Patient adherence and satisfaction and changes in anthropometric parameters with e-health versus in-person monitoring in bariatric surgery candidates: a systematic review and non-inferiority meta-analysis of cohort studies

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Background: Obesity is a risk factor for cardiovascular diseases and associated with reduced life expectancy. Surgery is a treatment approach for weight loss in some cases and patient monitoring is cost-effective and feasible. However, there is no strong evidence on the differences between e-health and in-person monitoring in bariatric surgery candidates. Methods and analyses: This review study will include cohort studies involving individuals with obesity (aged ≥18 years) and e-health or in-person patient monitoring before and after bariatric surgery. We will conduct searches in the following databases: PubMed, EMBASE (Elsevier), Cochrane (CENTRAL), Web of Science, SCOPUS and CINAHL (EBSCO), LILACS-VHL and SciELO. We will also search databases in the gray literature. The primary outcomes will be changes in body mass index (BMI), total body mass (kg) and body fat percentage (BF%) and patient adherence and satisfaction. The risk of bias of individual eligible studies will be assessed using the Newcastle-Ottawa Quality Assessment Scale and the overall quality will be assessed using the GRADE tool. Our analyses will involve comparisons of mean differences (MDs) or standardized mean differences (MSDs) across the groups using random-effects models and 95% confidence intervals. Statistical analyses will be performed with RStudio for Windows (v1.3.959) using R package meta (v3.6.1).

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