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Research in Bariatric Surgery
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To the Editor: Dr Flum and colleagues1 investigated early mortality among Medicare beneficiaries undergoing bariatric surgery. Other studies2-3 in the same issue of JAMA also bear on the practice and safety of bariatric surgery. All drew their conclusions from disparate administrative databases and were therefore subject to the limitations of working with such data (eg, outdated coding, inability to adjust for risk, missing information). These studies nonetheless demonstrate that there are vulnerable patient populations and potential additional costs associated with surgery and suggest that high surgical volume helps reduce these risks and costs.
An expert panel4 sponsored by the Commonwealth of Massachusetts Betsy Lehman Center for Patient Safety and Medical Error Reduction described similar findings in a multidisciplinary, evidence-based report on best practices in bariatric surgery. This report has been adopted by BlueCross BlueShield of Massachusetts5 and applied as a standard by the Massachusetts Board of Registration in Medicine.6 The . . . [Full Text of this Article]
George L. Blackburn, MD, PhD
gblackbu@bidmc.harvard.edu
Matthew M. Hutter, MD, MPH;
Daniel B. Jones, MD
Harvard Medical School
Boston, Mass
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