Updated Bariatric Analysis and Reporting Outcome System (BAROS)

The Bariatric Analysis and Reporting Outcome System (BAROS) evaluates the results of obesity treatments by analyzing 3 domains: weight loss, changes in co-morbidities, and quality of life. Up to 3 points are allowed for each, and points are deducted for complications and reoperations. The final score classifies the results in 5 outcome groups, providing an objective definition of success or failure. This report describes refinements to the original instrument.

The system has been used in many countries since the late 1990s. Feedback from its users and additional research prompted some changes. The quality of life questionnaire was tested in clinical practice in United States and Austria, which led to improvements. It was later compared with other instruments for validity and reliability using a group of 110 gastric bypass patients.

The updated BAROS includes the percentage of excess body mass index loss, new criteria for the diagnosis of diabetes, and clarifies the concept of its "improvement." The wording and drawings in the quality-of-life questionnaire were modified. A sixth question, analyzing eating behavior, was added, and the scoring key was changed to a 10-point Likert scale, creating the Moorehead-Ardelt Quality of Life Questionnaire II. The new instrument correlated significantly with the Medical Outcomes Study Short Form 36-item Health Survey, the Beck Depression Inventory II, and the Stunkard and Messick Eating Inventory.

The BAROS is very useful for evaluating and reporting the results of obesity treatments. It can be used to measure the outcomes of > or =1 operations and to compare the results among different surgeons, regardless of their location. If this is corroborated by generalized use of the system, the BAROS can contribute to a uniform assessment of outcomes.