• Br J Surg · Jul 2022

    Development of the ParaOesophageal hernia SympTom (POST) tool.

    • Aiysha Puri, Nikhil M Patel, Viknesh Sounderajah, Lorenzo Ferri, Ewen A Griffiths, Donald Low, Nick Maynard, Carmen Mueller, Manuel Pera, Mark I van Berge Henegouwen, David I Watson, Giovanni Zaninotto, George B Hanna, Sheraz R Markar, and POST Collaborative.
    • Department of Surgery and Cancer, Imperial College London, London, UK.
    • Br J Surg. 2022 Jul 15; 109 (8): 727732727-732.

    BackgroundThe aim of this study was to develop a symptom severity instrument (ParaOesophageal hernia SympTom (POST) tool) specific to para-oesophageal hernia (POH).MethodsThe POST tool was developed in four stages. The first was establishment of a Steering Committee. In the second stage, items were generated through a systematic review and online scoping survey of international experts. In the third stage, a three-round modified Delphi consensus process was conducted with a group of international experts who were asked to rate the importance of candidate items. An a priori threshold for inclusion was set at 80 per cent. The modified Delphi process culminated in a consensus meeting to develop the first iteration of the tool. In the final stage, two international patient workshops were held to assess the content validity and acceptability of the POST tool.ResultsThe systematic review and scoping survey generated 64 symptoms, refined to 20 for inclusion in the modified Delphi consensus process. Twenty-six global experts participated in the Delphi consensus process. Five symptoms reached consensus across two rounds: difficulty getting solid foods down, chest pain after meals, difficulty getting liquids down, shortness of breath only after meals, and an early feeling of fullness after eating. The subsequent patient workshops deemed these five symptoms to be relevant and suggested that reflux should be included; these were taken forward to create the final POST tool.ConclusionThe POST tool is the first instrument designed to capture POH-specific symptoms. It will allow clinicians to standardize reporting of symptoms of POH and evaluate the response to surgical intervention.© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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