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Sensitivity Analysis of Weight Reduction Results of an Observational Cohort Study in Overweight and Obese Children and Adolescents in Germany: The Evakuj Study

机译：德国超重和肥胖儿童及青少年的一项观察性队列研究减轻体重结果的敏感性分析：Evakuj研究

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In the German EvAKuJ observational cohort study, changes in the body mass index standard deviation score (BMI–SDS) of overweight and obese children and adolescents as primary outcome of multimodal (short, inpatient or long, outpatient) weight-loss interventions are difficult to interpret. Published intention-to-treat (ITT) and per protocol data obtained at the end of the intervention (T1), one year (T2), and two years (T3) after its end were used for sensitivity analysis of treatment success rates. The odds ratio and the number needed to treat (NNT) for BMI–SDS reduction of at least −0.2 (successful treatment) and at least −0.5 (good treatment success) were related to spontaneous BMI-SDS reduction rates in a hypothetical control group (control event rate, CER). At T1, treatment seems to be effective up to a CER of 10% in inpatients and of 5% in outpatients. ITT analysis, compromised by a loss to follow-up of 81 to 90% (inpatients) and 57 to 66% (outpatients), indicated that treatment may become less effective at a CER above 1% in inpatients (e.g., successful treatment at T2: NNT=106, at T3: NNT=51), and above 5% in outpatients (successful treatment at T2: NNT=7, at T3: NNT=8; good treatment success at T2 and T3: NNT=25). Positive short-term effects of inpatient treatment of overweight and obese children and adolescents may not be maintained in the long term. Long-term effectiveness of outpatient treatment may depend on age and the degree of overweight.
机译：在德国EvAKuJ观察性队列研究中，作为多模式（短期，住院或长期，门诊）减肥干预措施的主要结局，超重和肥胖儿童和青少年的体重指数标准差评分（BMI–SDS）的变化很难改变解释。在干预结束（T1），结束（一年）（T2）和结束（T3）两年（T3）时获得的已发布的意向治疗（ITT）和每个方案的数据用于治疗成功率的敏感性分析。假设对照组中BMI-SDS降低至少-0.2（成功治疗）和至少-0.5（良好治疗成功）的比值比和需要治疗的数量与自发BMI-SDS降低率相关（控制事件发生率，CER）。在T1，住院患者的CER最高可达10％，门诊患者的CER最高可达5％。 ITT分析受到81％至90％（住院患者）和57％至66％（门诊患者）的随访损失的影响，表明住院患者的CER超过1％时治疗效果可能会降低（例如，在T2时成功治疗） ：NNT = 106，在T3：NNT = 51），门诊患者高于5％（T2：NNT = 7，T3：NNT = 8； T2和T3：NNT = 25，治疗成功）。长期而言，可能无法维持对超重和肥胖儿童及青少年的住院治疗的积极短期效果。门诊治疗的长期有效性可能取决于年龄和超重程度。

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