JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort - XML Representation - Evidence Based Medicine on FHIR Implementation Guide v1.0.0-ballot

Evidence Based Medicine on FHIR Implementation Guide, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ebm/ and changes regularly. See the Directory of published versions
: JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort - XML Representation

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    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Citation</b><a name="104116"> </a><a name="hc104116"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">ResourceCitation &quot;104116&quot; Version &quot;9&quot; Updated &quot;2023-11-29 21:58:53+0000&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-journal-article-citation.html">JournalArticleCitation</a></p></div><p><b>url</b>: <code>https://fevir.net/resources/Citation/104116</code></p><p><b>identifier</b>: FEvIR Object Identifier/104116, <code>https://pubmed.ncbi.nlm.nih.gov</code>/29340680</p><p><b>version</b>: 1.0.0-ballot</p><p><b>title</b>: JournalArticleCitation: Association of Bariatric Surgery with Complications and Comorbidities JAMA 2018 Norwegian Cohort</p><p><b>status</b>: active</p><p><b>date</b>: 2022-09-06 14:07:55+0000</p><p><b>publisher</b>: HL7 International / Clinical Decision Support</p><p><b>contact</b>: HL7 International / Clinical Decision Support: <a href="http://www.hl7.org/Special/committees/dss">http://www.hl7.org/Special/committees/dss</a></p><p><b>description</b>: This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.</p><h3>UseContexts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td>FEvIR Platform Use (Details: Citation Classification Type code fevir-platform-use = 'FEvIR Platform Use', stated as 'FEvIR Platform Use')</td><td>Project Specific <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-artifact-classifier.html">Citation Artifact Classifier</a>#project-specific)</span></td></tr></table><p><b>jurisdiction</b>: World <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (m49.htm#001)</span></p><p><b>copyright</b>: https://creativecommons.org/licenses/by-nc-sa/4.0/</p><p><b>approvalDate</b>: 2018-01-26</p><p><b>lastReviewDate</b>: 2022-03-30</p><p><b>author</b>: Brian S. Alper: , Computable Publishing®: MEDLINE-to-FEvIR Converter: , Joanne Dehnbostel: </p><h3>Summaries</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Style</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td>Computable Publishing <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-summary-style.html">Citation Summary Style</a>#comppub)</span></td><td>Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities [Journal Article]. Contributors: Jakobsen GS, Småstuen MC, Sandbu R, Nordstrand N, Hofsø D, Lindberg M, Hertel JK, Hjelmesæth J. In: JAMA, PMID 29340680. Published January 16, 2018. Available at: https://pubmed.ncbi.nlm.nih.gov/29340680/.</td></tr></table><blockquote><p><b>classification</b></p><p><b>type</b>: Citation Source <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-classification-type.html">Citation Classification Type</a>#citation-source)</span></p><p><b>classifier</b>: MEDLINE <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: MEDLINE Citation Owner <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-classification-type.html">Citation Classification Type</a>#medline-owner)</span></p><p><b>classifier</b>: National Library of Medicine, Index Section <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (elements_descriptions.html#owner_value#NLM)</span></p></blockquote><p><b>currentState</b>: Medline Citation Status of MEDLINE <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-status-type.html">Citation Status Type</a>#medline-medline)</span>, PubMed PublicationStatus of ppublish <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-status-type.html">Citation Status Type</a>#pubmed-publication-status-ppublish)</span></p><blockquote><p><b>statusDate</b></p><p><b>activity</b>: PubMed Pubstatus of Entrez <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-status-type.html">Citation Status Type</a>#pubmed-pubstatus-entrez)</span></p><p><b>period</b>: ?? --&gt; 2018-01-18 06:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: PubMed Pubstatus of PubMed <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-status-type.html">Citation Status Type</a>#pubmed-pubstatus-pubmed)</span></p><p><b>period</b>: ?? --&gt; 2018-01-18 06:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: PubMed Pubstatus of Medline <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-status-type.html">Citation Status Type</a>#pubmed-pubstatus-medline)</span></p><p><b>period</b>: ?? --&gt; 2018-01-27 06:00:00+0000</p></blockquote><blockquote><p><b>citedArtifact</b></p><p><b>identifier</b>: <code>https://pubmed.ncbi.nlm.nih.gov</code>/29340680, pii/2669729, <code>https://doi.org</code>/10.1001/jama.2017.21055, <code>https://www.ncbi.nlm.nih.gov/pmc/</code>/PMC5833560</p><h3>Titles</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Language</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td>Primary title <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-title-type.html">Title Type</a>#primary)</span></td><td>English <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-ietf3066.html">Tags for the Identification of Languages</a>#en)</span></td><td>Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities.</td></tr></table><h3>Abstracts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td>Primary human use <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-abstract-type.html">Cited Artifact Abstract Type</a>#primary-human-use)</span></td><td>**Importance:** The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain.
