Development of a core patient-centred outcome set for adults living with obesity: a modified delphi-based international consensusResearch in context

Summary: Background: Obesity is a chronic disease linked to over 200 health conditions, reduced quality of life, and increased mortality. Despite the availability of multimodal treatments, there is a lack of standardised, patient-centred outcome measures to effectively assess and improve clinical c...

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Main Authors: Teferi Mekonnen, Leanne Staniford, Spencer Connell, Zofia Das-Gupta, Umanga DeSilva, Yasmine Saoud, Isabel Miller, Mohapradeep Mohan, Simon Nienhuijs, Megha Poddar, Vaishali Chetan Deshmukh, Marli Conradie-Smit, Soo Huat Teoh, Sanjeev Sockalingam, Emilia Huvinen, Paolo Sbraccia, Ronald Liem, Michael Vallis, Kenneth Clare, Tracy Zvenyach, Karen Coulman, Marianela Aguirre Ackermann, Verónica Vázquez-Velázquez, Yudith Preiss Contreras, Josep Vidal, Agbo Urudinachi, María Fernanda Tejeda-Muñoz, Ian Patton, T Alafia Samuels, Morgan Emile Gabriel Salmon Leguede, Georgia Rigas, Ximena Ramos Salas, Michael Crotty, Bruno Halpern, Daniel Bessesen, Laura Pizzi, Omniyat Mohammed Al Hajeri, Arya M. Sharma
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:EClinicalMedicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589537025003542
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author Teferi Mekonnen
Leanne Staniford
Spencer Connell
Zofia Das-Gupta
Umanga DeSilva
Yasmine Saoud
Isabel Miller
Mohapradeep Mohan
Simon Nienhuijs
Megha Poddar
Vaishali Chetan Deshmukh
Marli Conradie-Smit
Soo Huat Teoh
Sanjeev Sockalingam
Emilia Huvinen
Paolo Sbraccia
Ronald Liem
Michael Vallis
Kenneth Clare
Tracy Zvenyach
Karen Coulman
Marianela Aguirre Ackermann
Verónica Vázquez-Velázquez
Yudith Preiss Contreras
Josep Vidal
Agbo Urudinachi
María Fernanda Tejeda-Muñoz
Ian Patton
T Alafia Samuels
Morgan Emile Gabriel Salmon Leguede
Georgia Rigas
Ximena Ramos Salas
Michael Crotty
Bruno Halpern
Daniel Bessesen
Laura Pizzi
Omniyat Mohammed Al Hajeri
Arya M. Sharma
author_facet Teferi Mekonnen
Leanne Staniford
Spencer Connell
Zofia Das-Gupta
Umanga DeSilva
Yasmine Saoud
Isabel Miller
Mohapradeep Mohan
Simon Nienhuijs
Megha Poddar
Vaishali Chetan Deshmukh
Marli Conradie-Smit
Soo Huat Teoh
Sanjeev Sockalingam
Emilia Huvinen
Paolo Sbraccia
Ronald Liem
Michael Vallis
Kenneth Clare
Tracy Zvenyach
Karen Coulman
Marianela Aguirre Ackermann
Verónica Vázquez-Velázquez
Yudith Preiss Contreras
Josep Vidal
Agbo Urudinachi
María Fernanda Tejeda-Muñoz
Ian Patton
T Alafia Samuels
Morgan Emile Gabriel Salmon Leguede
Georgia Rigas
Ximena Ramos Salas
Michael Crotty
Bruno Halpern
Daniel Bessesen
Laura Pizzi
Omniyat Mohammed Al Hajeri
Arya M. Sharma
author_sort Teferi Mekonnen
collection DOAJ
description Summary: Background: Obesity is a chronic disease linked to over 200 health conditions, reduced quality of life, and increased mortality. Despite the availability of multimodal treatments, there is a lack of standardised, patient-centred outcome measures to effectively assess and improve clinical care. This project aimed to define a core set of standardised outcome measures for adults with obesity, incorporating both patient-reported and clinician-reported outcomes. Additional objectives included determining the optimal measurement frequency and identifying case-mix variables essential for risk adjustment. Methods: The International Consortium for Health Outcomes Measurement (ICHOM) established the Obesity Working Group (OWG), composed of 29 international experts and individuals living with obesity. Members were selected based on their expertise in obesity care and research and represented 21 countries. The development process, conducted from May 2023 to July 2024, began with a kick-off meeting to define scope, followed by eight virtual meetings. A comprehensive literature review informed the identification of relevant clinical outcomes, patient-reported outcomes, treatment-related complications, and case-mix variables. A three-round Delphi process was used to reach consensus on key outcomes and follow-up intervals. Outcomes were included in the final set if at least 80% of OWG members rated them between 7 and 9 on a 9-point scale. Validation was conducted through surveys with 95 patients and 106 healthcare professionals from fields such as dietetics, obesity medicine, and general practice. Findings: The OWG developed a standardised set of 20 outcome measures, comprising 17 core measures and 3 population-specific measures. These span domains including physical health, psychosocial well-being, health behaviours, body functioning, and adverse events. Specific measures were also developed for bariatric surgery and female reproductive health (both pregnant and non-pregnant individuals). Key case-mix factors and appropriate follow-up periods were defined to support global consistency in reporting. Interpretation: Adoption of this standardised outcome set enables clinicians, patients, and stakeholders to identify care gaps, monitor outcomes, and evaluate the quality of obesity care against global benchmarks. Implementation can support the creation of a robust international data resource to guide research, inform clinical practice, and shape policy and guidelines for adult obesity treatment. Limitations include limited geographical diversity in validation surveys, the exclusion of internalised weight bias due to a lack of validated measurement tools, and limited applicability to individuals with obesity and multiple comorbidities. Funding: Novo Nordisk, Eli Lilly, and Boehringer Ingelheim International GmbH.
