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Importance <p>The Ventral Hernia Recurrence Inventory (VHRI) was developed to establish a relationship between patient-reported outcomes and hernia recurrence after repair. Positive responses have subsequently been adopted as a screening mechanism for recurrence for patients that are unable to attend follow-up visits.</p> Objective <p>We aimed to externally validate the VHRI compared with recurrences identified on cross-sectional imaging.</p> Design <p>This is a retrospective analysis of patients that have undergone abdominal hernia repairs between 2014 and 2023 and had completed at least 1 year of follow-up from their index surgery.</p> Setting <p>Ventral hernia repairs and corresponding imaging analyses were carried out by surgeons with fellowship training in abdominal wall reconstruction.</p> Participants <p>Patients included in this cohort were also included in previously published clinical trials and retrospective cohorts with VHRI responses captured within 4 months of cross-sectional imaging. All reviewed images were obtained at least 1 year after the index surgery, up to a maximum of 4 years.</p> Main outcomes <p>The primary outcome was the sensitivity and positive predictive value of the VHRI for detecting imaging-confirmed recurrence.</p> Results <p>In 2236 patients, 577 patients had 604 sets of corresponding VHRI responses and cross-sectional images, yielding 70 imaging recurrences for a rate of 12% (95% CI: 9%–14%). More patients that had recurrences answered “no” to the question “Do you see or feel a bulge?” (41 vs. 29; <i>p</i> &lt; 0.01). Regarding the survey’s ability to screen for imaging recurrence, analysis showed a sensitivity and positive predictive value of 41% and 21% for “Do you see or feel a bulge?”, 28% and 20% for “Do you think your hernia has come back?”, and 43% and 16% for “Do you have any physical symptoms or pain at the site?”. When all three questions were used together—defining recurrence as a “yes” to any question—the sensitivity increased to 66% and the positive predictive value was 14%.</p> Conclusion and relevance <p>These findings suggest that the VHRI tool has a relatively low sensitivity and PPV when used as a screening tool for recurrences identified on cross-sectional imaging. Future work should focus on the discordance between patient-reported outcomes and recurrences identified on imaging.</p>

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Do patient-reported outcomes reliably screen for radiographic hernia recurrence? External validation of the ventral hernia recurrence inventory

  • 期刊论文

  • 发表日期：

    2026年3月16日

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  • Alvaro C. Carvalho,
  • William C. Bennet,
  • Erika M. Schmidt,
  • Noah X. Tocci,
  • Luciano Tastaldi,
  • Benjamin T. Miller,
  • Lucas R. Beffa,
  • Michael J. Rosen,
  • David M. Krpata,
  • Ajita S. Prabhu,
  • Clayton C. Petro

摘要

Importance

The Ventral Hernia Recurrence Inventory (VHRI) was developed to establish a relationship between patient-reported outcomes and hernia recurrence after repair. Positive responses have subsequently been adopted as a screening mechanism for recurrence for patients that are unable to attend follow-up visits.

Objective

We aimed to externally validate the VHRI compared with recurrences identified on cross-sectional imaging.

Design

This is a retrospective analysis of patients that have undergone abdominal hernia repairs between 2014 and 2023 and had completed at least 1 year of follow-up from their index surgery.

Setting

Ventral hernia repairs and corresponding imaging analyses were carried out by surgeons with fellowship training in abdominal wall reconstruction.

Participants

Patients included in this cohort were also included in previously published clinical trials and retrospective cohorts with VHRI responses captured within 4 months of cross-sectional imaging. All reviewed images were obtained at least 1 year after the index surgery, up to a maximum of 4 years.

Main outcomes

The primary outcome was the sensitivity and positive predictive value of the VHRI for detecting imaging-confirmed recurrence.

Results

In 2236 patients, 577 patients had 604 sets of corresponding VHRI responses and cross-sectional images, yielding 70 imaging recurrences for a rate of 12% (95% CI: 9%–14%). More patients that had recurrences answered “no” to the question “Do you see or feel a bulge?” (41 vs. 29; p < 0.01). Regarding the survey’s ability to screen for imaging recurrence, analysis showed a sensitivity and positive predictive value of 41% and 21% for “Do you see or feel a bulge?”, 28% and 20% for “Do you think your hernia has come back?”, and 43% and 16% for “Do you have any physical symptoms or pain at the site?”. When all three questions were used together—defining recurrence as a “yes” to any question—the sensitivity increased to 66% and the positive predictive value was 14%.

Conclusion and relevance

These findings suggest that the VHRI tool has a relatively low sensitivity and PPV when used as a screening tool for recurrences identified on cross-sectional imaging. Future work should focus on the discordance between patient-reported outcomes and recurrences identified on imaging.