Evaluation of gastroesophageal reflux disease questionnaire in diagnosis of gastroesophageal reflux disease

Abstract

Objective To evaluate the feasibility of gastroesophageal reflux disease questionnaire (GerdQ) in diagnosis of gastroesophageal reflux disease(GERD) and clinical characteristics of patients with GERD in China. Meanwhile, a standard for diagnostic trial of GERD using proton pomp inhibitor (PPI) for Chinese population was developed. Methods A multicenter study on diagnosis of GERD based on GerdQ was carried out in five hospitals of China. All patients were presented with a 6-item GerdQ. The diagnostic value of GerdQ was assessed according to the positive findings of enoscopy, 24hour ambulatory esophageal pH monitoring or PPI trial. The pre-established criterion for PPI trial was compared with findings of enoscopy or 24-hour ambulatory esophageal pH monitoring in order to get optimized criterion for GerdQ. Results The sensitivity of the pre-established PPI trial was 0. 6627 and the specificity was 0. 4872. The statistical analysis indicated that the optimized standard for PPI trial was defined as the total scores of heartburn and regurgitation in last 3 days of the first week treatment being decreased by 3 points in comparison with those before treatment. The optimized standard for PPI trial had sensitivity of 0. 3787, specificity of 0. 8077, positive predictive value of 0. 8101 and negative predictive value of 0. 3750, as well as the maximum Youden index of 0. 1864. After rectification of the population, a cut-off points of ten had a sensitivity of 0. 6690 and specificity of 0. 4390 with maximum Youden index of 0. 4390. The diagnostic value of GerdQ was decreasing when the scoring was increasing in female patients aged 50 or above. Conclusions The GerdQ is approved of value in diagnosis of GERD. For those with obvious symptom and hardly response to PPI trial, the diagnosis of GERD must be made carefully. It is better for evaluation of PPI trial using scores in the last 3 days of the first week treatment. Key words: Gastroesophageal reflux disease; Questionnaire; Proton pomp inhibitors