Assessment of a Korean Gastrointestinal Symptom Rating Scale (KGSRS) for Measuring Quality of Life in Patients with GERD Hye-kyung Jung, Ki-Nam Shim, Tae Hun Kim, Sung-Ae Jung, Sun Young Yi, Doe-Young Kim, Kwon Yoo, Ilhwan Moon Background: As the incidence of gastro-esophageal reflux (GERD) is increasing in Asian countries, the appropriate assessment of the symptom severity, quality of life, and their response to treatment, has become increasingly important in these regions. Patients with GERD also complain of other GI symptoms, representing heterogeneity. Therefore, developing appropriate GI symptom questionnaire will be a key element in performing clinical trials in this particular setting. Our objective was to develop and validate a questionnaire about health related quality of life (HRQOL) in relation to GI symptoms in patients with GERD. Method: Sixty eight, consecutive patients with GERD at the ambulatory clinic of a tertiary care center and 216 healthy subjects were enrolled in the study. GERD was defined by the presence of typical GERD symptoms, heartburn and acid regurgitation which occur twice or more than per week, regardless of whether they were associated with endoscopic erosive changes (ERD) or not (NERD). All subjects had endoscopy and filled up two kinds of self-reported questionnaires: modified Korean form of GI rating scale (KGSRS), a newly developed instrument, and KSF-36 health survey (Korean version of Medical Outcomes Study Short Form), a conventional one. KGSRS consisted of 16 questionnaires; each question was scored on a 5-point scale of symptom severity and included symptom frequency. Results: Internal consistency reliabilities for the KGSRS scales ranged from 0.58 to 0.84. There was a significant correlation between the KGSRS and KSF-36 scale scores (Spearman’s r Z 0.62, p!0.05). There were statistically significant differences between patients with GERD and healthy controls in the mean KGSRS scale scores (p!0.05) and 5 out of 8 items in KSF-36 (p!0.05). The patients with NERD showed similar decrease of QOL compared to those with ERD. However, patients with NERD showed more prevalent decrease of QOL in individual items such as abdominal pain, dyspepsia and constipation than those with ERD. Conclusion: KGSRS seems to be able to be used as a test of good reliability and validity in discriminating symptom severity and frequency in patients with GERD. It is noteworthy that the QOL of patients with NERD was similarly decreased with patients with ERD, however, decreased QOL in relation to individual symptoms such as abdominal pain, dyspepsia and constipation was more prevalent than those with ERD. M1281 Endoscopic Screening for Varices in Cirrhotics: Data From a National Endoscopic Database (the CORI Project) Mary Kovalak, Jeremy Lake, Nora Mattek, David Lieberman, Glenn Eisen, Atif Zaman Purpose: The current American College of Gastroenterology (ACG) guidelines for primary prophylaxis of variceal hemorrhage in cirrhotics recommend screening for varices with upper endoscopy (EGD). The national screening pattern of endoscopists is not known. Patient characteristics associated with the finding of varices on screening endoscopy are not fully established. Aim: Evaluate national endoscopic practice patterns and factors associated with finding varices on screening endoscopy using a national endoscopic database. Methods: Endoscopic reports generated by the Clinical Outcomes Research Initiative (CORI) repository were analyzed to determine the annual variation and findings of screening upper endoscopies between 1/1/2000 and 12/31/2003. Results: Data from 69 CORI practices (44 community/16 academic/9 Veterans Affairs Medical Center (VAMC)) was evaluated. A total of 1688 of 172,854 EGDs (9.8 per 1,000 EGDs) were performed for the purpose of screening for varices. Overall, there was a linear increase in annual proportion of screening EGDs performed. A significantly greater proportion of variceal screening EGDs are performed in academic centers (28.3 per 1,000 EGDs) compared to VAMC (10.8 per 1,000 EGDs) and community (5.3 per 1,000 EGDs). Among screening EGDs (n Z 1688), 881 (52.2%) yielded varices. Varices were found more often in Child-Pugh class B/C (71.9%) compared to ChildPugh class A (42.7%) patients. Of those with varices found, patients with Child-Pugh class B/C were more likely to have large varices (vs. small/med sized) than patients with Child-Pugh class A (p Z 0.02). Among procedures with an etiology reported (78%), patients with alcohol as an etiology of cirrhosis were significantly more likely (!.001) to have varices found than those who did not. Conclusions: The data shows 1) The proportion of EGDs performed for variceal screening has increased between 2000 and 2003. 2) A higher proportion of EGDs are performed for variceal screening in academic centers compared to VAMC and community. 3) Varices were found more frequently in Child-Pugh classes B and C and in patients with cirrhosis due to alcohol. 4) Patients with Child-Pugh class B/C were more likely to have large varices than patients with Child-Pugh class A.