Gram-Hanssen Anders, Tolstrup Anders, Zetner Dennis, Rosenberg Jacob
Department of Surgery, Center for Perioperative Optimization, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
Front Surg. 2020 Apr 16;7:17. doi: 10.3389/fsurg.2020.00017. eCollection 2020.
There are many ways to determine the success of an inguinal hernia operation. Traditional measures are hernia recurrence, neuralgia, mesh infection, or rather the absence of these complications. While these traditional measures obviously have their merits, alternative outcomes are emerging, and researchers and clinicians are gaining an increasing interest in patient-reported outcomes and patient reported outcome measures (PROMs). PROMs are patient questionnaires concerning quality of life, chronic pain, disability, or other subjects that are best assessed by the patients. PROMs come in two different forms: generic and condition specific. The generic PROMs concern general symptoms and issues, while the condition-specific PROMs target patients with a certain condition. Inguinal hernia-specific PROMs typically address issues like mesh-related symptoms, groin pain, sexual dysfunction, etc. Clinical measurement instruments such as PROMs should be carefully validated according to standardized guidelines to ensure their psychometric measurement properties. Unfortunately, this type of evidence is often lacking when it comes to inguinal hernia-specific PROMs. In this review, we explain why PROMs are useful for patients with inguinal hernia and why one should use inguinal hernia-specific PROMs as opposed to the generic ones. We address the importance of population-specific validation and explain what type of evidence is lacking. Last, we discuss the future prospects of using PROMs for patients with inguinal hernia.
有多种方法可以确定腹股沟疝手术的成功与否。传统的衡量标准是疝复发、神经痛、补片感染,或者更确切地说是这些并发症的不存在。虽然这些传统标准显然有其优点,但其他结果也在不断出现,研究人员和临床医生对患者报告的结果及患者报告结局测量指标(PROMs)越来越感兴趣。PROMs是关于生活质量、慢性疼痛、残疾或其他最好由患者评估的主题的患者问卷。PROMs有两种不同形式:通用型和疾病特异性型。通用型PROMs涉及一般症状和问题,而疾病特异性PROMs针对患有特定疾病的患者。腹股沟疝特异性PROMs通常涉及与补片相关的症状、腹股沟疼痛、性功能障碍等问题。像PROMs这样的临床测量工具应根据标准化指南进行仔细验证,以确保其心理测量特性。不幸的是,在腹股沟疝特异性PROMs方面往往缺乏这类证据。在本综述中,我们解释了为什么PROMs对腹股沟疝患者有用,以及为什么应该使用腹股沟疝特异性PROMs而不是通用型PROMs。我们阐述了针对特定人群进行验证的重要性,并解释了缺乏何种类型的证据。最后,我们讨论了将PROMs用于腹股沟疝患者的未来前景。