Validation of a brief inventory for diagnosis and monitoring of symptomatic gastro-oesophageal reflux.
BACKGROUND
This article presents a brief inventory for the diagnosis and monitoring of GORD symptoms.


METHODS
The inventory consists of five items pertaining to different aspects of GORD to be graded for frequency on a 5-point Likert scale. It was validated on a consecutive group of GORD patients diagnosed either by endoscopy (n = 25) or by 24-h ambulatory pH monitoring (acid exposure time > or = 5%; n = 233) and control subjects (n = 300).


RESULTS
Each of the inventory items was significantly associated with GORD (P < 0.001). Factor analysis indicated that all items loaded on a single scale with a high reliability (Cronbach alpha 0.88). Each item was weighted by its respective odds ratio in favour of GORD and a total score for the scale was then calculated as the sum of weighted scores on the five individual items. Receiver-operator (ROC) curve analysis implemented on a random sample comprising 67% of the group indicated that a total weighted score of 31.6 (percentage of the maximal possible weighted score) was 91% sensitive and 92% specific in the diagnosis of GORD. This score was then validated on the rest of the sample, where it correctly classified patients and controls with a sensitivity of 89% and specificity of 94%. The score proved stable on repeated administration in controls and in patients with stable symptoms, and decreased by 66% (P < 0.001) after 1 month of treatment with omeprazole in patients who reported symptom relief.


CONCLUSIONS
The scale described in this article is a brief, simple and accurate measure, for the diagnosis of GORD as well as for monitoring its symptoms.
Zimmerman
J
J
Gastroenterology Unit, Hadassah University Hospital, Kiryat Hadassah, Jerusalem, Israel. zimmerj@vms.huji.ac.il
D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
D000897:Anti-Ulcer Agents; D009853:Omeprazole