# Developing and Implementing Evidence-Based Hernia Care

> **NIH AHRQ K08** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $140,324

## Abstract

Project Summary
 Abdominal wall hernia repair is one of the most common operations performed in the United States.
Despite nearly every general surgeon in the country performing hernia repair, it remains the most
systematically understudied surgical procedure. Considerable variability in surgical approach exists for even
the most basic hernias. This variability results in suboptimal patient outcomes, both long and short term, as
well as a 3.2-billion-dollar cost to the healthcare system. The lack of comparative effectiveness research
impedes evidence-based practice. There are three key knowledge gaps to be addressed. First, we do not
understand the relationship between different surgical approaches, (e.g., minimally invasive and open) for
hernia repair and patient outcomes. Second, it is unclear whether it is necessary to tailor surgical approach
based on patient characteristics. Finally, the barriers and enablers to adoption of evidence-based practice
across hernia surgeons have not been explored. This proposal will address these key gaps. Leveraging the
capital from two unique data registries, the America Hernia Society Quality Collaborative (AHSQC) and the
Michigan Surgery Quality Collaborative (MSQC), we will explore the effectiveness of commonly employed
surgical approaches by hernia type and patient characteristics. Synthesizing this data with relevant
comparative effectiveness literature, we will develop evidence-based hernia recommendations and qualitatively
assess the barriers and facilitators to surgeon implementation of the proposed recommendations. The aims of
this research proposal are to 1) Evaluate the comparative effectiveness of commonly performed surgical
techniques for hernia repair 2) Identify heterogeneity in comparative effectiveness of hernia repair by patient
subgroups 3) Identify the barriers and facilitators to implementation of evidence-based hernia practice, based
on hernia and patient characteristics. In addition to the innovative research plan, this proposal will provide the
career development candidate (Dana Telem) with a rich mentorship experience. It will also provide her with the
methodologic training in comparative effectiveness research and a strong theoretical background in
implementation science. This project will lay the groundwork for Dr. Telem to become an independent
investigator focused on developing and implementing evidence-based approaches for common surgical
problems.

## Key facts

- **NIH application ID:** 9936308
- **Project number:** 5K08HS025778-03
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Dana Alexa Telem
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $140,324
- **Award type:** 5
- **Project period:** 2018-07-01 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9936308

## Citation

> US National Institutes of Health, RePORTER application 9936308, Developing and Implementing Evidence-Based Hernia Care (5K08HS025778-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9936308. Licensed CC0.

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