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A Novel, Dynamic Statistical Model for Predicting Patient Satisfaction with Fundoplication Based on Pre-Operative Symptom Patterns

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Abstract

Background

Fundoplication provides excellent control of gastro-oesophageal reflux disease (GORD), but there remain a number of unsatisfied patients who have proven difficult to identify pre-operatively. We hypothesised that pre-operative symptom patterns can predict of the risk of post-operative dissatisfaction.

Methods

Pre-operative symptoms and post-operative satisfaction were measured using standardised questionnaires along with routine investigations. These data were used to calculate our novel pre-operative risk of dissatisfaction (PROD) score. Potential pre-operative prognostic markers were tested against the post-operative satisfaction data, including the objective investigations and the PROD score. The prognostic utility of the PROD score and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) guideline was tested using receiver operating characteristic analysis to determine the area under the curve (AUC).

Results

An association was found between our PROD score and each of the satisfaction measures (n = 225, p < 0.001) which is likely to be of prognostic utility (AUC = 0.67–0.79). No such association was found between the routine investigations and post-operative satisfaction. The PROD score was found to be of greater prognostic utility than the SAGES guideline (n = 166, p < 0.001).

Conclusions

The PROD score is a novel, easy-to-use test that can predict individual patient satisfaction with fundoplication.

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Funding

This study was not supported by any grants.

Author information

Authors and Affiliations

  1. Department of General Surgery, Christchurch Hospital, Private Bag 4710, Christchurch, 8140, New Zealand

    B. L. Woodham & R. H. Roberts

  2. Department of General Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia

    B. L. Woodham

  3. Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, Bedford Park, South Australia, Australia

    R. Meng

Authors
  1. B. L. Woodham
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  2. R. Meng
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  3. R. H. Roberts
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Corresponding author

Correspondence to R. H. Roberts.

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Conflict of interest

The authors declare that they have no potential or real conflicts of interest or financial ties to disclose.

Ethical approval

Ethics approval for this study was obtained from the Health and Disability Ethics Committee, Ministry of Health, Government of New Zealand.

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Woodham, B.L., Meng, R. & Roberts, R.H. A Novel, Dynamic Statistical Model for Predicting Patient Satisfaction with Fundoplication Based on Pre-Operative Symptom Patterns. World J Surg 41, 2778–2787 (2017). https://doi.org/10.1007/s00268-017-4057-9

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  • DOI: https://doi.org/10.1007/s00268-017-4057-9

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