Carolinas HealthCare System

Carolinas Equation for Quality of Life - CeQOL

Carolinas Medical Center Recognized in the Wall Street Journal for Hernia Repair

Read article: "A Secret for Patients Undergoing Hernia Repair"

What does CeQOL do?
(PDF Version)

Hernia repairs are the most common operation performed worldwide, and, for many years, the surgical measure of success was almost solely considered to be the lack of hernia recurrence. Today, better defined surgical techniques and the use of mesh to repair a hernia have substantially decreased the incidence of surgical failure. Given this, we believe that the next phase in hernia surgery is to use a patient's quality-of-life (QOL) as the major measure of operative success.

The Carolinas Equation for Quality of Life (CeQOL) predicts the incidence of chronic discomfort following inguinal hernia repair. Users simply answer 19 simple questions about themselves, their hernia, and their current QOL status as it relates to their hernia, and a percentage chance of having some form of discomfort one year following surgery is produced and interpreted. The complex mathematical equation, which was derived from closely following patients from around the world after their surgery, has been independently tested and found to be accurate and reliable. Our ultimate goal is to use mobile app technology to provide surgeons and patients with a powerful educational tool that can predict individualized QOL outcomes after inguinal hernia surgery and offer patients extensive educational materials concerning many types of hernias and their treatments.

Where did CeQOL come from?
(PDF Version)

The International Hernia Mesh Registry (IHMR) was founded by Ethicon, Inc., a Johnson and Johnson company, in an effort to obtain unbiased surgical and quality of life outcomes data associated with hernia repair. To ensure the greatest possible impact, Ethicon formed a panel of leading hernia experts from around the world to function as an advisory board for the design and ongoing operation of the Registry. Surgeons and surgical scientists from the United States, Europe, Canada, and Australia participated in all phases of the study to ensure that the information was an international measure of hernia surgery outcomes. To date over 3700 patients are enrolled from 37 sites in ten countries. Patient quality of life outcomes were assessed via the Carolinas Comfort Scale® (CCS), a validated quality of life measurement tool specific to hernia repair, at baseline, 30 days post op, six months, 12 months and 24 months.

The IHMR was the first outcomes study of its kind ever performed; just to consider it was bold and ambitious and required a significant commitment of time and resources. To date, more than 4000 patients from all over the world have participated, and the volume of valuable information for surgeons and patients alike has been extraordinary. The scientific conclusions from the multitude of questions posed to the database have been presented and published in some of the most prestigious and important medical meetings and journals throughout the world. There is little doubt that Ethicon's commitment to patient-derived outcomes will change how both surgeons and patients approach the most common surgical procedures in the world - the repair of hernias.

Ethicon has become the benefactor of healthcare providers and their patients who have hernias. Evaluation of best surgical practice applications and their corresponding quality of life outcomes have and will have a great impact on surgical practice today and in the future. The unique nature of the data in the IHMR lends itself to complex mathematical analysis, allowing development of a predictive tool for quality of life after an operation – before the surgery actually occurs. This is remarkable, a break-through, and sets the standard for which we should strive with every operation or treatment plan: an objective tool to predict individualized quality of life outcomes from a proposed operation or therapy. As part of a mature and thoughtful consent, it allows for a physician and patient to not only discuss the patient’s options, the risks and possible complications. This mathematical algorithm permits a rich discussion of the expected quality of life after the proposed treatment so that it might play a major role in a patient’s decision making.

For more information, email us at ceqol@carolinashealthcare.org.

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