Limits Of The Reflux Disease Questionnaire In General Practice

Main Category: Acid Reflux/GERD
Also Included In: GastroIntestinal / Gastroenterology
Article Date: 16 Apr 2007 - 0:00 PDT

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A new study, published in the journal "Digestion", determined the diagnostic and therapeutic response of the Reflux Disease Questionnaire (RDQ) using the symptom association probability as reference. The symptom association probability objectively determines with a Fisher exact test whether symptoms are due to reflux events taking all symptom episodes and reflux events into account. In addition, the RDQ's construct validity and its relationship to quality of life were ascertained.

Seventy-four patients with gastro-oesophageal reflux disease (GORD) symptoms (age 51 years (22-78); male 62%) derived from primary care completed the RDQ, Gastrointestinal Rating Scale and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaires before and after a two-week course of esomeprazole, a proton pump inhibitor (40 mg daily). The symptom association probability was determined by a 24-hour pH recording before proton pump inhibitor treatment. The diagnostic abilities of the RDQ (total and 4 dimensions scores) were assessed with the area under the curve of a receiver operating curve. RDQ scores before and after proton pump inhibitor treatment were compared with Wilcoxon tests. Multiple linear regressions assessed the RDQ's construct validity (Gastrointestinal Rating Scale) and relationship to quality of life (QOLRAD).

The areas under the curve were low for all RDQ dimensions (<0.6). In patients positive for symptom association probability all RDQ dimensions improved (p < 0.0001) while the scores of those negative for symptom association probability did not (heartburn p < 0.01; GORD and total score p < 0.05; regurgitation and dyspepsia not significant). The RDQ was related to the total and reflux dimensions of the Gastrointestinal Rating Scale, while the food and drink quality of life dimension was linearly associated with the RDQ.

Therefore, the RDQ is a valid and reliable questionnaire with excellent construct validity and a good relationship to quality of life. The diagnostic value of the RDQ in primary care is limited, but combination with an additional proton pump inhibitor treatment course might improve the RDQ's ability to discriminate GORD patients according to their symptom association probability outcome.

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