Impact of disclosure of radiographic test results on quality of life among patients with hernias: a randomized controlled trial

• Published in: Hernia : the journal of hernias and abdominal wall surgery Vol. 28; no. 2; pp. 411 - 418
• Main Authors: Olavarria, O. A., Lyons, N. B., Bernardi, K., Dhanani, N. H., Neela, N., Arakelians, A., Cohen, B. L., Mohebzad, K., Coelho, R., Holihan, J. L., Liang, M. K.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.04.2024; Springer Nature B.V
• Subjects: Abdomen; Abdominal Surgery; Abdominal wall; Abdominal Wall - surgery; Computed tomography; Disclosure; Hernia; Hernia, Ventral - diagnostic imaging; Hernia, Ventral - surgery; Hernias; Herniorrhaphy - methods; Humans; Medicine; Medicine & Public Health; Original Article; Pelvis; Quality of Life; Surgical Mesh; Surveys; Hernia repair; Occult hernia; Ventral hernia; Quality of life
• ISSN: 1248-9204; 1265-4906; 1248-9204
• DOI: 10.1007/s10029-023-02824-w

Purpose Hernias noted on radiographic imaging are common. We aimed to determine if informing patients of the presence of a clinically apparent or occult hernia on imaging would change their abdominal wall quality of life (AW-QOL). Methods This study was registered on clinicaltrials.gov (NCT04355819) in April 2020. Patients with a ventral hernia on elective CT abdomen/pelvis were enrolled. Patients underwent standardized abdominal examination by surgeons, and completed the modified Activities Assessment Scale, a validated, hernia-specific AW-QOL survey. On this scale, 1 is poor AW-QOL, 100 is perfect, and the minimally clinically important difference is five for a minor change. Patients were randomized to complete the one-year follow-up survey before or after being informed of the presence of a hernia on their imaging results. Primary outcome was follow-up AW-QOL adjusted for baseline AW-QOL. Results Of 169 patients randomized, 126 (75%) completed follow up at one-year. Among patients with occult hernias, those who completed the follow-up survey after being informed of having a hernia had a lower follow-up AW-QOL (mean difference − 7.6, 95% CI =  − 20.8 to 5.7, p = 0.261) compared to those who completed the survey before being informed. Conversely, for patients with clinical hernias, those who completed the survey after being informed had higher adjusted follow-up AW-QOL (mean difference 10.3, 95% CI =  − 3.0 to 23.6, p = 0.126) than those that completed it after. Conclusion Conveying findings of hernias found on CT imaging can influence patients’ AW-QOL. Future research should focus on identifying and addressing patients’ concerns after disclosure of CT results.