**Objective:** To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment.
**Design, Setting, and Participants:** Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included).
**Exposures:** Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs.
**Main Outcomes and Measures:** Primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database. Prespecified secondary outcomes included changes in comorbidities. Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database.
**Results:** Among 1888 patients included in the study, the mean (SD) age was 43.5 (12.3) years (1249 women [66%]; mean [SD] baseline BMI, 44.2 [6.1]; 100% completed follow-up at a median of 6.5 years [range, 0.2-10.1]). Surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension (remission: absolute risk [AR], 31.9% vs 12.4%); risk difference [RD], 19.5% [95% CI, 15.8%-23.2%], relative risk [RR], 2.1 [95% CI, 2.0-2.2]; new onset: AR, 3.5% vs 12.2%, RD, 8.7% [95% CI, 6.7%-10.7%], RR, 0.4 [95% CI, 0.3-0.5]; greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]; greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]; and treatment with opioids: AR, 19.4% vs 15.8%, RD, 3.6% [95% CI, 2.3%-4.9%], RR, 1.3 [95% CI, 1.2-1.4]). Surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure (AR, 31.3% vs 15.5%; RD, 15.8% [95% CI, 13.1%-18.5%]; RR, 2.0 [95% CI, 1.7-2.4]). The proportion of patients with low ferritin levels was significantly greater in the surgical group (26% vs 12%, P &amp;lt; .001).
**Conclusions and Relevance:** Among patients with severe obesity followed up for a median of 6.5 years, bariatric surgery compared with medical treatment was associated with a clinically important increased risk for complications, as well as lower risks of obesity-related comorbidities. The risk for complications should be considered in the decision-making process.</td></tr></table><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: Journal Article <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-artifact-classifier.html">Citation Artifact Classifier</a>#D016428)</span></p><p><b>citation</b>: J Affect Disord. 2015 Mar 15;174:644-9</p><h3>Documents</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Url</b></td></tr><tr><td style="display: none">*</td><td><a href="https://pubmed.ncbi.nlm.nih.gov/25577158/">https://pubmed.ncbi.nlm.nih.gov/25577158/</a></td></tr></table><p><b>resourceReference</b>: <span><code>https://pubmed.ncbi.nlm.nih.gov</code>/25577158</span></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: Journal Article <span style="background: LightGoldenRodYellow; margin: 4px; 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291-301</p></blockquote><blockquote><p><b>webLocation</b></p><p><b>classifier</b>: Abstract <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-artifact-url-classifier.html">Artifact Url Classifier</a>#abstract)</span></p><p><b>url</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/29340680/">https://pubmed.ncbi.nlm.nih.gov/29340680/</a></p></blockquote><blockquote><p><b>webLocation</b></p><p><b>classifier</b>: DOI Based <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-artifact-url-classifier.html">Artifact Url Classifier</a>#doi-based)</span></p><p><b>url</b>: <a href="https://doi.org/10.1001/jama.2017.21055">https://doi.org/10.1001/jama.2017.21055</a></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: Publishing Model <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#publishing-model)</span></p><p><b>classifier</b>: Print <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-artifact-classifier.html">Citation Artifact Classifier</a>#Print)</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: Chemical <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#chemical)</span></p><p><b>classifier</b>: Ferritins <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (chemical-substances#9007-73-2; #D005293)</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: Publication type <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#publication-type)</span></p><p><b>classifier</b>: Comparative Study <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D003160)</span>, Journal Article <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D016428)</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: Citation subset <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#citation-subset)</span></p><p><b>classifier</b>: IM <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (elements_descriptions.html#citationsubset#IM)</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: MeSH Heading <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading)</span></p><p><b>artifactAssessment</b>: <a name="hcmeshHeading0"> </a></p><blockquote><p/><p><a name="meshHeading0"> </a></p><p><a name="hcmeshHeading0"> </a></p><p><b>artifact</b>: <a href="#">#</a></p><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Adult <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D000328)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Bariatric Surgery <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D050110)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is Major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: adverse effects <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000009)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Body Mass Index <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D015992)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Cohort Studies <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D015331)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Comorbidity <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D015897)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Depression <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D003863)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000150)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Diabetes Mellitus, Type 2 