Feasibility of automated registration of Patient-Reported Outcome Measures (PROMs) for inguinal hernia surgery : a single-centre pilot study

National registries have the potential to improve quality of inguinal hernia surgery by monitoring provided care and comparing outcomes. Patient-reported outcome measures (PROMs) are essential for assessing quality as they capture key outcomes directly from the patient's perspective. This pilot study evaluated feasibility of automated PROMs registration up to 2 years postoperatively with minimal administrative burden in a high-volume hernia clinic.

Adults who underwent elective inguinal hernia repair and received PROMs questionnaires between January 18, 2023, and August 25, 2025, were prospectively included. Patients received secure email invitations to complete questionnaires through the hospital's patient portal at baseline and at 6-8 weeks (short-term), 3 months, 1 year, and 2 years postoperatively. PROMs included pain, functional recovery, satisfaction, and hernia recurrence. The primary outcome was the response rate at different follow-up time points (target rate: 60%). Key secondary outcomes included physician-assisted response rates and responder versus non-responder differences.

A total of 3,628 patients were included. Preoperative and short-term response rates were 77.7% and 63.2%, respectively. Postoperative response rates declined to 47.7% (3 months), 44.2% (1 year), and 43.8% (2 years). Younger age and a higher burden of comorbidities were associated with non-response.

This study demonstrated feasibility of automated PROMs at baseline and short-term follow-up, but highlights the challenge of declining response rates over time and representativeness of the responding population. Integrating this approach into a national registry could improve data collection and overall efficiency. Strategies to optimize response rates and representativeness should be explored.