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Perioperative monitoring of inguinal hernia patients with a smartphone application



Patient Reported Outcomes have become standard in the evaluation of inguinal hernia repair. However, the chosen outcomes remain heterogeneous and the measurements time-consuming or inadequate. Perioperative measurement of pain and recovery could benefit from the contemporary possibilities that mobile health applications offer.


An application for smartphones and tablets was developed using the twitch crowdsourcing concept, classical questionnaires, experiences from randomised clinical trials, and patients’ input.


Dichotomous questions and numeric rating scales, both pre- and post-operative, were implemented in the freely available Q1.6 application. Content, timing and frequencies were adapted to the inguinal hernia patient’s daily life and assumed recovery. Certain combinations of answers were set as alert notifications to detect adverse events. Data are displayed on a web-based dashboard enabling real-time monitoring. Legal aspects were examined and taken into account.


The Q1.6 inguinal hernia app is an innovative tool for perioperative monitoring of pain and recovery of inguinal hernia patients. Previous limitations of classical measurements such as a large heterogeneity, retrospective data recording and different forms of bias can be eliminated. The `big data´ generated in this manner might be used for large-scale research to improve inguinal hernia surgery. The Q1.6 platform is not only hernia specific; it is also an innovative tool to measure PROs in any other domain.

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None of the authors declare to have received personal financial support for the current research project. The technical development of the application was carried out by Q1.6 BVBA (Antwerp, Belgium). Q1.6 received a grant for this technical work from C.R. Bard (Olen, Belgium, currently part of BD Medical, Erembodegem, Belgium). Both companies were not involved in the content of the research project in any way nor in the publication of results.

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Correspondence to L. van Hout.

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LvH declares no conflict of interest. WB declares no conflict of interest. MI declares no conflict of interest. PV declares no conflict of interest.

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All procedures performed were in accordance with the ethical standards of the institute and regional research committee and with the 1964 Helsinki declaration and its later amendments of comparable ethical standards.

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van Hout, L., Bökkerink, W.J.V., Ibelings, M.S. et al. Perioperative monitoring of inguinal hernia patients with a smartphone application. Hernia 24, 179–185 (2020).

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  • m-Health
  • Smartphone application
  • Inguinal hernia
  • Patient monitoring
  • Big data