one improvement

You could always double blind the study. Start with matched pairs, randomly assign each to one procedure or the other, then not tell either the assessor or the patient which procedure they received until the end of the study (5 years)

But,who would agree to that and who would pay?

I know this was how the US endobarrier trials were structured ( here it was either the procedure or a sham, no pairs, just matched cohorts), before the study was terminated early for hepatic infection in some who had the procedure. But, in this case, endobarrier was willing to pay in order to get access to the US market
 
Why so? From what I read matched cohorts in all qualities except for the variable in question is a standard method. What do you find unusual?

Here's a definition of retrospective cohort that I find particularly accurate: "The distinguishing feature of a retrospective cohort study is that the investigators conceive the study and begin identifying and enrolling subjects after outcomes have already occurred."

This is why I call it data mining. They have an idea of what they want to find and they may have very well matched patients to get the result they wanted. It's not accurate to compare same age/sex/BMI and yet have different lengths of time out from surgery. Each person was at least 5 years out and had at least one 5 year report. But, the SADI hasn't been around a long time. Most of those patients were likely ONLY 5 years out whereas DS patients could have been further out.

Additionally, the person conducting the "study" has a very personal interest in the outcome showing exactly what he believes to be true: the SADI-S is "as good as or superior to the DS"
 
Cottam says this review shows the DS is better for weight loss than the SADI-S....

" Dr. Cottam said the Roux DS procedure with 150 Roux/150 common channel seems to offer somewhat better weight loss at six years than the SADI-S procedure"

He also says to consider the other results skeptically because of sample size

"According to Dr. Cottam, the nutritional and complication data with a small cohort should be viewed skeptically."

Does this differ in any way from the view that DS is a better choice of weight loss surgery than SADI-S?

I looked again and the matching comparison of interest was similar total bowel length...

"prior to this study, it was unknown whether the long-term outcomes of Roux DS are superior, similar or inferior to those of SADI-S when controlling for similar total bowel lengths."

BTW... I don't see how you control total bowel length in the SADI-S, does it mean the distance from stomach to large intestine ( in SADI-S) is the same as the sum of the distances in the common and alimentary channel in the DS?
 
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Re the observation "It's not accurate to compare same age/sex/BMI and yet have different lengths of time out from surgery"... I don't see that in the abstract... it just says they were at least 5 years out.

The linked article states: "Data were obtained by matching DS patients to SADI-S patients of the same age, sex and body mass index. In addition, only patients who were out at least five years and had a minimum five-year follow-up were included in the study."

It does not state that they matched on years, only that the population was comprised of patients at least five years with at least one follow-up.
 
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It does not state that they matched on years, only that the population was comprised of patients at least five years with at least one follow-up.

It is silent on that matter... there is the possibility that one could match a 10 yr DS patient with a 5 year SADI-S patient.. that would introduce bias.. assuming the longer the time the greater the likelihood of weight gain

I'm not sure if this was a peer reviewed article... usually the reviewers pick up that kind of systemic error... and require changes to the paper


Re.."Data were obtained by matching DS patients to SADI-S patients of the same age, sex and body mass index. "... and don't forget total bowel length... whatever that means
 

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