Prospective, Real-World Assessment of the Abdominal Hernia‑Q: Patient Burden, Reliability, and Longitudinal Assessment of Quality of Life in Hernia Repair
Jessica R. Cunning, MD, MBA, Viren Patel, BS, Arturo J. Rios-Diaz, MD, Jaclyn T. Mauch, BA, Shelby L. Nathan, MD, Charles A. Messa, IV, BS, Cutler B. Whitely, BS, Omar Elfanagely, MD, Robyn B. Broach, PhD, Joseph M. Serletti, MD, John P. Fischer, MD, MPH.
University of Pennsylvania, Philadelphia, PA, USA.
Background: Traditional outcomes measures fail to capture the complete disease burden associated with Ventral Hernia Repair (VHR). Our group previously developed and psychometrically validated the Abdominal Hernia-Q (AHQ) patient-reported outcomes instrument through stakeholder engagement. The goal of this study is to prospectively assess quality of life (QoL) using the AHQ and to determine AHQ patient burden and internal reliability.
Methods: Pre- and post-operative AHQ surveys were administered to patients undergoing VHR. Paired t-tests served to compare AHQ scores within patients at different postoperative time points relative to their preoperative score. AHQ-burden was quantified as time to survey completion. Reliability through re-administration within 21 days was assessed by correlating average scores.
Results: Overall, 107 eligible patients completed pre- and post-operative AHQ surveys, for a total of 338 surveys. Median age and follow-up time were 55 years-old and 12 months, respectively. Fifty-four percent had mesh placed and 15% experienced surgical site occurrences. Mean QoL scores showed significant improvement one-month after surgery (pre 53 vs. post 84, p<0.01), peaked at nine months (90), and remained stable twelve months after surgery (82) relative to the immediate postoperative period (p>0.05). Median time-to-completion of the pre-AHQ and post-AHQ was 67 seconds (n=223) and 155 seconds (n=317), respectively. Test-retest assessment of the pre-AHQ (n=101) and post-AHQ (n=110) revealed excellent reliability (r=0.91 and r=0.87, respectively).
Conclusions: The AHQ is a psychometrically validated instrument that demonstrates real-world usability in practice, captures the significant QoL improvement related to VHR, exhibits low patient burden, and has excellent test-retest reliability for its pre- and post-operative modules.
Back to 2020 Abstracts