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D003924)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000150)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Female <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D005260)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Ferritins <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D005293)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: blood <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000097)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Humans <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D006801)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Hypertension <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D006973)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000150)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Male <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D008297)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Middle Aged <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D008875)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Obesity, Morbid <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D009767)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000150)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: drug therapy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000188)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: surgery <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000601)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Remission Induction <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D012074)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Treatment Outcome <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D016896)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: Knowledge Artifact Type <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#knowledge-artifact-type)</span></p><p><b>classifier</b>: Journal Article <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-artifact-classifier.html">Citation Artifact Classifier</a>#D016428)</span></p><p><b>artifactAssessment</b>: <span>: Classifier added by Computable Publishing LLC</span></p></blockquote><blockquote><p><b>contributorship</b></p><p><b>complete</b>: true</p><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="hcauthor0"> </a></p><blockquote><p/><p><a name="author0"> </a></p><p><a name="hcauthor0"> </a></p><p><b>name</b>: Gunn Signe Jakobsen </p></blockquote><p><b>forenameInitials</b>: GS</p><p><b>affiliation</b>: <span>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</span></p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="hcauthor1"> </a></p><blockquote><p/><p><a name="author1"> </a></p><p><a name="hcauthor1"> </a></p><p><b>name</b>: Milada Cvancarova Småstuen </p></blockquote><p><b>forenameInitials</b>: MC</p><p><b>affiliation</b>: <span>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</span></p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="hcauthor2"> </a></p><blockquote><p/><p><a name="author2"> </a></p><p><a name="hcauthor2"> </a></p><p><b>name</b>: Rune Sandbu </p></blockquote><p><b>forenameInitials</b>: R</p><p><b>affiliation</b>: </p><ul><li><span>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</span></li><li><span>: Department of Surgery, Vestfold Hospital Trust, Tønsberg, Norway.</span></li></ul></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="hcauthor3"> </a></p><blockquote><p/><p><a name="author3"> </a></p><p><a name="hcauthor3"> </a></p><p><b>name</b>: Njord Nordstrand </p></blockquote><p><b>forenameInitials</b>: N</p><p><b>affiliation</b>: <span>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</span></p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="hcauthor4"> </a></p><blockquote><p/><p><a name="author4"> </a></p><p><a name="hcauthor4"> </a></p><p><b>name</b>: Dag Hofsø </p></blockquote><p><b>forenameInitials</b>: D</p><p><b>affiliation</b>: <span>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</span></p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="hcauthor5"> </a></p><blockquote><p/><p><a name="author5"> </a></p><p><a name="hcauthor5"> </a></p><p><b>name</b>: Morten Lindberg </p></blockquote><p><b>forenameInitials</b>: M</p><p><b>affiliation</b>: <span>: Department of Laboratory Medicine, Vestfold Hospital Trust, Tønsberg, Norway.</span></p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="hcauthor6"> </a></p><blockquote><p/><p><a name="author6"> </a></p><p><a name="hcauthor6"> </a></p><p><b>name</b>: Jens Kristoffer Hertel </p></blockquote><p><b>forenameInitials</b>: JK</p><p><b>affiliation</b>: <span>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</span></p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="hcauthor7"> </a></p><blockquote><p/><p><a name="author7"> </a></p><p><a name="hcauthor7"> </a></p><p><b>name</b>: Jøran Hjelmesæth </p></blockquote><p><b>forenameInitials</b>: J</p><p><b>affiliation</b>: </p><ul><li><span>: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.</span></li><li><span>: Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.</span></li></ul></blockquote></blockquote></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author0</b><a name="author0"> </a><a name="hcauthor0"> </a></p><p><b>name</b>: Gunn Signe Jakobsen </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author1</b><a name="author1"> </a><a name="hcauthor1"> </a></p><p><b>name</b>: Milada Cvancarova Småstuen </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author2</b><a name="author2"> </a><a name="hcauthor2"> </a></p><p><b>name</b>: Rune Sandbu </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author3</b><a name="author3"> </a><a name="hcauthor3"> </a></p><p><b>name</b>: Njord Nordstrand </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author4</b><a name="author4"> </a><a name="hcauthor4"> </a></p><p><b>name</b>: Dag Hofsø </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author5</b><a name="author5"> </a><a name="hcauthor5"> </a></p><p><b>name</b>: Morten Lindberg </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author6</b><a