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Related Experiment Video

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Use of a Rat Model to Study Ventral Abdominal Hernia Repair
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The Abdominal Hernia-Q: Development, Psychometric Evaluation, and Prospective Testing.

Jaclyn T Mauch1, Fabiola A Enriquez1, Judy A Shea2

  • 1Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA.

Annals of Surgery
|January 3, 2019
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Summary

A new patient-reported outcome tool, the Abdominal Hernia-Q (AHQ), has been developed and validated for ventral hernia repair (VHR). The AHQ reliably measures patient outcomes, improving care for abdominal hernia patients.

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Area of Science:

  • Surgical Outcomes Research
  • Patient-Reported Outcomes Measurement
  • Health Services Research

Background:

  • Standardized methods for measuring hernia-related patient-reported outcomes (PRO) are lacking.
  • A need exists for a broadly applicable, hernia-specific tool incorporating patient perspectives.
  • Existing tools lack pre- and postoperative forms for comprehensive assessment.

Purpose of the Study:

  • To complete the development of a novel, ventral hernia-specific PRO tool: the Abdominal Hernia-Q (AHQ).
  • To estimate the psychometric properties, including validity and reliability, of the AHQ.
  • To provide a tool for assessing patient-defined outcomes in abdominal hernia management.

Main Methods:

  • Concept elicitation interviews, focus groups, and cognitive debriefing were used to define AHQ content.
  • The AHQ (preoperative and postoperative forms) was administered to patients undergoing ventral hernia repair (VHR).
  • Psychometric evaluation included internal consistency, correlations with SF-12 and HerQLes, and principal components analysis, followed by prospective testing.

Main Results:

  • Cross-sectional evaluations (pre n = 104; post n = 261) showed high internal consistency (Cronbach α pre = 0.86; post = 0.90).
  • Moderate correlations were found with HerQLes (r ≈ -0.70) and SF-12 domains (r ≥ 0.5 for 7/8 domains).
  • Prospective testing (n = 67) replicated psychometric findings and indicated sensitivity to clinical outcomes.

Conclusions:

  • The Abdominal Hernia-Q (AHQ) demonstrates validity and reliability for measuring hernia-specific PRO through patient involvement and rigorous psychometric evaluation.
  • The AHQ enhances clinical management by providing a better understanding of patient-defined outcomes in abdominal hernia treatment.
  • This tool advances the field by offering a comprehensive, patient-centered approach to assessing outcomes after ventral hernia repair.