Is the reflux disease questionnaire useful for identifying GERD according to the Montreal definition?
BACKGROUND
Scales for aiding physicians diagnose gastro-oesophageal reflux disease (GERD) have not been evaluated in terms of their ability to discriminate between troublesome symptoms (TS) and non-troublesome symptoms (NTS). Our objective is to evaluate the ability of the Reflux Disease Questionnaire (RDQ) to identify GERD according to referral of TS, in patients without previous proton pump inhibitor (PPI) treatment and in patients on PPI treatment.


METHODS
Patients consulting physicians because of heartburn or acid regurgitation were recruited at 926 primary-care centres in Spain. They were asked to complete several questionnaires including the RDQ, and to define which of their symptoms were troublesome. Information on drug treatment was collected by the physician. We performed a receiver operating characteristic (ROC) curve analysis to ascertain the RDQ's optimum cut-point for identifying TS.


RESULTS
4574 patients were included, 1887 without PPI and 2596 on PPI treatment. Among those without PPI treatment, 1722 reported TS. The area under the curve (AUC) was 0.79 for the RDQ, and the optimum RDQ cut-point for identifying TS was 3.18 (sensitivity, 63.2%; specificity, 80.2%). A total of 2367 patients on PPI treatment reported TS, and the optimum RDQ cut-off value was 3.06 (sensitivity, 65.4%; specificity, 71.8%).


CONCLUSIONS
An RDQ score higher than 3 shows good sensitivity and specificity for differentiating TS from NTS among patients without PPI or on PPI treatment. The RDQ is useful in primary care for diagnosis of GERD based on the Montreal definition.
Enrique
E
Rey
Department of Digestive Diseases, San Carlos Clinical Hospital, Madrid Complutense University, Madrid 28040, Spain. marta.barcelo@yahoo.es.
Marta
M
Barceló
Javier
J
Zapardiel
Eduardo
E
Sobreviela
Mercedes
M
Muñoz
Manuel
M
Díaz-Rubio
D000328:Adult; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006356:Heartburn / Q000209:etiology; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000209:etiology; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors; D012372:ROC Curve; D013030:Spain; D011795:Surveys and Questionnaires
D054328:Proton Pump Inhibitors