Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
Department of Surgery, Hernia Centre Brabant, Elisabeth-TweeSteden Hospital (ETZ), Tilburg, The Netherlands.
Hernia. 2024 Aug;28(4):1265-1274. doi: 10.1007/s10029-024-03019-7. Epub 2024 Mar 20.
The Q1.6 Inguinal Hernia application continuously measures patient-reported outcomes (PROs) by sampling experiences through brief, digital and condition-specific questions, utilising micro-moments. This can overcome the limitations of current paper questionnaires and give real-time insight into patient recovery. This exploratory study compares data from the application with retrospective data from electronic medical records (EMRs) to provide information on its accuracy in detecting postoperative complications after inguinal hernia repair.
Patients were asked to use the application in addition to their usual care. The application employs twitch crowdsourcing to gather PROs. Questions from validated and frequently used questionnaires were integrated. A retrospective assessment of EMRs was combined with an additional telephone interview. The primary endpoints were the sensitivity and specificity of the application in detecting chronic postoperative inguinal pain, recurrence and surgical-site infection (SSI).
A total of 215 patients were analysed. The sensitivity and specificity for detecting chronic postoperative inguinal pain were 100% (95% CI [47.8%, 100%]) and 93.7% (95% CI [88.3%, 97.1%]), respectively. For recurrence, the sensitivity was 77.8% (95% CI [40.0%, 97.2%]), and the specificity was 81.3% (95% CI [75.0%, 86.5%]). For SSI, the sensitivity and specificity were 75.0% (95% CI [19.4%, 99.4%]) and 89.8% (95% CI [84.8%, 93.6%]), respectively.
This study demonstrates satisfactory measurement capabilities of the Q1.6 Inguinal Hernia application for identifying postoperative complications following inguinal hernia repair. However, certain aspects require further improvement, such as addressing error-prone questions, enhancing long-term compliance, and validating (pain) measurements through prospective control data.
NL7813 (Dutch Trial Registry), 19 May 2019.
Q1.6 腹股沟疝应用程序通过利用微时刻，通过简短、数字化和特定于病情的问题来抽样患者的体验，持续测量患者报告的结果 (PRO)。这可以克服当前纸质问卷的局限性，并实时洞察患者的康复情况。本探索性研究将应用程序的数据与电子病历 (EMR) 的回顾性数据进行比较，以提供有关其在检测腹股沟疝修补术后术后并发症的准确性的信息。
患者被要求在常规护理之外使用该应用程序。该应用程序采用抽搐众包来收集 PRO。整合了来自经过验证和常用问卷的问题。对 EMR 的回顾性评估与额外的电话访谈相结合。主要终点是应用程序检测慢性术后腹股沟疼痛、复发和手术部位感染 (SSI) 的敏感性和特异性。
共分析了 215 名患者。应用程序检测慢性术后腹股沟疼痛的敏感性和特异性分别为 100%（95%CI [47.8%，100%]）和 93.7%（95%CI [88.3%，97.1%]）。对于复发，敏感性为 77.8%（95%CI [40.0%，97.2%]），特异性为 81.3%（95%CI [75.0%，86.5%]）。对于 SSI，敏感性和特异性分别为 75.0%（95%CI [19.4%，99.4%]）和 89.8%（95%CI [84.8%，93.6%]）。
本研究表明，Q1.6 腹股沟疝应用程序在识别腹股沟疝修补术后术后并发症方面具有令人满意的测量能力。然而，某些方面需要进一步改进，例如解决易错问题、提高长期依从性以及通过前瞻性对照数据验证（疼痛）测量。
NL7813（荷兰试验注册处），2019 年 5 月 19 日。
