Global sensitivity analysis of the probabilistic volume of tissue activated in a volume conductor model for deep brain stimulation

2013 ◽  
Author(s):  
Christian Schmidt ◽  
Ursula van Rienen
Keyword(s):  
Sensitivity Analysis ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Global Sensitivity Analysis ◽  
Volume Conductor ◽  
Global Sensitivity ◽  
Volume Conductor Model ◽  
Deep Brain

Deep brain stimulation compared with bariatric surgery for the treatment of morbid obesity: a decision analysis study

2010 ◽  
Vol 29 (2) ◽  
pp. E15 ◽  
Author(s):  
Jared M. Pisapia ◽  
Casey H. Halpern ◽  
Noel N. Williams ◽  
Thomas A. Wadden ◽  
Gordon H. Baltuch ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Sensitivity Analysis ◽  
Gastric Bypass ◽  
Deep Brain Stimulation ◽  
Decision Analysis ◽  
Success Rate ◽  
Brain Stimulation ◽  
Surgical Complications ◽  
Deep Brain

Object Roux-en-Y gastric bypass is the gold standard treatment for morbid obesity, although failure rates may be high, particularly in patients with a BMI > 50 kg/m2. With improved understanding of the neuropsychiatric basis of obesity, deep brain stimulation (DBS) offers a less invasive and reversible alternative to available surgical treatments. In this decision analysis, the authors determined the success rate at which DBS would be equivalent to the two most common bariatric surgeries. Methods Medline searches were performed for studies of laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB), and DBS for movement disorders. Bariatric surgery was considered successful if postoperative excess weight loss exceeded 45% at 1-year follow-up. Using complication and success rates from the literature, the authors constructed a decision analysis model for treatment by LAGB, LRYGB, DBS, or no surgical treatment. A sensitivity analysis in which major parameters were systematically varied within their 95% CIs was used. Results Fifteen studies involving 3489 and 3306 cases of LAGB and LRYGB, respectively, and 45 studies involving 2937 cases treated with DBS were included. The operative successes were 0.30 (95% CI 0.247–0.358) for LAGB and 0.968 (95% CI 0.967–0.969) for LRYGB. Sensitivity analysis revealed utility of surgical complications in LRYGB, probability of surgical complications in DBS, and success rate of DBS as having the greatest influence on outcomes. At no values did LAGB result in superior outcomes compared with other treatments. Conclusions Deep brain stimulation must achieve a success rate of 83% to be equivalent to bariatric surgery. This high-threshold success rate is probably due to the reported success rate of LRYGB, despite its higher complication rate (33.4%) compared with DBS (19.4%). The results support further research into the role of DBS for the treatment of obesity.

Sign in / Sign up

Export Citation Format

Share Document