If you're considering hernia repair surgery, you might want to check your smartphone.
Dr. Todd Heniford, a Carolinas Medical Center surgeon, and his colleagues have developed a free app to help hernia patients decide whether they will benefit from surgery.
Why hernia?
It's the most common surgery in the world, said Heniford, who was president of the American Hernia Society when he unveiled the app last March at the group's annual meeting in New York.
As he spoke, he said he watched physicians around the room reach for their phones to pull up the app.
It asks a few questions about age, symptoms, pain level and then calculates the probability a patient will experience chronic pain or discomfort after surgery. (You can find the free app by searching for "CeQOL.")
When Heniford demonstrated the app, he touched several pages on his electronic tablet, answering questions as a hypothetical patient, and came up with a 6 percent probability of pain after surgery.
It was quick and easy, and Heniford stresses, accurate.
The app is backed by a 3 1/2-page mathematical equation based on a study of more than 1,700 hernia surgery patients in North America, Europe and Australia.
The patients answered a questionnaire called the Carolinas Comfort Scale, developed by Heniford's team, to rate pre- and post-operative pain from zero to five under various circumstances -- while standing, lying down, walking, exercising, etc. Some of those patients have been tracked for more than four years.
Patients who have pain before surgery are more likely to have pain after a procedure, Heniford said, and younger patients tend to have more pain and discomfort than older ones.
In the informed consent process, Heniford said doctors traditionally advised patients primarily about the risks of infection or hernia recurrence. But in recent years, there has been a realization that "the impact on quality of life should be part of a consent process," Heniford said.
Studies show that 8 percent to 40 percent of patients who undergo groin hernia surgery have chronic pain afterward, according to General Surgery News. And poor results can lead to litigation.
In the United Kingdom, chronic pain following hernia repair is the No. 1 cause of malpractice suits. Heniford and his team say the probability of malpractice claims is higher in the United States. Improving patient education through a process that includes quality-of-life considerations can help reduce hernia malpractice claims, he said.
Using the questionnaire, the CMC research team was able to develop the equation that can predict patient outcomes.
"If you have enough quality data, then you can help people make quality decisions," said Heniford, chief of gastrointestinal and minimally invasive surgery at CMC.
In recent days, Heniford has operated on hernia patients from Florida, Alabama, Virginia, Tennessee and Indiana.
Many of them are referred by other doctors. But others find him through the Internet -- and now, the app store.
Karen Garloch: 704-358-5078 ___
