Recent trends in intensive treatments of obesity: Is academic research matching public interest?

BACKGROUND: The demand and the utilization of intensive treatments of obesity have been increased tremendously. OBJECTIVES: This study aimed to investigate trends in interest related to the intensive treatments of obesity in both academic research and the public domain, and assess whether they match each other. SETTING: The BMI Clinic, Double Bay, New South Wales, Australia. METHODS: Intensive treatment of obesity is defined as meal replacement, pharmacologic treatments, and surgical or endoscopic bariatric procedures identified by the national guidelines. To identify the academic research interests, the number of academic research publications for each search topic was identified as converted into relative popularity. To identify the public's interests, Google Trends relative search volume and Twitter message relative intensity for each topic was mined to identify the most recent interests in intensive obesity treatment among the public. RESULTS: There was an increase in academic publications in all treatment domains between 2007 and 2017, but that the research emphasis correlated poorly with public interest. Between 2007 and 2017, the most popular and increasing academic research interest in the intensive treatment of obesity was bariatric surgery, followed by weight loss medication. In 2007, the most popular public-interest treatment was weight loss medication followed by bariatric surgery. In contrast, in 2017, meal replacement and bariatric surgery were equally popular, while the interests in weight loss medication declined. Significant seasonal patterns were also recognized for the public's interests. CONCLUSION: Academic research and public interest are not currently sufficiently aligned in the area of obesity treatment.

Universal molecular screening does not effectively detect Lynch syndrome in clinical practice.

BACKGROUND: Lynch syndrome (LS) due to an inherited damaging mutation in mismatch repair (MMR) genes comprises 3% of all incident colorectal cancer (CRC). Molecular testing using immunohistochemistry (IHC) for MMR proteins is a recommended screening tool to identify LS in incident CRC. This study assessed outcomes of population-based routine molecular screening for diagnosis of LS in a regional center. METHODS: We conducted a prospective, consecutive case series study of universal IHC testing on cases of resected CRC from September 2004-December 2013. Referred cases with abnormal IHC results that attended a familial cancer clinic were assessed according to modified Bethesda criteria (until 2009) or molecular criteria (from 2009). RESULTS: 1612 individuals underwent resection for CRC in the study period and had MMR testing by IHC. Of these, 274 cases (16.9%) exhibited loss of expression of MMR genes. The mean age at CRC diagnosis was 68.1 years (± standard deviation 12.7) and the mean age of those with an IHC abnormality was 71.6 (± 11.8). A total of 82 (29.9%) patients with an abnormal result were seen in a subspecialty familial cancer clinic. Patients aged under 50 (p = 0.009) and those with loss of MSH6 staining (p = 0.027) were more likely to be referred and to attend. After germ-line sequencing, 0.6% (10 of 82) were identified as having a clinically significant abnormality. A further eight probands with pathogenic germ-line mutations were identified from other referrals to the service over the same time period. CONCLUSIONS: While technically accurate, the yield of 'universal' IHC in detecting new Lynch probands is limited by real-world factors that reduce referrals and genetic testing. We propose an alternative approach for universal, incident case detection of Lynch syndrome with 'one-stop' MMR testing and sequencing.