Specific HRQL instruments and symptom scores were more responsive than preference-based generic instruments in patients with GERD

Abstract

Objective To determine relative responsiveness of disease-specific and generic preference-based health-related quality of life instruments in gastroesophageal reflux disease (GERD). Study Design and Setting We compared standardized response means (SRM) of disease-specific and preference-based instruments in 217 outpatients with GERD. Results Quality of Life in Reflux and Dyspepsia and symptom scores were responsive across all domains, whereas global rating of change and Work Productivity and Activity Impairment-GERD only in single domains. The most responsive were Quality of Life in Reflux and Dyspepsia food/drink problems (SRM: 1.90, 95% confidence interval [CI]: 1.76–2.03) and vitality (SRM: 1.68, 95% CI 1.55–1.82) domains, Work Productivity and Activity Impairment-GERD workdays with reflux symptoms (SRM: 2.02, 95% CI 1.84–2.19), symptoms of heartburn (SRM: 1.83, 95% CI 1.69–1.96) and acid reflux (SRM: 1.48, 95% CI 1.35–1.62), and global rating of change in stomach problems (SRM: 2.19, 95% CI 2.05–2.32). The least responsive were Work Productivity and Activity Impairment-GERD domains related to hours absent at work (SRM: 0.22, 95% CI 0.05–0.38), reduced productivity at work (SRM: 0.66, 95% CI 0.48–0.83) and during other activities (SRM: 0.78, 95% CI 0.65–0.92), as well as emotional global rating of change (SRM: 0.72, 95% CI 0.58–0.85), and the standard gamble (SRM: 0.35, 95% CI 0.21–0.48), which was less responsive than the feeling thermometer (SRM: 0.92, 95% CI 0.78–1.05). Conclusions In patients with GERD, disease-specific health-related quality of life instruments and symptom scores showed greater responsiveness than preference-based generic instruments. The feeling thermometer proved more responsive than the standard gamble.