Bariatric Surgery Calculator icon

Bariatric Surgery Calculator

Cleveland Clinic
Evidence Tier:VALIDATED

Initial evidence from research studies

For:Clinicians & Healthcare Professionals
Free
Download on the App Store

App Summary

The Bariatric Surgery Calculator is a clinical decision-support tool designed to help surgeons select the optimal metabolic surgery for patients with type 2 diabetes. The app's 'Individualized Metabolic Surgery' score is based on a large cohort study (N=900) which identified four key predictors of long-term diabetes remission and categorized patients into three stages of disease severity. The associated research concludes this model allows for evidence-based procedure selection by identifying which patients are most likely to benefit from a specific surgical approach.

App Screenshots

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Detailed Description

Functionality & Mechanism

This clinical decision support tool provides bariatric surgeons with rapid, evidence-based guidance for procedure selection in patients with type 2 diabetes (T2DM). The mobile interface facilitates the input of four key patient variables: diabetes duration, number of medications, insulin use, and HbA1c levels. The system then calculates the Individualized Metabolic Surgery (IMS) score, which stratifies T2DM severity into three distinct stages. This output informs clinical judgment regarding the relative efficacy of Roux-en-Y gastric bypass versus sleeve gastrectomy.

Evidence & Research Context

  • The underlying Individualized Metabolic Surgery (IMS) score was developed and externally validated using a cohort of 900 patients with long-term glycemic follow-up (median 7 years).
  • The model incorporates four independent predictors of long-term diabetes remission: preoperative T2DM duration, number of diabetes medications, insulin use, and glycemic control (HbA1C).
  • For patients with intermediate-severity diabetes, the model indicates that Roux-en-Y gastric bypass (RYGB) is significantly more effective for remission than sleeve gastrectomy (SG).
  • In cases of mild T2DM, both procedures offer high efficacy, whereas in severe T2DM, both demonstrate limited potential for long-term diabetes remission.

Intended Use & Scope

This tool is intended for bariatric surgeons to aid in evidence-based procedural selection for patients with type 2 diabetes. Its primary utility is as a clinical decision support system to stratify T2DM severity and inform discussions on surgical options. The calculator does not replace comprehensive clinical judgment or account for all patient-specific factors and comorbidities.

Studies & Publications

2 publications

Peer-reviewed research associated with this app.

Development/Design Paper

Bariatric Surgery Decision-Making Calculator: A Novel Mobile App for Evidence-Based Clinical Practice

Aminian et al. (2017) · Surgery for Obesity and Related Diseases

Describes the research-driven development of this app
Over the past five years there has been tremendous growth in the development of medical focused mobile applications or "apps" that operate on smartphones and mobile devices. The majority of these apps are patient facing (e.g. fitness applications), few effective physician-patient apps have been developed and effectively utilized in medicine. The use of a physician-patient app is ideally suited in the field of bariatric surgery to ensure the
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Effectiveness/Outcome Study

Individualized Metabolic Surgery Score: Procedure Selection Based on Diabetes Severity

Aminian et al. (2017) · Annals of Surgery

The scoring system successfully predicted which patients would achieve diabetes remission five years after surgery.

Objective: To construct and validate a scoring system for evidence-based selection of bariatric and metabolic surgery procedures according to severity of type 2 diabetes (T2DM). Background: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) account for >95% of bariatric procedures in United States in patients with T2DM. To date, there is no validated model to guide procedure selection based on long-term glucose control in patients
... Read More

In the Media

Cleveland Clinic Study Shows Greater Long-Term Benefits of Bariatric Surgery Compared to GLP-1 Medicines

Cleveland Clinic researchers conducted the M6 study following 3,932 adults with diabetes and obesity for up to 10 years, comparing outcomes between metabolic surgery and GLP-1 receptor agonist medicines. "Even with today's best medicines, metabolic surgery offers unique and lasting benefits for people with obesity and diabetes," said Dr. Ali Aminian, noting that surgery patients averaged 21.6% body weight loss compared to 6.8% with GLP-1 medicines over the decade-long study. The research published in Nature Medicine found surgery patients experienced better blood sugar control and required fewer diabetes and heart medications.

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Cleveland Clinic Study Shows Bariatric Surgery Outperforms GLP-1 Diabetes Drugs for Kidney Protection

Cleveland Clinic researchers developed a study comparing bariatric surgery to GLP-1 medications for protecting kidney function in patients with type 2 diabetes, obesity, and chronic kidney disease. The study of 425 patients showed that bariatric surgery was associated with a 60% lower risk of kidney disease progression and a 44% lower risk of developing kidney failure or death compared to GLP-1 treatments. Lead author Dr. Ali Aminian stated that "bariatric surgery can protect the kidneys and prevent the worsening of kidney function" and "can change the trajectory of the disease."

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New App Shows Patients Individualized Health Risks, With and Without Bariatric Surgery

Cleveland Clinic researchers developed the Bariatric Surgery Calculator to help patients with obesity and Type 2 diabetes make informed treatment decisions, using machine-learning algorithms that analyze 26 patient-specific variables to predict 10-year health risks. "A patient can see, for example, that their risk of dying in 10 years would be 7% without the surgery, but with the surgery it would drop to 2%," says bariatric surgeon Dr. Ali Aminian. The predictive tool was introduced at the Obesity Week 2019 international conference.

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Cleveland Clinic Develops Calculator To Estimate 10-Year Risk Of Diabetes Complications

Cleveland Clinic researchers developed the Bariatric Surgery Calculator to help patients with type 2 diabetes and obesity estimate their 10-year risk of major health complications when choosing between usual medical care or weight-loss surgery. "The calculator can be a useful tool for physicians and patients with type 2 diabetes and obesity. It shows a patient's risk of heart disease, stroke, heart failure, diabetic kidney disease, and death over the next 10 years with usual care," said Dr. Ali Aminian, the lead researcher. The research was presented as one of the Top 10 studies at ObesityWeek 2019 international conference.

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Bariatric Surgery Calculator

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