Grade C	Due to the increasing pace of change and the complexity of ventral/incisional hernia patients and techniques, use of traditional human subjects clinical research, evidence-based methods and guidelines in health care should be considered a starting point rather than a goal.
Grade C	The application of principles of complex adaptive systems science, particularly real-world clinical quality-improvement methods, likely will be required to improve the value of care (e.g., quality outcomes measures, satisfaction, patient experience, costs) for the patient with a ventral/incisional hernia.