Systematic Review Report

Running Head: SYSTEMATIC REVIEW REPORT
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Systematic Review Report
Student’s Name
Institutional Affiliation

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Systematic Review Report
Introduction
Research is an orderly review of available data to generate new information, by making
correlations to prove or disprove a scientific claim (Chen, 2016). The research process is
categorized differently based on the data being analyzed and the manner of analysis used.
Subsequently, the findings are used to improve on effectiveness, ease or creativity across various
disciplines such as finance, governance, and medicine. The use of research in medical practice is
known as an evidence-based practice (Balakas & Smith, 2016).
The knowledge obtained from research is assessed before it can be applied. The study
design gives the best indicator for the strength of the evidence obtained. A systematic review of
each study design offers the highest level of evidence within their respective categories while the
penultimate measure of the best source of evidence is a systematic review of randomized clinical
trials (Smith, Devane, Begley, & Clarke, 2011). However, it is not a definitive measure of
evidence.
A systematic review entails using defined criteria to abstract secondary data from
research papers, critically appraise them and generate results. There are numerous types of
systematic reviews such as qualitative, effectiveness, prevalence, cost, and risk reviews. All
these types of reviews assess different phenomena in varied contexts. For example, effectiveness
reviews evaluate the effectiveness of an intervention in comparison to a control group by
assessing experimental, quasi-experimental and observational studies. The purpose of this report
is to critically plan a systematic review after the formulation of a research question.
Background
Obesity is a non-communicable disease characterized by a disordered weight gain and
accumulation of adipose tissue that predisposes one to health complications. The constant
hyperglycemic state causes excessive release of insulin. Insulin receptors in organ tissues such as
the liver become resistant due to continued exposure resulting in type 2 diabetes (Paulus et al.,
2015). Hyperlipidemia also commonly occurs in obese patients resulting in atherosclerosis
causing coronary artery disease. It is hypothesized that excessive insulin release in obese patients

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results in increased sodium retention causing fluid expansion of blood volume predisposing the
patient to hypertension. The total cholesterol increase causes an increase in the formation of
cholesterol stones while hyperlipidemia causes fatty liver disease that may progress to liver
cirrhosis or fibrosis (Di Ciaula et al., 2019).
Such complications can be averted by lifestyle interventions, pharmacological and/or
surgical interventions (Bosello, Donataccio, & Cuzzolaro, 2016). While lifestyle changes may be
the gold standard used in managing obesity due to excessive caloric intake, its effectiveness
remains questionable because it is dependent on patient motivational factors. Bariatric surgery
has gradually become a common intervention strategy for obese patients (Qi et al., 2017). It is
more likely to yield objective results. The surgical intervention entails alteration to the digestive
tract to minimize the absorption of ingested foods. There are different types of bariatric surgery
such as bypass surgery, sleeve gastrectomy, and gastric banding (Carpentier, 2016). The
successes of the following surgery are relatively unknown in comparison to lifestyle
intervention.
Justification
The number of obese patients is constantly rising each year predisposing more people to
potentially fatal health complications. While lifestyle interventions such as changes in diet and
increasing physical activity are considered the gold standard for the management of obesity
caused by excess caloric intake, it takes months to attain results, some patients may not adhere
and there is a possibility of relapse after the intervention. Definitive measures such as surgery
can, therefore, be explored as a remedy to obesity. A majority of the articles present to conduct a
systematic review to determine the effectiveness of bariatric surgery in managing type 2 diabetes
and obstructive sleep apnea. Additionally, the studies show that there is a higher likelihood of
post-surgical complications in obese patients with comorbidities (Ashrafian et al., 2015).
Therefore, it is worth investigating if bariatric surgery can be used earlier on before obesity-
related complications set in.

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Statement of problem/ Research question
To address this gap a systematic review is required to determine the effectiveness of
bariatric surgery compared to lifestyle interventions in achieving a reduction in Body Mass Index
in the target population of obese patients without comorbidities.
Significance
The implementation of surgery as a definitive/ first-line treatment option may greatly
favor older obese patients that may not be physically capable to effect behavioral intervention
such as moderate to vigorous exercise. The use of the surgery may greatly favor obese patients
whose primary cause of excessive weight gain is clinical depression or associated with it.
Additionally, mortality associated with treating complications such as cholesterol stones with
cholecystectomy can be avoided (Augustin et al., 2017).
Objectives
The objectives set are specific, measurable, achievable, realistic and timely as follows :
 To compare the reduction of body mass index in the intervention group versus the control
group
 To determine how long it took the control group to achieve a reduction in body mass
index compared to the control group
 To determine the prevalence of complications that may occur in the intervention group in
comparison to the control group