{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T22:57:05Z","timestamp":1776466625491,"version":"3.51.2"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["J. Abdom. Wall Surg."],"abstract":"<jats:p>Clinical guidelines are evidence-based recommendations developed by healthcare organizations or expert panels to assist healthcare providers and patients in making appropriate and reliable decisions regarding specific health conditions, aiming to enhance the quality of healthcare by promoting best practices, reducing variations in care, and at the same time, allowing tailored clinical decision-making. European Hernia Society (EHS) guidelines aim to provide surgeons a reliable set of answers to their pertinent clinical questions and a tool to base their activity as experts in the management of abdominal wall defects. The traditional approach to guideline production is based on gathering key opinion leader in a particular field, to address a number of key questions, appraising papers, presenting evidence and produce final recommendations based on the literature and consensus. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method offers a transparent and structured process for developing and presenting evidence summaries and for carrying out the steps involved in developing recommendations. Its main strength lies in guiding complex judgments that balance the need for simplicity with the requirement for complete and transparent consideration of all important issues. EHS guidelines are of overall good quality but the application of GRADE method, began with EHS guidelines on open abdomen, and the increasing adherence to the process, has greatly improved the reliability of our guidelines. Currently, the need to application of this methodology and the creation of stable and dedicated group of researchers interested in following GRADE in the production of guidelines has been outlined in the literature. Considering that the production of clinical guidelines is a complex process, this paper aim to highlights the primary features of guideline production, GRADE methodology, the challenges associated with their adoption in the field of hernia surgery and the project of the EHS to establish a stable guidelines committee to provide technical and methodological support in update of previously published guideline or the creation of new ones.<\/jats:p>","DOI":"10.3389\/jaws.2024.13007","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T04:11:10Z","timestamp":1720757470000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["ENGINE\u2014An EHS Project for Future Guidelines"],"prefix":"10.3389","volume":"3","author":[{"given":"Cesare","family":"Stabilini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavros","family":"Antoniou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederik","family":"Berrevoet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marja","family":"Boermeester","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umberto","family":"Bracale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"de Beaux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbora","family":"East","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakan","family":"G\u00f6k","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Lopez Cano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filip","family":"Muysoms","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Capoccia Giovannini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten","family":"Simons","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s10029-018-1873-2","article-title":"Accreditation and Certification Requirements for Hernia Centers and Surgeons: The ACCESS Project","volume":"23","author":"K\u00f6ckerling","year":"2019","journal-title":"Hernia"},{"key":"B2","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1016\/j.ijsu.2018.04.052","article-title":"Defining the Characteristics of Certified Hernia Centers in Italy: The Italian Society of Hernia and Abdominal wall Surgery Workgroup Consensus on Systematic Reviews of the Best Available Evidences","volume":"54","author":"Stabilini","year":"2018","journal-title":"Int J Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE Guidelines: 1. Introduction-GRADE Evidence Profiles and Summary of Findings Tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1136\/bmj.328.7454.1490","article-title":"Grading Quality of Evidence and Strength of Recommendations","volume":"328","author":"Atkins","year":"2004","journal-title":"Bmj"},{"key":"B5","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1007\/s10029-018-1818-9","article-title":"EHS Clinical Guidelines on the Management of the Abdominal wall in the Context of the Open or Burst Abdomen","volume":"22","author":"L\u00f3pez-Cano","year":"2018","journal-title":"Hernia"},{"key":"B6","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1097\/SLA.0000000000003036","article-title":"Guideline Assessment Project: Filling the GAP in Surgical Guidelines: Quality Improvement Initiative by an International Working Group","volume":"269","author":"Antoniou","year":"2019","journal-title":"Ann Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1016\/j.jclinepi.2012.03.013","article-title":"GRADE Guidelines: 14. Going from Evidence to Recommendations: The Significance and Presentation of Recommendations","volume":"66","author":"Andrews","year":"2013","journal-title":"J Clin Epidemiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1007\/s10029-009-0529-7","article-title":"European Hernia Society Guidelines on the Treatment of Inguinal Hernia in Adult