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A patient-reported questionnaire for incisional hernias (IH) shows promise for ruling out the condition due to its high negative predictive value. However, it cannot reliably diagnose IH and clinical examination remains essential for accurate follow-up.

Keywords:
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Area of Science:

  • Abdominal Surgery
  • Hernia Research
  • Diagnostic Tool Validation

Background:

  • Incisional hernia (IH) is a common complication following abdominal surgery.
  • Current diagnostic methods for IH, such as physical examination and imaging, are time-consuming, costly, and not always prioritized.
  • A patient-reported diagnostic questionnaire was developed to address these challenges in IH follow-up.

Purpose of the Study:

  • To validate a patient-reported diagnostic questionnaire for the detection of incisional hernias (IH).
  • To assess the diagnostic accuracy of the questionnaire in a consecutive sample of post-abdominal surgery patients.

Main Methods:

  • A prospective study included 241 patients over 18 years old who had undergone abdominal surgery with a midline incision at least 12 months prior.
  • Patients completed the diagnostic questionnaire and underwent a physical examination.
  • Diagnostic accuracy was evaluated using multivariable logistic regression, comparing questionnaire results to physical examination findings.

Main Results:

  • Physical examination diagnosed incisional hernias (IH) in 54 (22%) of the 241 patients.
  • The questionnaire demonstrated an area under the receiver operating characteristic curve of 0.82, with 81.5% sensitivity and 77.5% specificity.
  • The questionnaire had a high negative predictive value (94%) but a lower positive predictive value (51.2%), missing 19% of IH cases.

Conclusions:

  • The current patient-reported questionnaire is not sufficient for diagnosing incisional hernias (IH).
  • Due to its high negative predictive value, the questionnaire may be useful in ruling out IH.
  • Clinical examination remains the recommended method for long-term follow-up and diagnosis of incisional hernias.