Prospective Psychometric Validation of the Hernia-Q: A Patient-Reported Outcomes Tool
Fabiola A. Enriquez, BA, Irfan A. Rhemtulla, MD, MS, Robyn B. Broach, PhD, Sheri Thrippleton, PA-C, John P. Fischer, MD, MPH.
University of Pennsylvania, Philadelphia, PA, USA.
PURPOSE: Ventral Hernia Repair (VHR) is a common surgical procedure, however there are limited tools aimed to measure the patient experience. The purpose of this study was to evaluate the reliability and validity of the Hernia-Q, a novel VHR PRO tool, assessing patient expectations and satisfaction.
METHODS: The preoperative and postoperative Hernia-Q were developed through the concept elicitation interviews, focus groups, and cognitive debriefing interviews. The questionnaires were implemented with 7 domains and refined by 30 cognitive interviews. The refined questionnaires were field tested and administered electronically or during clinic visits on 350 VHR patients (response rate, preop 40%, postop 28%). The HerQLes and SF-12 questionnaires accompanied the Hernia-Q for comparison purposes. Descriptive, inferential statistics, and psychometric analyses were performed on all the data collected.
RESULTS: The data was 100% complete, with no floor and ceiling effects demonstrating variance. There were 40 individual assessments made (15 for the preoperative, 25 for the postoperative) survey, to explore internal consistency and redundancy. The Hernia-Q strongly correlated with the HerQLes (Cronbach α pre=0.93, post= 0.94) and the SF-12, in all domains except general health and mental health, confirming its wide application. Principal component analyses suggest four factors, but more detailed exploration will determine interpretability and magnitude of correlations among factors.
CONCLUSION:Hernia-Q demonstrates excellent validity and reliability scores. Strengthening quality metrics will help ensure clinical validation of the tool. This questionnaire is able to quantify satisfaction and identify important VH domains, such as general and mental health, which can improve patient-provider communication
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