Jairam An P, Wilson Michael, Steyerberg Ewout W, Jeekel Johannes, Lange Johannes F
Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Surg Res. 2016 Jun 15;203(2):378-82. doi: 10.1016/j.jss.2016.03.005. Epub 2016 Mar 10.
Incisional hernia (IH) is the most frequent complication after abdominal surgery. Long-term follow-up is crucial. Patient-reported outcome measurements (PROMs) are able to monitor patients' disease progression after treatment. Until now, there are no PROMs that assess patients after abdominal surgery or that detects patients with IH. We aimed to develop a reliable questionnaire to assist in diagnosing IH, called the "PROMIS questionnaire": Patient-Reported Outcome Measurements in the Diagnosis of Incisional Hernias. In this pilot study, the reliability of this questionnaire is being determined.
Patients diagnosed with IH between 2013 and 2014 were included. A questionnaire with seven questions was developed. Patients were asked whether they thought they had IH, whether they felt any pain at the site of the scar, and whether they saw or felt a lump or a bulge. Furthermore, smoking history and patients' weight and height were taken into account. Patients were approached three times by telephone, with an interval of 1 week. Test-retest reliability, internal consistency, and sensitivity were measured.
Forty-three patients were included. Test-retest reliability was 1.0, and internal consistency was 0.56. The question regarding patients' pain was least consistent with other questions. The overall sensitivity of the questionnaire was 95%.
The PROMIS questionnaire is a highly reliable questionnaire, but the internal consistency is modest. The clinical relevancy of pain in IH patients is essential. Therefore, this question will be kept in the current PROMIS questionnaire. It needs further validation in a prospective cohort study, to use it as a diagnostic tool in the future to detect IH.
切口疝（IH）是腹部手术后最常见的并发症。长期随访至关重要。患者报告结局测量（PROMs）能够监测患者治疗后的疾病进展。到目前为止，尚无用于评估腹部手术后患者或检测切口疝患者的PROMs。我们旨在开发一种可靠的问卷，以协助诊断切口疝，即“PROMIS问卷”：切口疝诊断中的患者报告结局测量。在这项初步研究中，正在确定该问卷的可靠性。
纳入2013年至2014年间诊断为切口疝的患者。编制了一份包含七个问题的问卷。询问患者是否认为自己患有切口疝，是否在瘢痕部位感到疼痛，以及是否看到或摸到肿块或隆起。此外，还考虑了吸烟史以及患者的体重和身高。通过电话对患者进行三次随访，间隔为1周。测量了重测信度、内部一致性和敏感性。
纳入43例患者。重测信度为1.0，内部一致性为0.56。关于患者疼痛的问题与其他问题的一致性最差。问卷的总体敏感性为95%。
PROMIS问卷是一种高度可靠的问卷，但内部一致性一般。切口疝患者疼痛的临床相关性至关重要。因此，这个问题将保留在当前的PROMIS问卷中。需要在前瞻性队列研究中进一步验证，以便将来将其用作检测切口疝的诊断工具。
