Prof Patricia Kearney

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Patricia Kearney obtained a medical degree from University College Cork in 1998, graduating first in her class. She completed training in internal medicine in Ireland and the US. She was awarded a Fulbright Scholarship to undertake a MPH in Tulane University School of Public Health and Tropical Medicine and she subsequently completed a PhD in Public Health. In 2003 she was awarded a Wellcome Trust Cardiovascular Research Initiative Junior Research Fellowship to work as a Clinical Research Fellow at the University of Oxford. She worked at the Clinical Trial Services Unit & Epidemiological Studies Unit and her work focused on tabular and individual patient data meta-analyses.

In 2007 she was awarded a Beeson Fellowship (NIH funded career development award) to work on TILDA, the Irish Longitudinal Study on Ageing and during her fellowship she worked as a Visiting Assistant Professor at the Centre of Aging and Population Health at the University of Pittsburgh as well as a Clinical Research Fellow in Trinity College Dublin and University College Cork. In 2008 she was appointed as Senior Lecturer in Public Health in University College Cork. Her research interests are in primary and secondary prevention of traditional risk factors for cardiovascular disease, lifecourse epidemiology and clinical trials. She is the Irish lead PI for TRUST, an EU funded FP7 clinical trial in subclinical hypothyroidism in healthy older adults. She leads a Health Research Board funded Interdisciplinary Capacity Enhancement (ICE) award that is utilizing data from 9 Irish observational studies to look at lifestyle transitions across the lifecourse. She is a member of the national steering committee for TILDA and chairs the cardiovascular working group.

She has over 200 publications, including over 50 articles in peer reviewed international journals with approximately 21,600 citations, a h-index of 27 and an i-10 index of 55. She has generated ~€5.5 million in research grant funding since her appointment to UCC in 2009 and supervises a multi-disciplinary research team of 15 including research nurses, clinical fellows, post-doctorates and research students and she also supervises 10 PhD students. In 2013 she was one of six recipients nationally of the prestigious HRB Research Leader Award to undertake a project on a population approach to the prevention and control of diabetes.  She was also appointed as a Research Professor in UCC. In May 2016 she was appointed Professor of Epidemiology.

Abstract

Unmet Need for Bariatric Surgery

KN O’Neill a, FM Finucane b, CW le Roux c, AP Fitzgerald a,d, PM Kearney  a.

a Department of Epidemiology and Public Health, University College Cork, Ireland.

b Bariatric Medicine Service, Galway Diabetes Research Centre, HRB Clinical Research Facility, Galway, Ireland.

c Diabetes Complications Research Centre, Conway Institute, University College Dublin, Ireland

d Department of Statistics, University College Cork, Ireland.

Introduction: With the rising prevalence of severe obesity and type 2 diabetes, bariatric surgery offers a clinical and cost-effective treatment for carefully selected patients. Despite this, the provision of surgical services varies significantly between countries.

Aim: To inform health service planning by estimating the number of people potentially eligible for bariatric surgery in Ireland based on established clinical criteria and then to refine the number of potentially eligible patients by identifying those who suffer from the diseases with high morbidity, mortality and healthcare cost, that respond best to bariatric surgery.

Methods: We conducted a cross sectional analysis of the first wave (2009–2011) of The Irish Longitudinal Study on Ageing (TILDA). Two separate evidence based criteria sets for eligibility for bariatric surgery were applied to the data. For the first set of criteria, we considered those with body mass index (BMI) ≥40kg/m² or ≥35kg/m² and one or more of the following conditions; type 2 diabetes, hypertension, previous myocardial infarction (MI) or sleep apnoea. For the second set of criteria, we considered patients with type 2 diabetes and BMI ≥35kg/m², with one or more of the following conditions; previous MI, elevated urine albumin-creatinine ratio, retinopathy, neuropathy or peripheral vascular disease. Prevalence estimates were applied to census figures for 2011, estimating absolute numbers meeting the criteria.

Results: Among adults aged ≥50 years, 7.97% (95% CI: 7.23, 8.78), representing 92,573 (95% CI: 83,978, 101,981) people, met criteria one and 0.97% (95% CI: 0.73, 1.28), representing 11,231 (95% CI: 8,471, 14,890) people, met criteria two. With fewer than 1/100,000 population publicly funded surgeries taking place annually, current service provision meets less than 0.1% of the need.

Conclusion: While many adults who fulfil the eligibility criteria for bariatric surgery may not want or require it, the current level of need for bariatric surgical services is not being met. A strategy to develop and expand the provision of bariatric care is urgently needed.

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