"Safe" and "effective" are defined as follows: Safety is the condition of presenting a reasonably low risk of harm, injury, or loss when a technology is utilized in the specified indication; and effectiveness is the quality of producing a desired, beneficial effect under the conditions of actual use. The categories for response to a DATTA question are defined as follows: Established—a technology demonstrated and accepted as safe and effective by the practicing medical community; investigational—a technology largely confined to use under research protocol; unacceptable—the risk/benefit ratio is unfavorable; and indeterminate—the evidence is insufficient for a definitive decision, and no consensus exists to date; further study may be warranted.
χ2 Analysis of the responses of the DATTA panelists determined that the distribution of responses (established, investigational, indeterminate, or unacceptable) differs significantly from those expected due to chance alone (P<.05) for the four questions. Construction of the 95% confidence interval comparing the established category vs the combination of investigational, unacceptable, and indeterminate did not show a significant difference for any of the four questions. Twelve panelists had no opinion on questions 1A and 1B and 11 panelists had no opinion on questions 2A and 2B.
Kral JG, Heymsfield S. Morbid obesity: definitions, epidemiology, and methodological problems . Gastroenterol Clin North Am. 1987;;16:197-205.
Kral JG. Morbid obesity and related health risks . Ann Intern Med. 1985;;103(6, pt
Barrett-Connor EL. Obesity, atherosclerosis, and coronary artery disease . Ann Intern Med. 1985;:103(6, pt
Bray AB. Complications of obesity . Ann Intern Med. 1985;;103(6, pt
Garfinkel L. Overweight and cancer . Ann Intern Med. 1985;;103(6, pt
Carey LC, Martin EW Jr, Mojzisik C. The surgical treatment of morbid obesity . Curr Probl Surg. 1984;;21(
Stunkard AJ, Stinnett JL, Smoller JW. Psychological and social aspects of the surgical treatment of obesity . Am J Psychiatry. 1986;;143:417-429.
Kral JG. The current status of obesity surgery: constructive criticism . Surg Annu. 1986;;18:165-180.
Johnson D, Drenick EJ. Therapeutic fasting in morbid obesity . Arch Intern Med. 1977;;137:1381-1382.
Andersen T, Backer OG, Stokholm KH, Quaade F. Randomized trial of diet and gastroplasty compared with diet alone in morbid obesity . N Engl J Med. 1984;;310:352-356.
Hocking MP, Duerson MC, O'Leary JP, Woodward ER. Jejunoileal bypass for morbid obesity . N Engl J Med. 1983;:308:995-999.
Adibi SA, Stanko RT. Perspectives on gastrointestinal surgery for treatment of morbid obesity: the lesson learned . Gastroenterology. 1984;;87:1381-1391.
Scopinaro N, Gianetta E, CiValleri D, et al. Biliopancreatic bypass . In: Griffen WO, Printen KJ, eds. Surgical Management of Morbid Obesity . New York, NY: Marcel Dekker Inc; 1987;:93-162.
Flickinger EG, Sinar DR, Swanson M. Gastric bypass . Gastroenterol Clin North Am. 1987;;16(
Mason EE. Gastric bypass for morbid obesity . Surg Annu. 1979;;11:99-126.
Griffen WO. Gastric bypass . In: Griffen WO, Printen KJ, eds. Surgical Management of Morbid Obesity . New York, NY: Marcel Dekker Inc; 1987;:27-45.
Mason EE, Printen KJ, Lewis JW, et al. Gastric bypass: criteria for effectiveness . Int J Obes. 1981;;5:405-411.
Willbanks OL. Gastric restrictive procedures: gastroplasty . Gastroenterol Clin North Am. 1987;;16(
Mason EE. Gastroplasty . In: Griffen WO, Printen KJ, eds. Surgical Management of Morbid Obesity . New York, NY: Marcel Dekker Inc; 1987;:47-69.
Mason EE. Vertical banded gastroplasty for obesity . Arch Surg. 1982;;117:701-706.
Eckhout GV, Willbanks OL, Moore JT. Vertical ring gastroplasty for morbid obesity . Am J Surg. 1986;;152:713-716.
