Establishing the minimal clinically important difference for the Hernia-Related Quality of Life Survey (HerQLes)

Background: Hernia-Related Quality of Life Survey (HerQLes) assesses quality of life (QoL) after hernia repair, but the minimal clinically important difference (MCID) is unknown.

Methods: Using 2013-2019 data from the Abdominal Core Health Quality Collaborative, HerQLes summary scores were calculated for VHR patients at baseline and 1-year. MCID was calculated using distribution-based method. Multivariate regression identified factors associated with exceeding MCID at 1 year.

Results: 1817 patients met criteria. MCID was identified as a change in HerQLes of at least 15.6 points. Mean 1-year post-op score was 74.9 (SD ± 26.2), which exceeded the MCID threshold (p < 0.001). Patients with increasing hernia width had higher odds of exceeding MCID at 1 year post-op (OR 1.04, p < 0.01), as did patients with greater ASA class (OR 8.9, p < 0.01).

Conclusion: Using MCID can help identify patients who may significantly improve QoL after VHR, as well as power clinical trials with QoL as primary outcome.