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spelling doaj-art-7d792ab801aa42ecb1d4c642abb3f2302025-08-22T04:57:12ZengElsevierEClinicalMedicine2589-53702025-09-018710342210.1016/j.eclinm.2025.103422Development of a core patient-centred outcome set for adults living with obesity: a modified delphi-based international consensusResearch in contextTeferi Mekonnen0Leanne Staniford1Spencer Connell2Zofia Das-Gupta3Umanga DeSilva4Yasmine Saoud5Isabel Miller6Mohapradeep Mohan7Simon Nienhuijs8Megha Poddar9Vaishali Chetan Deshmukh10Marli Conradie-Smit11Soo Huat Teoh12Sanjeev Sockalingam13Emilia Huvinen14Paolo Sbraccia15Ronald Liem16Michael Vallis17Kenneth Clare18Tracy Zvenyach19Karen Coulman20Marianela Aguirre Ackermann21Verónica Vázquez-Velázquez22Yudith Preiss Contreras23Josep Vidal24Agbo Urudinachi25María Fernanda Tejeda-Muñoz26Ian Patton27T Alafia Samuels28Morgan Emile Gabriel Salmon Leguede29Georgia Rigas30Ximena Ramos Salas31Michael Crotty32Bruno Halpern33Daniel Bessesen34Laura Pizzi35Omniyat Mohammed Al Hajeri36Arya M. Sharma37Nordic Institute of Dental Materials and Norwegian Institute of Public Health, NorwayLancaster University, EnglandICHOM, USAICHOM, USAICHOM, USAICHOM, USAICHOM, USAICHOM, USACatharina Hospital Eindhoven, Eindhoven, NetherlandsMcMaster University, Ontario, CanadaDeenanath Mangeshkar Hospital and Deshmukh Clinic and Research Centre, Pune, IndiaDivision of Endocrinology, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South AfricaUniversiti Sains Malaysia, Pulau Pinang, MalaysiaCentre for Addiction and Mental Health, University of Toronto, Toronto, CanadaDepartment of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandDepartment of Systems Medicine, University of Rome Tor Vergata, Rome, ItalyGroene Hart Ziekenhuis in Gouda, Netherlands and Nederlandse Obesitas Kliniek in the Hague and Gouda, NetherlandsFamily Medicine, Dalhousie University, Halifax, CanadaLeeds Beckett University, Leeds, EnglandObesity Action Coalition, United StatesBristol Medical School - Department of Population Health Sciences, University of Bristol, EnglandCIEN Foundation, Integral Center for Obesity and Diabetes, ArgentinaInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Obesidades, Mexico City, MexicoClínica MEDS, Centro Médico NOVAMED, Santiago, ChileDepartment of Endocrinology, Institut d‘Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, SpainDepartment of Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State, NigeriaObesidades, Mexico City, MexicoObesity Canada, Edmonton, Alberta, CanadaCaribbean Institute for Health Research, University of the West Indies, Kingston, JamaicaAlianza Hispana de Personas con Obesidad, Copenhagen, DenmarkSt George & Sutherland Clinical School, University of New South Wales-Medicine, Sydney, AustraliaReplica Communications, SwedenIrish College of GPs, IrelandObesity Centre, Hospital 9 de Julho, São Paulo, BrazilThe Obesity Society, USAThe International Society for Pharmacoeconomics and Outcomes Research (ISPOR), USAAbu Dhabi Public Health Center, Abu Dhabi, United Arab EmiratesDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada; Corresponding author.Summary: Background: Obesity is a chronic disease linked to over 200 health conditions, reduced quality of life, and increased mortality. Despite the availability of multimodal treatments, there is a lack of standardised, patient-centred outcome measures to effectively assess and improve clinical care. This project aimed to define a core set of standardised outcome measures for adults with obesity, incorporating both patient-reported and clinician-reported outcomes. Additional objectives included determining the optimal measurement frequency and identifying case-mix variables essential for risk adjustment. Methods: The International Consortium for Health Outcomes Measurement (ICHOM) established the Obesity Working Group (OWG), composed of 29 international experts and individuals living with obesity. Members were selected based on their expertise in obesity care and research and represented 21 countries. The development process, conducted from May 2023 to