制定意大利减肥和代谢手术临床实践指南，以及设计和方法方面。
背景：肥胖及其并发症在许多国家是一个日益严重的问题。意大利肥胖减肥和代谢外科学会（SocietàItalianadiChirurgiadell\'ObesitàedelleMalattieMetaboliche-SICOB）制定了第一个意大利肥胖治疗指南。
方法：SICOB指南的创建基于由24名成员和协调员组成的小组所做的扩展工作。建议的分级,评估,开发和评估（等级）方法已用于确定目标，参考人口，并针对卫生专业人员。使用PICO创建了临床问题(患者，干预,比较,结果）概念框架。问题的定义使用了基于Delphi的两步法，通过反复的问卷和小组的共识意见进行。
结果：小组提出了37个问题。33人(89.2%)立即达成共识,有31人批准，两个拒绝，三个没有立即达成共识。进一步的讨论达成了共识，其中一项获得批准，两项被拒绝。
结论：临床问题涵盖的领域包括代谢/减肥手术的适应症，手术类型,和手术管理。对于确定治疗策略和正确适应症，已经讨论了手术或非手术方法的选择。
Development of the Italian clinical practice
guidelines on bariatric and metabolic surgery, as well as design and methodological aspects.
BACKGROUND: Obesity and its complications are a growing problem in many countries. Italian Society of Bariatric and Metabolic Surgery for Obesity (Società Italiana di Chirurgia dell\'Obesità e delle Malattie Metaboliche-SICOB) developed the first Italian
guidelines for the treatment of obesity.
METHODS: The creation of SICOB
Guidelines is based on an extended work made by a panel of 24 members and a coordinator. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology has been used to decide the aims, reference population, and target health professionals. Clinical questions have been created using the PICO (Patient, Intervention, Comparison, Outcome) conceptual framework. The definition of questions used the two-step web-based Delphi method, made by repeated rounds of questionnaires and a consensus opinion from the panel.
RESULTS: The panel proposed 37 questions. A consensus was immediately reached for 33 (89.2%), with 31 approved, two rejected and three which did not reach an immediate
consensus. The further discussion allowed a
consensus with one approved and two rejected.
CONCLUSIONS: The areas covered by the clinical questions included indications of metabolic/bariatric surgery, types of surgery, and surgical management. The choice of a surgical or a non-surgical approach has been debated for the determination of the therapeutic strategy and the correct indications.
