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Measuring Success in Complex Abdominal Wall Reconstruction: The Role of Validated Outcome Scales
Javier Otero1, Michael R Arnold1, William W Hope1
1From the Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center; and Department of Surgery, New Hanover Regional Medical Center, UNC-Chapel Hill.
Background:
Diminished quality of life (QOL) often drives patients to hernia repair, and patient-reported outcomes have gained importance in hernia research. Functional outcomes provide a patient-centered evaluation of a treatment, and improved QOL is a desired outcome assessing treatment effectiveness.
Methods:
Properties of validated QOL measure are reviewed and distinctions between generic and disease-specific measures are discussed. Based on a review of the literature, current validated outcome scales are evaluated and compared.
Results:
Currently, there is little agreement over the best means to measure QOL. As a result, several measures have been created, focusing on several distinct aspects of QOL. While generic measures provide global assessments, disease-specific measures report changes as they relate to the hernia itself and hernia surgery. With the introduction of new QOL measures, it is important to understand the properties of a good QOL measure.
Conclusions:
Several questions remain unanswered regarding QOL, including which measures best assess hernia patients, what is the ideal time to evaluate QOL, and for how long postoperatively should QOL be measured. The introduction of guidelines to address these issues may enable improvement in value assessment.
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