Key result
Five-year SF-BARI scores in a registry cohort match merged RCTs, validating the score.
Why the study?
The Swiss-Finnish Bariatric Metabolic Outcome Score (SF-BARI Score) was established using merged data from two RCTs, but external validation using registry data was needed.
Is the SF-BARI Score a valid tool for evaluating and categorizing outcomes after metabolic bariatric surgery in a large real-world registry cohort compared to RCT data?
Observational (n=22,060)
Yes
Is the SF-BARI Score a valid tool for evaluating and categorizing outcomes after metabolic bariatric surgery in a large real-world registry cohort compared to RCT data?
The SF-BARI Score is a feasible and valid tool for standardized reporting and comparison of outcomes after metabolic bariatric surgery, performing similarly in large real-world registries as in the original RCTs.
Supports SF-BARI Score for standardized registry reporting; extends RCT validation but leaves open prospective confirmation before routine use.
BACKGROUND: The Swiss-Finnish Bariatric Metabolic Outcome Score (SF-BARI Score), based on merged data of two RCTs, is a composite endpoint designed to evaluate and categorize outcomes after metabolic bariatric surgery (MBS). The aim of this study was to externally validate the score using registry data. METHODS: Individual patient data were included from the Dutch Audit for Treatment of Obesity, the Scandinavian Obesity Surgery Registries (SOReg-Sweden and SOReg-Norway), and the merged RCT data used for establishing the SF-BARI Score. All patients undergoing primary MBS from January 2010 to June 2018, with complete baseline characteristics, as well as complete 1- and 5-year follow-up data, were included. The mean total score and distribution were compared between the combined registry and merged RCT data. RESULTS: There was no statistically significant difference in the mean SF-BARI Score between the registries (21 603 patients) and merged RCTs (457 patients) at 5 years (90.9 versus 89.1 points; difference = 1.8 (95% c.i. -1.0 to 4.7); P = 0.212), and the score distribution was similar. Statistically significant differences in baseline characteristics existed regarding sex (male 20.9% versus 29.3%), type 2 diabetes (16.7% versus 33.9%), hypertension (30.4% versus 66.1%), dyslipidaemia (13.7% versus 46.5%), obstructive sleep apnoea syndrome (12.0% versus 17.4%), and sleeve gastrectomy (SG) rate (21.0% versus 49.9%) (P < 0.001). The mean score estimate at 5 years in Roux-en-Y gastric bypass was 11.2 (95% c.i. 10.2 to 12.2) points higher compared with SG (P < 0.001). CONCLUSION: This study verified the feasibility of the SF-BARI Score, enabling standardized reporting and allowing for comparison of different treatment modalities.
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Bruinsma et al. (2025) conducted an observational in Metabolic bariatric surgery (n=22,060). Registry cohort vs. Merged RCT cohort was evaluated on Mean SF-BARI Score at 5 years (MD 1.8, 95% CI -1.0 to 4.7, p=0.212). The mean SF-BARI Score at 5 years was similar between the registry cohort and merged RCTs (90.9 vs 89.1 points; difference 1.8, 95% CI -1.0 to 4.7; P=0.212), validating the score.
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