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Validation of the GerdQ questionnaire for the diagnosis of gastro-oesophageal reflux disease.
Aliment Pharmacol Ther. 2013 Mar; 37(5):564-72.AP

Abstract

BACKGROUND

The diagnosis of gastro-oesophageal reflux disease (GERD) remains a challenge as both invasive methods and symptom-based strategies have limitations. The symptom-based management of GERD in primary care may be further optimised with the use of a questionnaire.

AIM

To assess the diagnostic validity of the GerdQ questionnaire in patients with symptoms suggestive of GERD.

METHODS

Patients with symptoms suggestive of GERD without alarm features, underwent upper endoscopy, and if normal, pH-metry. Patients were followed for 4 weeks and GerdQ was completed blinded to the investigator at both visits. Reflux oesophagitis or pathological acid exposure was used as diagnostic references for GERD. The diagnostic accuracy for GERD on symptom response to proton pump inhibitor (PPI) was assessed.

RESULTS

Among the 169 patients, a GerdQ cutoff ≥9 gave the best balance with regard to sensitivity, 66% (95% CI: 58-74), and specificity, 64% (95% CI: 41-83), for GERD. The high prevalence of reflux oesophagitis (81%) resulted in a high proportion of true positives, but at the same time a high proportion of false-negatives. Consequently, GerdQ had a high positive predictive value, 92% (95% CI: 86-97), but a low negative predictive value, 22% (95% CI: 13-34), for GERD. Symptom resolution on PPI therapy had high sensitivity, 76% (95% CI: 66-84), but low specificity, 33% (95% CI: 17-53), for GERD.

CONCLUSIONS

GerdQ is a useful complementary tool for the diagnosis of gastro-oesophageal reflux disease in primary care. The implementation of GerdQ could reduce the need for upper endoscopy and improve resource utilisation. Symptom resolution on proton pump inhibitor did not predict gastro-oesophageal reflux disease.

Authors+Show Affiliations

Institute of Medicine, University of Bergen, Norway. christian.jonasson@med.uib.noNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

23289763

Citation

Jonasson, C, et al. "Validation of the GerdQ Questionnaire for the Diagnosis of Gastro-oesophageal Reflux Disease." Alimentary Pharmacology & Therapeutics, vol. 37, no. 5, 2013, pp. 564-72.
Jonasson C, Wernersson B, Hoff DA, et al. Validation of the GerdQ questionnaire for the diagnosis of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2013;37(5):564-72.
Jonasson, C., Wernersson, B., Hoff, D. A., & Hatlebakk, J. G. (2013). Validation of the GerdQ questionnaire for the diagnosis of gastro-oesophageal reflux disease. Alimentary Pharmacology & Therapeutics, 37(5), 564-72. https://doi.org/10.1111/apt.12204
Jonasson C, et al. Validation of the GerdQ Questionnaire for the Diagnosis of Gastro-oesophageal Reflux Disease. Aliment Pharmacol Ther. 2013;37(5):564-72. PubMed PMID: 23289763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Validation of the GerdQ questionnaire for the diagnosis of gastro-oesophageal reflux disease. AU - Jonasson,C, AU - Wernersson,B, AU - Hoff,D A L, AU - Hatlebakk,J G, Y1 - 2013/01/07/ PY - 2012/11/16/received PY - 2012/12/03/revised PY - 2012/12/17/revised PY - 2012/12/17/accepted PY - 2013/1/8/entrez PY - 2013/1/8/pubmed PY - 2013/7/19/medline SP - 564 EP - 72 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 37 IS - 5 N2 - BACKGROUND: The diagnosis of gastro-oesophageal reflux disease (GERD) remains a challenge as both invasive methods and symptom-based strategies have limitations. The symptom-based management of GERD in primary care may be further optimised with the use of a questionnaire. AIM: To assess the diagnostic validity of the GerdQ questionnaire in patients with symptoms suggestive of GERD. METHODS: Patients with symptoms suggestive of GERD without alarm features, underwent upper endoscopy, and if normal, pH-metry. Patients were followed for 4 weeks and GerdQ was completed blinded to the investigator at both visits. Reflux oesophagitis or pathological acid exposure was used as diagnostic references for GERD. The diagnostic accuracy for GERD on symptom response to proton pump inhibitor (PPI) was assessed. RESULTS: Among the 169 patients, a GerdQ cutoff ≥9 gave the best balance with regard to sensitivity, 66% (95% CI: 58-74), and specificity, 64% (95% CI: 41-83), for GERD. The high prevalence of reflux oesophagitis (81%) resulted in a high proportion of true positives, but at the same time a high proportion of false-negatives. Consequently, GerdQ had a high positive predictive value, 92% (95% CI: 86-97), but a low negative predictive value, 22% (95% CI: 13-34), for GERD. Symptom resolution on PPI therapy had high sensitivity, 76% (95% CI: 66-84), but low specificity, 33% (95% CI: 17-53), for GERD. CONCLUSIONS: GerdQ is a useful complementary tool for the diagnosis of gastro-oesophageal reflux disease in primary care. The implementation of GerdQ could reduce the need for upper endoscopy and improve resource utilisation. Symptom resolution on proton pump inhibitor did not predict gastro-oesophageal reflux disease. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/23289763/Validation_of_the_GerdQ_questionnaire_for_the_diagnosis_of_gastro_oesophageal_reflux_disease_ L2 - https://doi.org/10.1111/apt.12204 DB - PRIME DP - Unbound Medicine ER -