Meuzelaar, R.R. (2021) Feasibility of the Inguinal Hernia Smartphone Application for Inguinal Hernia Repair: A pilot study. thesis, Medicine.
Full text available on request.Abstract
Background: Inguinal hernia repair accounts for the majority of elective surgery performed worldwide and generates substantial consumption of healthcare resources. In a climate of growing healthcare expenditure it is important to minimize the burden of disease and healthcare costs while optimizing clinical efficiency. Better techniques for inguinal hernia surgery, implementation of clinical care pathways and high-volume clinics have contributed to a reduction of healthcare budget. Yet, significant effect could be achieved by reducing regular follow-up and unplanned consultations. Furthermore traditional registration of patient related outcomes (PROs) for follow-up stays challenging due to missing data, recall bias and transcription errors. In order to overcome these challenges, the Inguinal Hernia application (IH-app) was created. Objective: The main goal of the application is to minimize unnecessary healthcare consumption by supplying patient information and to facilitate registration of PROs for internal quality control and research. In this study we evaluated the usability and validity of the IH-app. Methods: This prospective cohort study was performed in a high-volume hernia clinic. During a 2-month period all patients between 18- 80 years scheduled for elective hernia repair were included if they possessed a smartphone compatible with the app and understood the Dutch language sufficiently. To examine feasibility the utilization of the app was evaluated through a newly formulated survey. Questionnaires in the app were asked at specific time points (pre-op, 2 and 6 weeks post-op and 44 days post-op). Results from the app surveys were validated by comparing them to the standardized EuraHS-Quality of Life (QoL) instrument pre-operatively and 6 weeks post-operatively. In addition test-retest reliability was examined comparing scores obtained at s6 weeks and 6 weeks and 2 days. Results: From May until July 2021 a total of 290 patients were assessed for eligibility and a sample of 100 patients was included. The median age was 56 years (inter quartile range (IQR) 40-64) with an average Body Mass Index (BMI) of 25.2 and predominantly being male (98%). The majority of subjects received a TEP procedure (TEP vs Lichtenstein, 78 vs 22). Of the 100 patients, 96 completed the evaluation survey. Most respondents valued the application (67%) as a supplementary tool to their treatment, reported that the information provided in the app was useful (pre-operative: 77%, 6-weeks postoperative: 71%) and agreed the application was user-friendly (71%). Barely half of the patients (n=45) answered all four surveys. The reliability of the app was considered excellent (>0.90) and convergent validity was significant (p=0.01). The same applies to the test-retest reliability for all variables with a large sample size (p=0.01). Conclusions: The IH-app is an innovative tool serving as patient information platform and is reliable for patient data registration. However, further improvements are necessary to facilitate adequate registration of PROs. These should target increasing compliance and acquiring compatibility with electronic patient files. Additional research is needed to investigate if the IH-app reduces unnecessary postoperative consultations by telephone or at the outpatient clinic and its effect on the total costs.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Burgmans, J.P.J. and Westreenen, H.L. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 10:14 |
| Last Modified: | 07 Jan 2022 10:14 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2993 |
Actions (login required)
 |
View Item |