The DS IS better than RNY

Thanks for sending it :)

Edit: Oops, Originally I didn't see that this study showed any of the numbers of patients in the actual study populations either (much like the OP's study) But this paper does show that at the very very end past all of the references, lol.  Sooo thanks for sending an actual reliable study. :) I can see that this one used significant populations without any significant difference in the amount of RNYers studied versus DSers studied. THIS article actually supports the claim that the OP's article unsuccessfully tries to make with real scientific accuracy. Thanks!

I would note that this finding does not necessarily make DS better than RNY for everyone, or even for diabetics though :)

Page four gives the numbers. And quite frankly, this meta-analysis gives more than enough numbers to satisfy the most picky statistician.  But you have to know how to read the numbers to get the full impact.  A meta-analysis evaluates and compares numerous previous studies that meet a certain criteria.  The Buchwald study is well designed and well documented. 

Red

Page 4 doesn't give those statistics for how many diabetic RNYers were studied and how many diabetic DSers were studied, in fact it doesn't even narrow the studies reviewed down to the number of diabetic patients studied at all... or even RNYers vs Dsers....The table on page 4 is all about the statistics for the studies not for individual people.

...but I do believe a portion of page 14 does have the necessary info I was looking for.

Page 6 lists patient characteristics.

Yes it does.... for the total amount of studies they looked at in page 4, not for the actual amount of patients they included in their particular study and percentage. Page 14 has that.

I don't have the article in front of me, but most meta-analyses include a blob-o-gram (yes, it's really called that) depicting the sample sizes for the studies that were reviewed. The article should present the inclusion criteria for the studies (e.g., RCT) that should answer any concerns about methods. As it's name reveals, a meta-analysis does a combined analysis of the results. This compilation of samples adds to the power of the study.

The author does high quality, much respected work.

SherryB

 I found the abstract.  Hope this helps.


Duodenal Switch Provides Superior Resolution of Metabolic Comorbidities Independent of Weight Loss in the Super-Obese (Bmi ≥ 50 Kg/M2) Compared with Gastric Bypass
Vivek N. Prachand^*1, Marc Ward², John C. Alverdy^1
1Surgery, University of Chicago, Chicago, IL; ²Pritzker School of Medicine, University of Chicago, Chicago, IL

OBJECTIVE(S): Increased BMI is associated with greater incidence and severity of obesity-related comorbidities and inadequate post-bariatric surgery weight loss. Accordingly, comorbidity resolution is an important measure of surgical outcome in super-obese individuals. We previously reported superior weight loss in super-obese patients following duodenal switch (DS) compared to Roux-en-Y Gastric Bypass (RYGB) in a large single institution series. We now report follow-up comparison of comorbidity resolution and correlation with weight loss.

METHODS: Data from patients undergoing DS and RYGB between August 2002 and October 2005 were prospectively collected and used to identify super-obese patients with diabetes, hypertension, dyslipidemia, and gastroesophageal reflux disease (GERD). Ali-Wolfe scoring was used to describe comorbidity severity. Chi-square analysis was used to compare resolution and two-sample t-tests used to compare weight loss between patients whose comorbidities resolved and persisted.

RESULTS: 350 super-obese patients [DS (n=198), RYGB (n=152)] were identified. Incidence and severity of hypertension, dyslipidemia, and GERD was comparable in both groups while diabetes was less common but more severe in the DS group (24.2% vs. 35.5%, Ali-Wolfe 3.27 vs. 2.94, p<0.05). Diabetes, hypertension, and dyslipidemia resolution was greater at 36 months for DS (diabetes, 100% vs. 60%; hypertension, 68.0% vs. 38.6%; dyslipidemia, 72% vs. 26.3%), while GERD resolution was greater for RYGB (76.9% vs. 48.57%; p<0.05). There were no differences in weight loss between comorbidity “resolvers" and “persisters".

CONCLUSIONS: In comparison to RYGB, DS provides superior resolution of diabetes, hypertension, and dyslipidemia and inferior resolution of GERD in the super-obese independent of weight loss.

The abstract doesn't really give the raw information needed, It comes closer, by telling me how many patients had DS and how many had RNY. but I still don't know how many of both the RNYers and DSers had diabetes. Unless they all had all of the diseases mentioned... but it is comforting to know they used a chi aquare test to evaluate the results... though I don't know in what way they used it exactly...

Actually the "results" section answers both how many patients had diabetes pre-op (24.2% of the DSers and 35.5% of the RNYers) AND how far out they were tested to see if the diabetes was resolved (36 months).

"...diabetes was less common but more severe in the DS group (24.2% vs. 35.5%, Ali-Wolfe 3.27 vs. 2.94, p<0.05). Diabetes, hypertension, and dyslipidemia resolution was greater at 36 months for DS (diabetes, 100% vs. 60%; hypertension, 68.0% vs. 38.6%; dyslipidemia, 72% vs. 26.3%)..."

First of all I didn't claim that the abstract (posted long after the OP) neglected to tell the time constrints of the study.
Second, when I said I didn't know the numbers of individuals, I was a tad too rushed to do the math. (boiling pot to check on) I can crunch the numbers now that I have the time. From the percents given and the numbers of participants for each surgery given I can tell they studied approx. 48 DSers with diabetes and 54 RNYers. That being said, this study in itself doesn't prove much to me as far as its claim goes. The sample group is very low, and I have seen another study that gives a much better argument in favor of the data the OP's article claims to support with a much larger sample which creates a much greater accuracy of data.
This particular study is miniscule and unreliable on its own. The 60% quoted for RNY diabetes resolution is much lower than the percentage quoted in a much larger and comprehensive study by Buchwald that says, "Diabetes resolution was greatest for patients undergoing biliopancreatic diversion/duodenal switch (95.1% resolved), followed by gastric bypass (80.3%) " Since their study comprised of over 300 diabetic participants in each surgery's population it actually makes the point it's trying to.

Again I'll remind you I'm not arguing the truthfulness of the main statement in the OP, but I AM arguing that the supporting article and (now thet i've seen the abstract) referenced study fail to prove the point enough to make the percentage claims they reported accurate.