It’s not clear when you can say, “there’s an app for that,” because Apple has apparently trademarked the phrase. But now there’s an app to help determine whether to undergo weight-loss surgery. It is called “BariatricCalc” and was unveiled just this past week at the ObesityWeek 2019 conference held in Las Vegas.
Speaking of Vegas, this calculator, which comes as an app and also sits in the Cleveland Clinic Risk Calculator Library website, shows that the decision to get bariatric surgery is not just a spin of the roulette wheel. There’s been a number of scientific studies to help determine who could benefit from weight-loss surgery otherwise known as metabolic and bariatric surgery and one set of studies has been run by the developers of the app.
If you go to the website in the Library entitled 10-year Individualized Diabetes Complications Risk Scores, you can plug in different characteristics such as age, body mass index (BMI), smoking history, other medical history, blood pressure, laboratory tests, and current medications. If you then hit “Run Calculator,” it will churn out your risk of bad stuff including death, heart failure, coronary heart disease, and diabetic kidney disease with and without metabolic and bariatric surgery.
The risk scores for the calculator came from a study conducted by a team led by Ali Aminian, MD, a bariatric surgeon based at the Cleveland Clinic. Results from this study appeared in a September publication in JAMA, authored by a research team from the Cleveland Clinic (Ali Aminian, MD, Alexander Zajichek, MS, Kathy E. Wolski, MPH, Philip R. Schauer, MD, Michael W. Kattan, PhD, and Steven E. Nissen, MD), Kaiser Permanente Washington Health Research Institute (David E. Arterburn, MD, MPH) and The Ohio State University Wexner Medical Center (Stacy A. Brethauer, MD). The study analyzed what happened to 2,287 patients who had undergone bariatric surgery and 11, 435 similar patients who didn’t. The study found that those who had had bariatric surgery were significantly (39%) less likely to have had different cardiovascular problems. The differences then served as the basis for the calculator.
Keep in mind that the risk calculator is based on associations found in a large population study. Therefore, the calculator cannot account for the entire complex system of factors that affect body weight and the risk of different cardiovascular problems. For example, those with more stressful situations and environments may find it harder to lose weight or avoid bad heart outcomes. Remember correlation does not mean causation. Moreover, every person is different. In healthcare, when determining the proper course of action, you have got to account for a person’s personal situation.
These are just a few reasons why an app should never completely replace a doctor and his or her advice. If our society ever gets to a point where someone says “your app will see you now,” and the app has an option of saying “that must be hard for you,” things would have gone in the wrong direction. What this app can do is help provide more information to patients, doctors, and other health professionals to then make more informed decisions. Trying to absorb medical information can be like drinking from a fire hose while it is raining and someone is continuously dumping buckets of water on your head. Oh, also, your pager keeps beeping while your phone is ringing. Even doctors with unbelievable memories can’t keep everything in their heads. The best doctors know when and where to seek assistance.
This app also helps show how health apps need to be developed in the future, based on real medical knowledge and data and by people who really understand health and health care. There shouldn’t be, “oh, trust this calculator because we are famous or a well-known brand.” Making a health app is lot more complex than building an app to help you find a car to ride or avocado toast to eat. You should be able to understand how an app or calculator was developed and that explanation should not include the words “roulette wheel” or “special sauce.” Oh, and if an app ever says, you should stick a jade egg in your orifice, it’s time to delete the app.