PRS Global Open Article Review: “The BODY-Q: A Patient-Reported Outcome Instrument for Weight Loss and Body Contouring Treatments”

by Francesco M. Egro, MD, MSc, MRCS (@FrancescoEgro)

Klassen et al.1 recently published “The BODY-Q: A Patient-Reported Outcome Instrument for Weight Loss and Body Contouring Treatments” where they introduce to the plastic surgery community yet another incredibly useful tool, the BODY-Q, which is designed to measure patients’ perceptions of weight loss and/or body contouring. The authors describe the psychometric properties of the BODY-Q scales after they conducted an international field-test in Canada, the United States, and the United Kingdom, and collected data from 403 weight loss and 331 body contouring patients between November 2013 and February 2015.

The BODY-Q questionnaire measures 3 domains: appearance, health-related quality of life, and experience of healthcare, via 18 independently functioning scales: body, abdomen, arms, back, buttocks, hips and outer thighs, skin, scars, body image, physical, psychological, sexual, social, symptoms, doctor, information, medical team, and office staff. The full list of items within each scale is shown in Table 4 of the article (included below). Statistical analysis showed that most BODY-Q items had ordered thresholds, good item fit, and that scale reliability was acceptable.  Appearance and health-related quality of life scores were lower in participants with more obesity-related symptoms, higher body mass index, and more excess skin, and in those patients with pre- versus postoperative body contouring. Out of the 403 weight loss patients, 134 completed the BODY-Q twice, either at 6 weeks (weight loss/nonsurgical body contouring program) or at 6 months (bariatric program).  Their results, improved significantly on 7 appearance and 4 health-related quality of life scales.

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The BODY-Q questionnaire is an important tool because data like seroma or wound dehiscence rate, is easily quantifiable by clinical assessment and chart reviews. However, data on body contouring patient-centered outcomes (such as social or psychological outcomes) is more complex to assess and BODY-Q allows for easy quantification of such outcomes. Both are needed to ensure that cosmetic body contouring procedures are safe and effective. Prior to BODY-Q, patient-centered outcomes research in body contouring used generic (eg, SF-362), obesity specific (eg, Moorehead-Ardelt Questionnaire3), or body part specific (eg, BREAST-Q reduction module4) questionnaires. The ability to collect patient-centered data is needed to provide information on patient selection and education, comparative effectiveness research, and to help make healthcare policy decisions.

Evidence-based medicine is the standard of practice in today’s society. The BODY-Q research team from Memorial Sloan Kettering Cancer Center in New York City has advanced the way we approach patient-reported outcomes by introducing yet another useful validated scale. They previously developed the BREAST-Q and FACE-Q, which have been a great success. My experience with these scales has been very positive, allowing me to easily quantify patient-reported outcomes using a validated questionnaire pre and postoperatively. I would like to emphasize the word “validated” as many studies utilize non-validated scales, which are unable to reflect outcomes accurately.

To conclude, the BODY-Q is a free-of-charge questionnaire that provides a means to collect evidence-based outcomes data in body contouring from the patient’s perspective. I therefore highly recommend to physicians who are contemplating performing clinical outcomes research in body contouring to utilize this tool. Klassen et al’s article is is a must read as it introduces a tool that will likely become the gold standard in patient-centered outcomes evaluation in body contouring.

 

References:

  1. Klassen AF, et al. The BODY-Q: A Patient-Reported Outcome Instrument for Weight Loss and Body Contouring Treatments. Plast Reconstr Surg Glob Open 2016;4:e679
  2. Available at: http://www.qualitymetric.com. Accessed. October 1, 2015.
  3. Moorehead MK, Ardelt-Gattinger E, Lechner H, et al. The validation of the Moorehead-Ardelt Quality of Life Questionnaire II. Obes Surg. 2003;13:684–692.
  4. Pusic AL, Klassen AF, Scott AM, et al. Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg. 2009;124:345–353.
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