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Perioperative monitoring of inguinal hernia patients with a smartphone application

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Abstract

Introduction

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.

Methods

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

Results

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.

Discussion

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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References

  1. Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J et al (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13(4):343–403

    Article  CAS  Google Scholar 

  2. Jenkins JT, O'Dwyer PJ (2008) Inguinal hernias. BMJ 336(7638):269–272

    Article  Google Scholar 

  3. Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R et al (1998) Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 51(11):1055–1068

    Article  CAS  Google Scholar 

  4. Heniford BT, Walters AL, Lincourt AE, Novitsky YW, Hope WW, Kercher KW (2008) Comparison of generic versus specific quality-of-life scales for mesh hernia repairs. J Am Coll Surg 206(4):638–644

    Article  Google Scholar 

  5. Muysoms F, Campanelli G, Champault GG, DeBeaux AC, Dietz UA, Jeekel J et al (2012) EuraHS: the development of an international online platform for registration and outcome measurement of ventral abdominal wall hernia repair. Hernia 16(3):239–250

    Article  CAS  Google Scholar 

  6. Muysoms FE, Vanlander A, Ceulemans R, Kyle-Leinhase I, Michiels M, Jacobs I et al (2016) A prospective, multicenter, observational study on quality of life after laparoscopic inguinal hernia repair with ProGrip laparoscopic, self-fixating mesh according to the European Registry for Abdominal Wall Hernias Quality of Life Instrument. Surgery 160(5):1344–1357

    Article  Google Scholar 

  7. Staerkle RF, Villiger P (2011) Simple questionnaire for assessing core outcomes in inguinal hernia repair. Br J Surg 98(1):148–155

    Article  CAS  Google Scholar 

  8. Kehlet H, Bay-Nielsen M, Kingsnorth A (2002) Chronic postherniorrhaphy pain—a call for uniform assessment. Hernia 6(4):178–181

    Article  CAS  Google Scholar 

  9. Muysoms FE, Deerenberg EB, Peeters E, Agresta F, Berrevoet F, Campanelli G et al (2013) Recommendations for reporting outcome results in abdominal wall repair: results of a Consensus meeting in Palermo, Italy, 28–30 June 2012. Hernia 17(4):423–433

    Article  CAS  Google Scholar 

  10. Kehlet H, Roumen RM, Reinpold W, Miserez M (2013) Invited commentary: persistent pain after inguinal hernia repair: what do we know and what do we need to know? Hernia 17(3):293–297

    Article  CAS  Google Scholar 

  11. Schulz KF, Altman DG, Moher D (2011) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Int J Surg 9(8):672–677

    Article  Google Scholar 

  12. Kyle-Leinhase I, Kockerling F, Jorgensen LN, Montgomery A, Gillion JF, Rodriguez JAP et al (2018) Comparison of hernia registries: the CORE project. Hernia 22(4):561–575

    Article  CAS  Google Scholar 

  13. Peyre H, Leplege A, Coste J (2011) Missing data methods for dealing with missing items in quality of life questionnaires A comparison by simulation of personal mean score, full information maximum likelihood, multiple imputation, and hot deck techniques applied to the SF-36 in the French 2003 decennial health survey. Qual Life Res 20(2):287–300

    Article  Google Scholar 

  14. Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP (2003) Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol 88(5):879–903

    Article  Google Scholar 

  15. Organisation for Economic Co-operation and Development (OECD). OECD Guidelines on Measuring Subjective Well-being. Paris: OECD Publishing; 2013 Mar 20. 2, Methodological considerations in the measurement of subjective well-being. https://www.ncbi.nlm.nih.gov/books/NBK189566/

  16. Waller A, Forshaw K, Carey M, Robinson S, Kerridge R, Proietto A et al (2015) Optimizing patient preparation and surgical experience using eHealth technology. JMIR Med Inform 3(3):e29

    Article  Google Scholar 

  17. Semple JL, Sharpe S, Murnaghan ML, Theodoropoulos J, Metcalfe KA (2015) Using a mobile app for monitoring post-operative quality of recovery of patients at home: a feasibility study. JMIR Mhealth Uhealth 3(1):e18