Halpern NB. Surgery for obesity: an overview . Ala J Med Sci. 1985;;22:53-57.
Task Force of the American Society for Clinical Nutrition. Guidelines for surgery for morbid obesity . Am J Clin Nutr. 1985;;42(
Drenick EJ. Risk of obesity and surgical indications . Int J Obes. 1981;;5:387-398.
Gentry K, Halverson JD, Heisler S. Psychologic assessment of morbidly obese patients undergoing gastric bypass: a comparison of preoperative and postoperative adjustment . Surgery. 1984;;95:215-220.
Valley V. Preoperative psychologic assessment in determining outcome from gastric stapling for morbid obesity . Can J Surg. 1984;;27:129-130.
Olsson SA, Ryden O, Danielsson A, Nilsson-Ehle P. Weight reduction after gastroplasty: the predictive value of surgical, metabolic and psychological variables . Int J Obes. 1984;;8:245-258.
Brolin RE. Results of obesity surgery. Gastroenterol Clin North Am. 1987;:16(
Printen KJ. Operative complications of gastric restrictive procedures . In: Griffen WO, Printen KJ, eds. Surgical Management of Morbid Obesity . New York, NY: Marcel Dekker Inc; 1987;:163-174.
Amaral JF, Thompson WR, Caldwell MD, et al. Prospective hematologic evaluation of gastric exclusion surgery for morbid obesity . Ann Surg. 1985;;201:186-193.
Abarbanel JM, Berginer VM, Osimani A, et al. Neurologic complications after gastric restriction surgery for morbid obesity . Neurology. 1987;;37:196-200.
Feit M, Glasberg M, Ireton C, et al. Peripheral neuropathy and starvation after gastric partitioning for morbid obesity . Ann Intern Med. 1982;;96:453-455.
Schneider SB, Erikson N, Gebel HM, et al. Cutaneous anergy and marrow suppression as complications of gastroplasty for morbid obesity . Surgery . 1983;;94:109-111.
Makarewicz PA, Freeman JB, Burchett H, Brazeau P. Vertical banded gastroplasty: assessment of efficacy . Surgery. 1985;;98:700-707.
Halverson JD, Koehler RE. Gastric bypass: analysis of weight loss and factors determining success . Surgery. 1981;;90:446-455.
Deitel M, Jones BA, Petrov I, et al. Vertical banded gastroplasty: results in 233patients . Can J Surg. 1986;;29:322-324.
Mason EE, Maher JW, Scott DH, et al. Vertical banded gastroplasty: sixth year results . Presented at the American Society for Bariatric Surgery Annual Meeting; June 1-3,1988 ; Iowa City, Ia
Lechner GW, Callender AK. Subtotal gastric exclusion and gastric partitioning: a randomized prospective comparison of one hundred patients . Surgery. 1981;;90:637-644.
Freeman JB, Burchett HJ. A comparison of gastric bypass and gastroplasty for morbid obesity . Surgery . 1980;;88:433-444.
Pories WJ, Flickinger EG, Meelheim D, et al. The effectiveness of gastric bypass over gastric partition in morbid obesity . Ann Surg. 1982;;196:389-399.
Linner JH. Comparative effectiveness of gastric bypass and gastroplasty . Arch Surg. 1982;;117:695-700.
Sugerman HJ, Starkey JV, Birkenhauer R. A randomized prospective trial of gastric bypass versus vertical banded gastroplasty for morbid obesity and their effects on sweets versus non-sweets eaters . Ann Surg. 1987;;205:613-624.
Fobi MA, Fleming AW. Vertical banded gastroplasty vs gastric bypass in the treatment of obesity . J Natl Med Assoc. 1986;;78:1091-1098.
Gleysteen JJ, Barboriak JJ. Improvement in heart disease risk factors after gastric bypass . Arch Surg. 1983;;118:681-684.
Herbst CA, Hughes TA, Gwynne JT, Buckwalter JA. Gastric bariatric operation in insulin-treated adults . Surgery. 1984;;95:209-214.
Diagnostic and Therapeutic Technology Assessment. Gastric restrictive surgery for morbid obesity . JAMA . 1984;;251:3011.