Validation of the GerdQ questionnaire for the diagnosis of gastro‐oesophageal reflux disease. Issue 5 (7th January 2013)

• Record Type: Journal Article
• Authors: Jonasson, C.; Wernersson, B.; Hoff, D. A. L.; Hatlebakk, J. G.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 37:Issue 5(2013)
• Page Start: 564
• Page End: 572
• Publication Date: 2013-01-07
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.12204
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" xml:lang="en" id="apt12204-abs-0001"> <title>Summary</title> <sec id="apt12204-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="apt12204-sec-0002" sec-type="section"> <title>Aim</title> <p>To assess the diagnostic validity of the GerdQ questionnaire in patients with symptoms suggestive of GERD.</p> </sec> <sec id="apt12204-sec-0003" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="apt12204-sec-0004" sec-type="section"> <title>Results</title> <p>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.</p> </sec> <sec id="apt12204-sec-0005" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>