Determining the minimal important change of the abdominal Hernia-Q

The Abdominal Hernia-Q(AHQ) is a validated PRO tool for hernia patients. This study aimed to determine the Minimal Important Change (MIC) for the AHQ, examining changes in AHQ scores and exploring associations with key clinical characteristics.

A retrospective cohort design was used. Patients who underwent hernia repair between January 2017 and January 2022 and completed the AHQ preoperatively and six months postoperatively were included. Anchor (Short Form Health Survey (SF-12) and Hernia-related Quality of Life Survey (HerQLes)) and distribution-based methods were used to compute the MIC. The distribution method used 0.5×standard deviation [SD] and minimal detectable change [MDC; 1.96×SEM], to identify the MIC.

A total of 147 patients met the inclusion criteria, with a mean age of 55.69 (SD 12.26), 60% female and a BMI of 30.8 km/m2 (26.9-36.5). A grand mean MIC of 6.8 was derived. One hundred twenty-nine patients met or exceeded the MIC, while 18 did not. Patients meeting the MIC had significantly worse baseline AHQ scores (46 vs. 68, p < 0.001) and higher postoperative AHQ scores (86 vs. 67, p < 0.001). There was no difference in operative characteristics or complications between groups, with the exception that patients not achieving MIC had a higher rate of seroma (28% vs. 9.3%, p = 0.038).

The findings suggest that patients with worse preoperative status may still experience clinically significant benefits. Establishing the MIC for the AHQ may enable the identification of patients likely to experience significant improvements in quality of life after hernia repair.