Evidence map›Paper›PMID 38227093›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2024

The enigma of incisional hernia prediction unraveled: external validation of a prognostic model in colorectal cancer patients.

C Amro, L Smith, J Shulkin, J R McGraw, N Hill, R B Broach, J Torkington, J P Fischer

Abstract read
PubMed Publisher
In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.7field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. The invite study: incisional hernia prevention: prophylactic mesh from the patient's perspective.Hernia : the journal of hernias and abdominal wall surgery · 2025
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

C Amro *Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14t Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA. Chris.amro@pennmedicine.upenn.edu.ORCID 0000-0001-6002-8265
L Smith *Department of Colorectal Surgery, University Hospital of Wales, Cardiff, UK.
J ShulkinDivision of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14t Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
J R McGrawDivision of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14t Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
N HillSchool of Medicine, Cardiff University, Cardiff, UK.
R B BroachDivision of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14t Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
J TorkingtonDepartment of Colorectal Surgery, University Hospital of Wales, Cardiff, UK.
J P FischerDivision of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, PCAM South Pavilion 14t Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
University of Pennsylvania Health System · USUniversity Hospital of Wales · GBCardiff University · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAccurate prediction of hernia occurrence is vital for surgical decision-making and patient management, particularly in colorectal surgery patients. While a hernia prediction model has been developed, its performance in external populations remain to be investigated. This study aims to validate the existing model on an external dataset of patients who underwent colorectal surgery.

methodsThe "Penn Hernia Calculator" model was externally validated using the Hughes Abdominal Repair Trial (HART) data, a randomized trial comparing colorectal cancer surgery closure techniques. The data encompassed demographics, comorbidities, and surgical specifics. Patients without complete follow-up were omitted. Model performance was assessed using key metrics, including area under the curve (AUC-ROC and AUC-PR) and Brier score. Reporting followed the TRIPOD consensus.

resultsAn external international dataset consisting of 802 colorectal surgery patients were identified, of which 674 patients with up to 2 years follow-up were included. Average patient age was 68 years, with 63.8% male. The average BMI was 28.1. Prevalence of diabetes, hypertension, and smoking were 15.7%, 16.3%, and 36.5%, respectively. Additionally, 7.9% of patients had a previous hernia. The most common operation types were low anterior resection (35.3%) and right hemicolectomy (34.4%). Hernia were observed in 24% of cases by 2-year follow-up. The external validation model revealed an AUC-ROC of 0.66, AUC-PR of 0.72, and a Brier score of 0.2.

conclusionThe hernia prediction model demonstrated moderate performance in the external validation. Its potential generalizability, specifically in those undergoing colorectal surgery, may suggest utility in identifying and managing high-risk hernia candidates.

Indexed as

Colorectal NeoplasmsIncisional HerniaAbdomenAgedFemaleHerniorrhaphyHumansMalePrognosisRandomized Controlled Trials as TopicRetrospective StudiesColorectalExternal validationHerniaPenn Hernia CalculatorPredictionRisk assessment

Identifiers

PMID38227093
OpenAlexW4390913461

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.