Protocol to develop a core outcome set in incisional hernia surgery: the HarMoNY Project

Introduction: Incisional hernia has an incidence of up to 20% following laparotomy and is associated with significant morbidity and impairment of quality of life. A variety of surgical strategies including techniques and mesh types are available to manage patients with incisional hernia. Previous works have reported significant heterogeneity in outcome reporting for abdominal wall herniae, including ventral and inguinal hernia. This is coupled with under-reporting of important clinical and patient-reported outcomes. The lack of standardisation in outcome reporting contributes to reporting bias, hinders evidence synthesis and adequate data comparison between studies. This project aims to develop a core outcome set (COS) of clinically important, patient-oriented outcomes to be used to guide reporting of future research in incisional hernia.

Methods: This project has been designed as an international, multicentre, mixed-methods project. Phase I will be a systematic review of current literature to examine the current clinical and patient-reported outcomes for incisional hernia and abdominal wall reconstruction. Phase II will identify the outcomes of importance to all key stakeholders through in depth qualitative interviews. Phase III will achieve consensus on outcomes of most importance and for inclusion into a COS through a Delphi process. Phase IV will achieve consensus on the outcomes that should be included in a final COS.

Ethics and dissemination: The adoption of this COS into clinical and academic practice will be endorsed by the American, British and European Hernia Societies. Its utilisation in future clinical research will enable appropriate data synthesis and comparison and will enable better clinical interpretation and application of the current evidence base. This study has been registered with the Core Outcome Measures in Effectiveness Trials initiative.


The aim of this project is to develop a COS of clinically important, patient-oriented outcomes to be used to guide reporting of future research in incisional hernia.


Deena Harji, Christophe Thomas, Stavros Antoniou, Harsha Chandraratan, Ben Griffiths, B Todd Heniford, Liam Horgan, Ferdinand Koeckerling, Manuel Lopez-Cano, Lisa Massey, Marc Miserez, Agneta Montgomery, Filip Muysoms, Benjamin Poulose, Wolfgang Reinpold, Neil Smart


Journal: BMJ Open
Volume: 12
Pages: -
Year: 2022
DOI: 10.1136/bmjopen-2021-059463

Further Study Information

Current Stage: Ongoing
Funding source(s): This project has been funded by the British Hernia Society and the European Hernia Society.

Health Area

Disease Category: Other

Disease Name: Hernia

Target Population

Age Range: 18 - 100

Sex: Either

Nature of Intervention: Surgery

Stakeholders Involved

Study Type

- COS for clinical trials or clinical research
- COS for practice


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