Patients","volume":"13","author":"Simons","year":"2009","journal-title":"Hernia"},{"key":"B9","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1007\/s00464-018-6322-x","article-title":"Surgeon Utilization of Minimally Invasive Techniques for Inguinal Hernia Repair: A Population-Based Study","volume":"33","author":"Vu","year":"2019","journal-title":"Surg Endosc"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e2023684","DOI":"10.1001\/jamanetworkopen.2020.23684","article-title":"Exploration of Factors Associated with Surgeon Deviation from Practice Guidelines for Management of Inguinal Hernias","volume":"3","author":"Ehlers","year":"2020","journal-title":"JAMA Netw Open"},{"key":"B11","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1186\/1745-6215-14-357","article-title":"Laparoscopic Bridging vs. Anatomic Open Reconstruction for Midline Abdominal Hernia Mesh Repair [LABOR]: Single-Blinded, Multicenter, Randomized, Controlled Trial on Long-Term Functional Results","volume":"14","author":"Stabilini","year":"2013","journal-title":"Trials"},{"key":"B12","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1186\/s12874-017-0459-5","article-title":"A Scoping Review of Comparisons between Abstracts and Full Reports in Primary Biomedical Research","volume":"17","author":"Li","year":"2017","journal-title":"BMC Med Res Methodol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.jclinepi.2010.07.015","article-title":"GRADE Guidelines: 3. Rating the Quality of Evidence","volume":"64","author":"Balshem","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1016\/j.jclinepi.2013.02.004","article-title":"The GRADE Approach Is Reproducible in Assessing the Quality of Evidence of Quantitative Evidence Syntheses","volume":"66","author":"Mustafa","year":"2013","journal-title":"J Clin Epidemiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1002\/uog.19194","article-title":"Leone Roberti Maggiore U: Transvaginal Sonography with vs without Bowel Preparation in Diagnosis of Rectosigmoid Endometriosis: Prospective Study","volume":"53","author":"Ferrero","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A Revised Tool for Assessing Risk of Bias in Randomised Trials","volume":"366","author":"Sterne","year":"2019","journal-title":"Bmj"},{"key":"B17","doi-asserted-by":"publisher","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A Tool for Assessing Risk of Bias in Non-Randomised Studies of Interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"Bmj"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1016\/j.jclinepi.2011.01.012","article-title":"GRADE Guidelines 6. Rating the Quality of Evidence\u2013Imprecision","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.1016\/j.jclinepi.2011.03.017","article-title":"GRADE Guidelines: 7. Rating the Quality of Evidence\u2013Inconsistency","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1016\/j.jclinepi.2011.04.014","article-title":"GRADE Guidelines: 8. Rating the Quality of Evidence\u2013Indirectness","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1016\/j.jclinepi.2011.01.011","article-title":"GRADE Guidelines: 5. Rating the Quality of Evidence\u2013Publication Bias","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1016\/j.jclinepi.2011.06.004","article-title":"GRADE Guidelines: 9. Rating up the Quality of Evidence","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1093\/intqhc\/mzaa019","article-title":"Patient-Reported Outcome Measures for Inguinal Hernia Repair Are Insufficiently Validated: A Systematic Review","volume":"32","author":"Gram-Hanssen","year":"2020","journal-title":"Int J Qual Health Care"},{"key":"B24","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3389\/fsurg.2020.00017","article-title":"Patient-Reported Outcome Measures for Patients Undergoing Inguinal Hernia Repair","volume":"7","author":"Gram-Hanssen","year":"2020","journal-title":"Front Surg"},{"key":"B25","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1007\/s10029-020-02154-1","article-title":"Long-Term Patient-Reported Outcomes and Quality of the Evidence in Ventral Hernia Mesh Repair: A Systematic Review","volume":"24","author":"Sand\u00f8","year":"2020","journal-title":"Hernia"},{"key":"B26","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s10029-017-1718-4","article-title":"A Systematic Methodological Review of Reported Perioperative Variables, Postoperative Outcomes and Hernia Recurrence from Randomised Controlled Trials of Elective Ventral Hernia Repair: Clear Definitions and Standardised Datasets Are Needed","volume":"22","author":"Parker","year":"2018","journal-title":"Hernia"},{"key":"B27","doi-asserted-by":"publisher","first-page":"15","DOI":"10.3389\/fsurg.2015.00015","article-title":"Is Pooled Data Analysis of Ventral and Incisional Hernia Repair Acceptable?","volume":"2","author":"K\u00f6ckerling","year":"2015","journal-title":"Front Surg"},{"key":"B28","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1007\/s10029-019-02033-4","article-title":"Pooled Data Analysis of Primary Ventral (PVH) and Incisional Hernia (IH) Repair Is No More Acceptable: Results of a Systematic Review and Metanalysis of Current Literature","volume":"23","author":"Stabilini","year":"2019","journal-title":"Hernia"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1097\/SLA.0000000000002860","article-title":"Design, Conduct, and Analysis of Surgical Randomized Controlled Trials: A Cross-Sectional Survey","volume":"270","author":"Yu","year":"2019","journal-title":"Ann Surg"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1136\/bmj.39493.646875.AE","article-title":"Going from Evidence to Recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"Bmj"},{"key":"B31","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/j.jclinepi.2013.02.003","article-title":"GRADE Guidelines: 15. Going from Evidence to Recommendation-Determinants of a Recommendation's Direction and Strength","volume":"66","author":"Andrews","year":"2013","journal-title":"J Clin Epidemiol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1016\/j.surg.2019.08.021","article-title":"Lightweight Mesh Is Recommended in Open Inguinal (Lichtenstein) Hernia Repair: A Systematic Review and Meta-Analysis","volume":"167","author":"Bakker","year":"2020","journal-title":"Surgery"},{"key":"B33","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1097\/SLA.0000000000003831","article-title":"Heavyweight Mesh Is Superior to Lightweight Mesh in Laparo-Endoscopic Inguinal Hernia Repair: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials","volume":"273","author":"Bakker","year":"2021","journal-title":"Ann Surg"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1016\/S0140-6736(15)60459-7","article-title":"Small Bites versus Large Bites for Closure of Abdominal Midline Incisions (STITCH): A Double-Blind, Multicentre, Randomised Controlled Trial","volume":"386","author":"Deerenberg","year":"2015","journal-title":"Lancet"},{"key":"B35","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/S0140-6736(17)31332-6","article-title":"Prevention of Incisional Hernia with Prophylactic Onlay and Sublay Mesh Reinforcement versus Primary Suture Only in Midline Laparotomies (PRIMA): 2-Year Follow-Up of a Multicentre, Double-Blind, Randomised Controlled Trial","volume":"390","author":"Jairam","year":"2017","journal-title":"Lancet"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1093\/bjs\/znac302","article-title":"Updated Guideline for Closure of Abdominal wall Incisions from the European and American Hernia Societies","volume":"109","author":"Deerenberg","year":"2022","journal-title":"Br J Surg"},{"key":"B37","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1007\/s10029-019-01894-z","article-title":"Hernia Prevention: Practice Patterns and Surgeons' Attitudes about Abdominal wall Closure and the Use of Prophylactic Mesh","volume":"23","author":"Fischer","year":"2019","journal-title":"Hernia"},{"key":"B38","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1007\/s10029-021-02492-8","article-title":"Results from Patient-Reported Outcome Measures Are Inconsistently Reported in Inguinal Hernia Trials: A Systematic Review","volume":"26","author":"Gram-Hanssen","year":"2022","journal-title":"Hernia"},{"key":"B39","doi-asserted-by":"publisher","first-page":"769938","DOI":"10.3389\/fsurg.2021.769938","article-title":"Patient Views Around Their Hernia Surgery: A Worldwide Online Survey Promoted through Social Media","volume":"8","author":"East","year":"2021","journal-title":"Front Surg"},{"key":"B40","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1007\/s10029-021-02521-6","article-title":"Understanding Patient-Reported Knowledge of Hernia Surgery: A Quantitative Study","volume":"26","author":"Jim\u00e9nez","year":"2022","journal-title":"Hernia"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1016\/j.surg.2020.12.001","article-title":"Perceptions and Understanding about Mesh and Hernia Surgery: What Do Patients Really Think?","volume":"169","author":"Elhage","year":"2021","journal-title":"Surgery"},{"key":"B42","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1016\/j.jclinepi.2022.06.001","article-title":"A Framework Is Proposed for Defining, Categorizing, and Assessing Conflicts of Interest in Health Research","volume":"149","author":"Akl","year":"2022","journal-title":"J Clin Epidemiol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.1007\/s00134-018-5367-6","article-title":"Conflicts of Interest Disclosure Forms and Management in Critical Care Clinical Practice Guidelines","volume":"44","author":"Alhazzani","year":"2018","journal-title":"Intensive Care Med"},{"key":"B44","doi-asserted-by":"publisher","first-page":"48S","DOI":"10.1378\/chest.11-2286","article-title":"Introduction to the Ninth Edition: Antithrombotic Therapy and Prevention of Thrombosis, 9th Ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"Guyatt","year":"2012","journal-title":"Chest"},{"key":"B45","doi-asserted-by":"publisher","first-page":"71s","DOI":"10.1378\/chest.08-0693","article-title":"Executive Summary: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)","volume":"133","author":"Hirsh","year":"2008","journal-title":"Chest"},{"key":"B46","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.jclinepi.2016.07.007","article-title":"Guideline Conflict of Interest Management and Methodology Heavily Impacts on the Strength of Recommendations: Comparison between Two Iterations of the American College of Chest Physicians Antithrombotic Guidelines","volume":"81","author":"Agoritsas","year":"2017","journal-title":"J Clin Epidemiol"}],"container-title":["Journal of Abdominal Wall Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontierspartnerships.org\/articles\/10.3389\/jaws.2024.13007\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T04:11:15Z","timestamp":1720757475000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontierspartnerships.org\/articles\/10.3389\/jaws.2024.13007\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,12]]},"references-count":46,"alternative-id":["10.3389\/jaws.2024.13007"],"URL":"https:\/\/doi.org\/10.3389\/jaws.2024.13007","relation":{},"ISSN":["2813-2092"],"issn-type":[{"value":"2813-2092","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,12]]},"article-number":"13007"}}