What is it about?
Let’s consider the following, typical real-world scenario: Imagine that you are a GP seeing a patient with visible signs of obesity. You think to yourself, I really need to talk to this patient about their weight, but I am concerned about how they will react, so I don’t. Next, imagine yourself as the patient, thinking, I want to discuss my weight with this GP, but I am scared of being judged, blamed, and what they might say, so I don’t. Raising the sensitive topics of weight and weight management are challenging for both GPs and their patients. The solution could be the new EOSS-2 Risk Tool. First, we co-developed (with clinician end-users) and validated a brief screening tool (‘EOSS-2 Risk Tool’) for detecting potential weight related health complications in a nationally representative sample of adults at ‘high risk’ (with overweight and obesity), for application in general practice. The EOSS-2 Risk Tool efficiently estimates the degree of risk for weight related complications according to the widely used diagnostic criteria in the Edmonton Obesity Staging System (EOSS). Then, we conducted a nationwide pilot study and generate preliminary qualitative evidence of feasibility and applicability of the EOSS-2 Risk Tool for activating comfortable weight management discussions in general practice.
Photo by Towfiqu barbhuiya on Unsplash
Why is it important?
The EOSS-2 Risk Tool is a scalable, point-of-care screening tool that enables comfortable communication between GPs and their patients about the sensitive topics of weight and weight management. It could enhance patient engagement in weight management, so patients can commence their weight management journey for first time. If implemented on scale, it could increase the number of patients with obesity potentially benefiting from GP weight management for the first time by 20%. This equates to ~800K out of 4M Australian adults who typically present to their GP with obesity each year but do not discuss weight management!
Read the Original
This page is a summary of: Clinical usefulness of brief screening tool for activating weight management discussions in primary cARE (AWARE): A nationwide mixed methods pilot study, PLoS ONE, October 2021, PLOS, DOI: 10.1371/journal.pone.0259220.
You can read the full text:
Development and internal validation of the Edmonton Obesity Staging System-2 Risk screening Tool (EOSS-2 Risk Tool) for weight-related health complications: a case-control study in a representative sample of Australian adults with overweight and obesity
Abstract Objective Excess weight and related health complications remain under diagnosed and poorly treated in general practice. We aimed to develop and validate a brief screening tool for determining the presence of unknown clinically significant weight-related health complications for potential application in general practice. Design We considered 14 self-reported candidate predictors of clinically significant weight-related health complications according to the Edmonton Obesity Staging System (EOSS score of ≥2) and developed models using multivariate logistic regression across training and test data sets. The final model was chosen based on the area under the receiver operating characteristic curve and the Hosmer-Lemeshow statistic; and validated using sensitivity, specificity and positive predictive value. Setting and participants We analysed cross-sectional data from the Australian Health Survey 2011–2013 sample aged between 18 and 65 years (n=7518) with at least overweight and obesity. Results An EOSS≥2 classification was present in 78% of the sample. Of 14 candidate risk factors, 6 (family history of diabetes, hypertension, high sugar in blood/urine, high cholesterol and self-reported bodily pain and disability) were automatically included based on definitional or obvious correlational criteria. Three variables were retained in the final multivariate model (age, self-assessed health and history of depression/anxiety). The EOSS-2 Risk Tool (index test) classified 89% of those at ‘extremely high risk’ (≥25 points), 67% of those at ‘very high risk’ (7–24 points) and 42% of those at ‘high risk’ (<7 points) of meeting diagnostic criteria for EOSS≥2 (reference). Conclusion The EOSS-2 Risk Tool is a simple, safe and accurate screening tool for diagnostic criteria for clinically significant weight-related complications for potential application in general practice. Research to determine the feasibility and applicability of the EOSS-2 Risk Tool for improving weight management approaches in general practice is warranted.
The following have contributed to this page