Impact of disclosure of radiographic test results on quality of life among patients with occult hernias: a randomized controlled trial

Abstract Aim Ventral and groin hernias are commonly diagnosed using radiographic imaging. We aimed to determine if informing patients of the presence of a clinically apparent or occult hernia on imaging would change their abdominal wall quality of life (AW-QOL). Materials and Methods Consecutive patients with a hernia on elective CT abdomen/pelvis were enrolled. Patients underwent standardized abdominal examination by surgeons, and completed the modified Activities Assessment Scale, a validated, hernia-specific AW-QOL survey. On this scale, 1 is poor AW-QOL, 100 is perfect, and the minimally clinically important difference is 7. Patients were randomized to complete the one-year follow-up survey before or after being informed of the presence of a hernia on their imaging results. Primary outcome was change in AW-QOL compared to baseline. Results Of 169 patients randomized, 126 (75%) completed follow up at one-year. Among patients with occult hernias, those who completed the follow-up survey after being informed of having a hernia had a lower follow-up AW-QOL (mean difference -7.6, 95% CI = -20.8 to 5.7, p=0.261) compared to those who completed the survey before being informed. Conversely, for patients with clinical hernias, those who completed the survey after being informed had higher adjusted follow-up AW-QOL (mean difference 10.3, 95% CI = -3.0 to 23.6, p = 0.126) than those that completed it after. Conclusions Conveying findings of hernias found on CT imaging can influence patients’ AW-QOL. Future research should focus on identifying and addressing patients’ concerns after disclosure of CT results.