The Surgical Outcomes Measurement System (SOMS) is a Superior Measure of Patient Centered Outcomes Following Hernia Repair Compared to Short Form 36

Introduction: The Surgical Outcomes Measurement System (SOMS) is a novel tool designed to specifically assess postoperative recovery but has not been validated. Alternatively, Short Form 36 (SF-36) is commonly used in... [ view full abstract ]

Introduction: The Surgical Outcomes Measurement System (SOMS) is a novel tool designed to specifically assess postoperative recovery but has not been validated. Alternatively, Short Form 36 (SF-36) is commonly used in surgery, but was designed for chronic diseases with content not specific to postoperative patients.  We aimed to validate SOMS and test if SOMS has favorable psychometrics compared to SF-36 in hernia repair patients.

Methods: Single institution prospective database of 1165 hernia repairs from March 2010 to August 2015. All patients received questionnaires postoperatively at 3 weeks, 6 months and 1 year which included Carolina Comfort Scale (CCS), a validated tool for hernia repairs and either one overall quality of life measurement system (SOMS, n=871 or SF-36, n=671), or both SOMS and SF-36 (n=377).

Results:  SOMS demonstrated good internal reliability (Cronbach's alpha 0.81 to 0.97).  In comparison analysis, all SOMS domains correlated statistically better with overall CCS scores (Pearson correlation coefficient, ρ: 0.50-0.78) as compared to SF-36 domains (ρ: 0.37-0.59) at 3 weeks.  SOMS also exhibited greater discriminant ability between poor outcome (CCS≥30) and good outcome (CCS<30) as compared to SF-36.  In fact some SF-36 domains demonstrated no discriminant properties in this study population.

Conclusions:  SOMS is both a valid and a superior measure of overall quality of life after hernia surgery over SF-36, with better correlation of postoperative outcome and discriminative properties. SOMS shows promise to replace SF-36 as the generic quality of life tool for surgical patients, however future studies are necessary in other surgical cohorts.