Methodological and reporting quality of randomized controlled trials assessing health outcomes after bariatric surgery in obese adolescents: a methodological study
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Abstract
Objective: To assess the methodological and reporting quality of randomized controlled trials (RCTs) that have evaluated the impact of bariatric surgery on health outcomes in adolescents with obesity. Materials and Methods: A systematic search and methodological analysis was conducted using data retrieved from PubMed, Scopus, Web of Science, and SciELO up to May 2025. Two independent reviewers selected RCTs involving adolescents who underwent gastric bypass, sleeve gastrectomy, or gastric banding as surgical interventions. The CONSORT 2025 checklist (39 sub-items) and the Joanna Briggs Institute tool for RCTs (13 items) were employed for evaluation. Results: Three RCTs published between 2010 and 2024 were included, totaling 141 adolescents (mean of 47 per trial). All studies were prospectively registered, and 67% were multicenter trials. Surgical interventions consistently demonstrated superiority in weight control (mean weight loss of 12-35 kg) and remission of metabolic syndrome (0-22% in controls vs. 78-100% in surgical groups). No significant effects were observed on global cognitive function (mean difference: 0.4 IQ points; 95% CI: -3.9 to 4.8). The mean CONSORT checklist adherence was 71.8%. Methodological quality averaged 74% compliance, with two studies fulfilling 10 out of 13 items, and one fulfilling 9. Conclusions: Although studies on bariatric surgery suggest that it offers benefits for weight loss and metabolism in adolescents, the evidence is based on a limited number of studies with significant gaps in transparency and in control of surgical biases.
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