Experience with the PINQ-PHONE telephone questionnaire for detection of recurrences after endoscopic inguinal hernia repair

PurposeThe PINQ-PHONE is a 4-question telephone questionnaire designed and validated as a recurrence detection method after laparo-endoscopic inguinal hernia repair. The study aim was to evaluate the PINQ-PHONE by describing our experience with the questionnaire in a high-volume randomized-controlled trial.MethodsThe PINQ-PHONE was performed 5years postoperatively after endoscopic totally extraperitoneal (TEP) repair. Positive PINQ-PHONE responses were compared with clinical assessments for a recurrence. An experience with the PINQ-PHONE-survey was conducted among the executing researchers. Furthermore, positive predictive values (PPV) for the separate questions and overall PINQ-PHONE were determined.ResultsFifty-two of 769 responding patients (6.8%) had positive PINQ-PHONE responses and were invited to visit the outpatient clinic, thus preventing follow-up visits in 93.2% of included patients. Two recurrences were detected (0.3%). The overall PPV of the PINQ-PHONE was low (0.057). The PPV of question 1 (0.040) and 2 (0.100) was lower than that of question 3 (0.222) and 4 (0.286). The PPV of only question 3 and 4 combined was 0.183, and no recurrence would have been missed. The researcher survey unanimously produced that the PINQ-PHONE was user-friendly and executed in <5min, and questions 3 and 4 were considered adequate for recurrence detection. The majority found questions 1 and 2 to be inadequate questions.ConclusionsThe PINQ-PHONE proved to be a valuable tool in TEP repair follow-up for recurrences. Enhancement of the PINQ-PHONE using only question 3 and 4 is recommended, since more patients refrain from outpatient clinic visits, and nevertheless, recurrences are safely detected.