July 2024, began with a kick-off meeting to define scope, followed by eight virtual meetings. A comprehensive literature review informed the identification of relevant clinical outcomes, patient-reported outcomes, treatment-related complications, and case-mix variables. A three-round Delphi process was used to reach consensus on key outcomes and follow-up intervals. Outcomes were included in the final set if at least 80% of OWG members rated them between 7 and 9 on a 9-point scale. Validation was conducted through surveys with 95 patients and 106 healthcare professionals from fields such as dietetics, obesity medicine, and general practice. Findings: The OWG developed a standardised set of 20 outcome measures, comprising 17 core measures and 3 population-specific measures. These span domains including physical health, psychosocial well-being, health behaviours, body functioning, and adverse events. Specific measures were also developed for bariatric surgery and female reproductive health (both pregnant and non-pregnant individuals). Key case-mix factors and appropriate follow-up periods were defined to support global consistency in reporting. Interpretation: Adoption of this standardised outcome set enables clinicians, patients, and stakeholders to identify care gaps, monitor outcomes, and evaluate the quality of obesity care against global benchmarks. Implementation can support the creation of a robust international data resource to guide research, inform clinical practice, and shape policy and guidelines for adult obesity treatment. Limitations include limited geographical diversity in validation surveys, the exclusion of internalised weight bias due to a lack of validated measurement tools, and limited applicability to individuals with obesity and multiple comorbidities. Funding: Novo Nordisk, Eli Lilly, and Boehringer Ingelheim International GmbH.http://www.sciencedirect.com/science/article/pii/S2589537025003542ICHOMAdult obesityClinical practiceOutcome measuresPatient-centred outcomes
spellingShingle Teferi Mekonnen
Leanne Staniford
Spencer Connell
Zofia Das-Gupta
Umanga DeSilva
Yasmine Saoud
Isabel Miller
Mohapradeep Mohan
Simon Nienhuijs
Megha Poddar
Vaishali Chetan Deshmukh
Marli Conradie-Smit
Soo Huat Teoh
Sanjeev Sockalingam
Emilia Huvinen
Paolo Sbraccia
Ronald Liem
Michael Vallis
Kenneth Clare
Tracy Zvenyach
Karen Coulman
Marianela Aguirre Ackermann
Verónica Vázquez-Velázquez
Yudith Preiss Contreras
Josep Vidal
Agbo Urudinachi
María Fernanda Tejeda-Muñoz
Ian Patton
T Alafia Samuels
Morgan Emile Gabriel Salmon Leguede
Georgia Rigas
Ximena Ramos Salas
Michael Crotty
Bruno Halpern
Daniel Bessesen
Laura Pizzi
Omniyat Mohammed Al Hajeri
Arya M. Sharma
Development of a core patient-centred outcome set for adults living with obesity: a modified delphi-based international consensusResearch in context
EClinicalMedicine
ICHOM
Adult obesity
Clinical practice
Outcome measures
Patient-centred outcomes
title Development of a core patient-centred outcome set for adults living with obesity: a modified delphi-based international consensusResearch in context
title_full Development of a core patient-centred outcome set for adults living with obesity: a modified delphi-based international consensusResearch in context
title_fullStr Development of a core patient-centred outcome set for adults living with obesity: a modified delphi-based international consensusResearch in context
title_full_unstemmed Development of a core patient-centred outcome set for adults living with obesity: a modified delphi-based international consensusResearch in context
title_short Development of a core patient-centred outcome set for adults living with obesity: a modified delphi-based international consensusResearch in context
title_sort development of a core patient centred outcome set for adults living with obesity a modified delphi based international consensusresearch in context
topic ICHOM
Adult obesity
Clinical practice
Outcome measures
Patient-centred outcomes
url http://www.sciencedirect.com/science/article/pii/S2589537025003542
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