Understanding patient-reported knowledge of hernia surgery: a quantitative study

ENGINE-An EHS Project for Future Guidelines

Clinical guidelines are evidence-based recommendations developed by healthcare organizations or expert panels to assist healthcare providers and patients in making appropriate and reliable decisions regarding specific health conditions, aiming to enhance the quality of healthcare by promoting best practices, reducing variations in care, and at the same time, allowing tailored clinical decision-making. European Hernia Society (EHS) guidelines aim to provide surgeons a reliable set of answers to their pertinent clinical questions and a tool to base their activity as experts in the management of abdominal wall defects. The traditional approach to guideline production is based on gathering key opinion leader in a particular field, to address a number of key questions, appraising papers, presenting evidence and produce final recommendations based on the literature and consensus. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method offers a transparent and structured process for developing and presenting evidence summaries and for carrying out the steps involved in developing recommendations. Its main strength lies in guiding complex judgments that balance the need for simplicity with the requirement for complete and transparent consideration of all important issues. EHS guidelines are of overall good quality but the application of GRADE method, began with EHS guidelines on open abdomen, and the increasing adherence to the process, has greatly improved the reliability of our guidelines. Currently, the need to application of this methodology and the creation of stable and dedicated group of researchers interested in following GRADE in the production of guidelines has been outlined in the literature. Considering that the production of clinical guidelines is a complex process, this paper aim to highlights the primary features of guideline production, GRADE methodology, the challenges associated with their adoption in the field of hernia surgery and the project of the EHS to establish a stable guidelines committee to provide technical and methodological support in update of previously published guideline or the creation of new ones.

Ventral Hernia in the Al-Ahsa Region, Saudi Arabia: Risk Factor Knowledge Assessment

Introduction A ventral hernia is defined as a non-inguinal, non-hiatal defect in the fascia of the abdominal wall. Approximately 350,000 ventral hernia procedures are performed each year. Ventral hernia can have a negative impact on a person's quality of life and, in severe situations, lead to hospitalization and even death. Aim This study aimed to assess the knowledge of the general population living in the Al-Ahsa region regarding the risk factors of ventral hernia. Subjects and methods This is a cross-sectional study conducted among the general population living in the Al-Ahsa region of Saudi Arabia. A self-administered questionnaire was distributed among the population using an online platform. The questionnaire includes basic demographic characteristics (age, gender, and body mass index (BMI)) and a nine-item questionnaire to assess the knowledge of risk factors of ventral hernia. Results Of the 803 respondents involved, 42.1% were aged between 22 and 28 years old, and 44.4% were either overweight or obese. According to participants' knowledge, the most common risk factor of ventral hernia was heavy weight lifting (87.4%), and pregnancy and labor (64.1%). The overall mean knowledge score was 5.78 (standard deviation (SD): 2.68) out of 12 points. Nearly half (49.4%) were considered to have poor knowledge levels, 40.2% were considered to have moderate knowledge levels, and only 10.6% were considered to have good knowledge levels. Increased knowledge was seen more frequently in younger participants, males, and respondents with normal or underweight BMI. Conclusion The knowledge of the general population regarding the risk factors of ventral hernia was insufficient. Of all the population, male respondents who were younger and had a normal body mass index demonstrated a better understanding of the ventral hernia's risk factors compared to the rest of the subjects. Further research is needed to establish the knowledge of the general population regarding the risk factors of ventral hernia in our region.