name="author6"> </a><a name="hcauthor6"> </a></p><p><b>name</b>: Jens Kristoffer Hertel </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author7</b><a name="author7"> </a><a name="hcauthor7"> </a></p><p><b>name</b>: Jøran Hjelmesæth </p></blockquote><hr/><blockquote><p><b>Generated Narrative: ArtifactAssessment #meshHeading0</b><a name="meshHeading0"> </a><a name="hcmeshHeading0"> </a></p><p><b>artifact</b>: <a href="#">#</a></p><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Adult <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D000328)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Bariatric Surgery <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D050110)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is Major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: adverse effects <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000009)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Body Mass Index <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D015992)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Cohort Studies <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D015331)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Comorbidity <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D015897)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Depression <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D003863)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000150)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Diabetes Mellitus, Type 2 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D003924)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000150)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Female <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D005260)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Ferritins <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D005293)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: blood <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000097)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Humans <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D006801)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Hypertension <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D006973)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000150)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Male <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D008297)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Middle Aged <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D008875)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Obesity, Morbid <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D009767)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000150)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: drug therapy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000188)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: surgery <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000601)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Remission Induction <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D012074)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Treatment Outcome <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D016896)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote></blockquote></div>
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            value="**Importance:** The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain.
**Objective:** To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment.
**Design, Setting, and Participants:** Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway. Consecutive treatment-seeking adult patients (n = 2109) with severe obesity assessed (221 patients excluded and 1888 patients included).
**Exposures:** Bariatric surgery (n = 932, 92% gastric bypass) or specialized medical treatment (n = 956) including individual or group-based lifestyle intervention programs.
**Main Outcomes and Measures:** Primary outcomes included remission and new onset of hypertension based on drugs dispensed according to the Norwegian Prescription Database. Prespecified secondary outcomes included changes in comorbidities. Adverse events included complications retrieved from the Norwegian Patient Registry and a local laboratory database.
**Results:** Among 1888 patients included in the study, the mean (SD) age was 43.5 (12.3) years (1249 women [66%]; mean [SD] baseline BMI, 44.2 [6.1]; 100% completed follow-up at a median of 6.5 years [range, 0.2-10.1]). Surgically treated patients had a greater likelihood of remission and lesser likelihood for new onset of hypertension (remission: absolute risk [AR], 31.9% vs 12.4%); risk difference [RD], 19.5% [95% CI, 15.8%-23.2%], relative risk [RR], 2.1 [95% CI, 2.0-2.2]; new onset: AR, 3.5% vs 12.2%, RD, 8.7% [95% CI, 6.7%-10.7%], RR, 0.4 [95% CI, 0.3-0.5]; greater likelihood of diabetes remission: AR, 57.5% vs 14.8%; RD, 42.7% [95% CI, 35.8%-49.7%], RR, 3.9 [95% CI, 2.8-5.4]; greater risk of new-onset depression: AR, 8.9% vs 6.5%; RD, 2.4% [95% CI, 1.3%-3.5%], RR, 1.5 [95% CI, 1.4-1.7]; and treatment with opioids: AR, 19.4% vs 15.8%, RD, 3.6% [95% CI, 2.3%-4.9%], RR, 1.3 [95% CI, 1.2-1.4]). Surgical patients had a greater risk for undergoing at least 1 additional gastrointestinal surgical procedure (AR, 31.3% vs 15.5%; RD, 15.8% [95% CI, 13.1%-18.5%]; RR, 2.0 [95% CI, 1.7-2.4]). The proportion of patients with low ferritin levels was significantly greater in the surgical group (26% vs 12%, P &amp;lt; .001).
**Conclusions and Relevance:** Among patients with severe obesity followed up for a median of 6.5 years, bariatric surgery compared with medical treatment was associated with a clinically important increased risk for complications, as well as lower risks of obesity-related comorbidities. The risk for complications should be considered in the decision-making process."/>
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