    Article  Google Scholar 

  18. Semple JL, Armstrong KA (2017) Mobile applications for postoperative monitoring after discharge. CMAJ 189(1):E22–E24

    Article  Google Scholar 

  19. Russell TG, Buttrum P, Wootton R, Jull GA (2011) Internet-based outpatient telerehabilitation for patients following total knee arthroplasty: a randomized controlled trial. J Bone Joint Surg Am 93(2):113–120

    Article  Google Scholar 

  20. Armstrong KA, Semple JL, Coyte PC (2014) Replacing ambulatory surgical follow-up visits with mobile app home monitoring: modeling cost-effective scenarios. J Med Internet Res 16(9):e213

    Article  Google Scholar 

  21. Central Bureau for Statistics (CBS). Statistics Netherlands: Internet; access, use and facilities. 2018. https://opendata.cbs.nl/statline/#/CBS/nl/dataset/83429NED/table?dl=84A5. Accessed 08 Mar 2018.

  22. Q1.6 BVBA. Q1.6—non intrusive app that skyrockets true user engagement. 2019. https://www.questions.ai/. Accessed 21 May 2019.

  23. Vaish R, Wyngarden K, Chen J, Cheung B, Bernstein MS (2014) Twitch crowdsourcing: crowd contributions in short bursts of time. In: CHI ’14: Proceedings of the SIGCHI conference on human factors in computing systems: 2014 April 26; Toronto, Ontario, Canada. ACM, New York, p 3645–3654

  24. Oulasvirta A, Tamminen S, Roto V, Kuorelahti J (2005) Interaction in 4-second bursts: the fragmented nature of attentional resources in mobile HCI. In: CHI ’05: Proceedings of the SIGCHI conference on human factors in computing systems: 2005 April 2–7; Portland, Oregon, USA. ACM, New York, p 919–928

  25. Falaki H, Mahajan R, Kandula S, Lymberopoulos D, Govindan R, Estrin D (2010) Diversity in Smartphone Usage. In: MobiSys ’10; Proceedings of the 8th international conference on mobile systems, applications, and services; 2019 Jun 15; San Francisco, California, USA. ACM, New York, p 179–194

  26. EuraHs Working Group. European Registry Of Abdominal Wall Hernias. https://www.eurahs.eu/HOME.php. Accessed 21 May 2019.

  27. Koning GG, Keus F, Koeslag L, Cheung CL, Avci M, van Laarhoven CJ et al (2012) Randomized clinical trial of chronic pain after the transinguinal preperitoneal technique compared with Lichtenstein's method for inguinal hernia repair. Br J Surg 99(10):1365–1373

    Article  CAS  Google Scholar 

  28. Bokkerink WJV, Koning GG, Malagic D, van Hout L, van Laarhoven CJHM, Vriens PWHE (2019) Long-term results from a randomized comparison of open transinguinal preperitoneal hernia repair and the Lichtenstein method (TULIP trial). Br J Surg 106(7):856–861

    Article  CAS  Google Scholar 

  29. Prins MW, Koning GG, Keus EF, Vriens PW, Mollen RM, Akkersdijk WL, et al. Study protocol for a randomized controlled trial for anterior inguinal hernia repair: transrectus sheath preperitoneal mesh repair compared to transinguinal preperitoneal procedure. Trials 2013 14:65–6215–14–65.

    Article  Google Scholar 

  30. Bokkerink WJV, Koning GG, Vriens PWHE, de Vries J, van Laarhoven CJHM. Patients' perspective on inguinal hernia repair: a focus group study. Submitted for publication. 2019.

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Acknowledgements

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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Authors and Affiliations

  1. Department of Surgery, Hernia Centre Brabant, Elisabeth-TweeSteden Hospital (ETZ), Hilvarenbeekseweg 60, 5022 GC, Tilburg, The Netherlands

    L. van Hout, W. J. V. Bökkerink, M. S. Ibelings & P. W. H. E. Vriens

  2. Department of Surgery, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands

    W. J. V. Bökkerink

Authors
  1. L. van Hout
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  2. W. J. V. Bökkerink
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  3. M. S. Ibelings
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  4. P. W. H. E. Vriens
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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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This article does not contain any studies with human participants or animals performed by any of the authors.

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For this study formal consent is not required.

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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). https://doi.org/10.1007/s10029-019-02053-0

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  • DOI: https://doi.org/10.1007/s10029-019-02053-0

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