Pittsburgh Surgical Outcomes Research Center
Transforming the conduct of clinical research

MIS/Bariatric

Shared Decision Making for Bariatric Surgery in Patients with Severe Obesity

This project team proposes to incorporate the new PCORI comparative effectiveness research evidence on bariatric surgery from the PCORnet Bariatric Study into its decision aid and the Shared Decision Making approach, which has a demonstrated impact on patient knowledge, decisional conflict, satisfaction, and care decisions, and then implement and rigorously evaluate the updated strategy at two large healthcare systems: Kaiser Permanente Washington and UPMC in Pennsylvania.

Generation of a Cellular Atlas of Adipose Tissue in Mouse and Man

The overall goal is to build an atlas of murine and human adipose tissue at single cell resolution, providing a unique resource that will inform and enable the next generation of metabolic studies. The specific aims are to: (1) build a cellular atlas of murine adipose tissue, (2) develop a network model of adipose-stromal-immune cell interactions, and (3) generate the human adipose tissue cell type atlas.

Intestinal Mechanisms and Molecular Predictors of Type 2 Diabetes Remission After Roux-en-Y Gastric Bypass Surgery

This project involves the collection of additional preliminary data for revision of the R01 submission of the same name. Preliminary data collection will focus on development and implementation on a small group of participants, strategies to measure and provide a thorough analysis of participants’ physical activity and caloric and nutritional intake/restriction relative to the tissue analysis.

Intestinal Metabolic Reprogramming as a Key Mechanism of Gastric Bypass in Humans

This is a descriptive, observational, longitudinal trial where the metabolism of the Roux limb of the small intestine will be analyzed in patients who have had RYGB. This analysis will include the time course of its adaptive changes in patients with Class II and Class III obesity who have T2D or people who do not (study groups).

Adolescent Bariatrics: Assessing Health Benefits and Risks (Teen LABS)

This prospective and longitudinal study examines the impact of bariatric surgery as a treatment for severe obesity by measuring comorbidities, health outcomes, surgical complications, and quality of life in adolescents. Standardized instruments and established definitions of data elements are collected as well as laboratory studies and plasma and serum for future testing using uniform data collection protocols. The study continues long-term data collection, including comparisons to Adult LABS data.

Alliance of Randomized trials of Medicine vs. Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D) Consortium

This project provides long-term multi-center extension to four randomized trials comparing surgical and medical treatments in Type 2 Diabetes. It includes the UPMC’s Triabetes Study (A Randomized Trial to Compare Surgical and Medical Treatments for Type 2 Diabetes), which compares outcomes of 3 of the most common bariatric surgical procedures with a comprehensive medical treatment for Type 2 Diabetes in a large cohort of randomized patients (>300) with body mass index between 30 and 40.

Identifying clinically relevant variables associated with early versus delayed postoperative venous thromboembolic disease.

Venous thromboembolic disease (VTE), which encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common and preventable source of post-operative morbidity and mortality. The high incidence of VTE reflects both underutilization of standard thromboprophylactic regimens and also an incomplete understanding of how surgery and critical illness affect the risk of post-operative VTE over time.

Effectiveness of Gastric Sleeve vs. Gastric Bypass for Cardiovascular Disease

The goal of the proposed study is to provide population-based, comprehensive, rigorous evidence for both clinical and policy decision-making; informing the choice between RYGB and VSG for overall CVD risk reduction and risk factor remission, as well as safety in a diverse group of patients (55% racial/ethnic minority). With our aims we will be able to provide recommendations to providers and patients about the decision between procedures, and help prioritize future health policy decisions and research investments in this area.

Continuation of the Longitudinal Assessment of Bariatric Surgery (LABS) – DCC

This renewal of the Data Coordinating Center (DCC) for the Longitudinal Assessment of Bariatric Surgery (LABS) will continue to support a multi-center consortium that was created to facilitate coordinated clinical, epidemiological and behavioral research in bariatric surgery.  The DCC developed the core database and provides logistical and scientific support in all aspects of study design, conduct, analysis, and administration.  A supplement funds activities for ending data collection and management, archiving datasets, and completing statistical analyses.

Intestinal Metabolic Reprogramming as a Key Mechanism of Gastric Bypass in Humans (Mechanisms)

This is a descriptive, observational, longitudinal trial where the metabolism of the Roux limb of the small intestine will be analyzed in patients who have had Roux-in-Y Gastric Bypass surgery (RYGB). This analysis will include the time course of its adaptive changes in patients with Class II and Class III obesity, who have eight Type 2 diabetes (T2DM) or people who do not (study groups).