A validated symptoms questionnaire (Chinese GERDQ) for the diagnosis of gastro-oesophageal reflux disease in the Chinese population.
ABSTRACT To develop a validated gastro-oesophageal disease (GERD) symptom questionnaire for the Chinese population.
One hundred Chinese patients with GERD and 101 healthy Chinese controls were presented with a 20-item GERD questionnaire in the Chinese language (Chinese GERDQ). Quality of life in GERD patients was assessed by SF-36. A standard dose of proton pump inhibitors for 4 weeks was prescribed to 35 patients with newly diagnosed GERD. The Chinese GERDQ was performed before, 4 weeks and 8 weeks after treatment. Concept, content, construct, discriminant validity and reliability of the questionnaire were assessed.
Seven items were selected by logistic regression to account for most of the differences between controls and GERD patients with a good reproducibility and internal consistency. A cut-off score of equal or greater than 12 was determined to discriminate between controls and GERD patients with a sensitivity of 82% and a specificity of 84%. The Chinese GERDQ correlated negatively with five domains of the SF-36 and discriminated between GERD patients who reported symptomatic improvement during proton pump inhibitor treatment and symptoms deterioration upon withdrawal of proton pump inhibitor treatment.
The Chinese GERDQ could be used in epidemiological studies to assess the frequency and severity of GERD in patient populations and in interventional studies of GERD.
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ABSTRACT: A number of reports have suggested that there are substantial racial differences in the frequency of gastro-oesophageal reflux disease and its complications, but few studies have compared directly the frequency of this disorder amongst different racial groups. To explore the racial differences in the frequency of gastro-oesophageal reflux disease and its complications. We reviewed endoscopy reports and medical records for data on race and complications of gastro-oesophageal reflux disease in 2,477 consecutive patients who had endoscopic examinations at the general endoscopy unit of an academic hospital. In addition, we prospectively interviewed 129 out-patients attending general medical clinics in the hospital and in an Asian community health centre in Boston to obtain data on race and gastro-oesophageal reflux disease symptoms. One or more gastro-oesophageal reflux disease complications (peptic oesophageal ulcer, stricture or Barrett's oesophagus) were observed in 267 of 2,174 white patients (12.3%), seven of 249 black patients (2.8%), one of 21 West Asian patients (4.8%) and none of 33 East Asian patients seen at the general endoscopy unit (P < 0.001); 34.6% of whites, 46.1% of blacks and 2.6% of East Asian patients interviewed claimed that they had heartburn (P < 0.01), but the term 'heartburn' was understood by only 34.6%, 53.8% and 13.2% of whites, blacks and East Asians, respectively (P < 0.01). Asian patients in Boston infrequently complain of heartburn, whereas heartburn is commonly reported by both white and black patients. Many patients do not understand the meaning of the term heartburn, however, and so physicians should be cautious when using the term during patient interviews. Complicated gastro-oesophageal reflux disease appears to be predominantly a disorder of whites.Alimentary Pharmacology & Therapeutics 10/2002; 16(10):1795-800. · 4.55 Impact Factor
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ABSTRACT: Gastroesophageal reflux is considered a common condition, but detailed population-based data on reflux in the United States are lacking. The aim of this study was to determine the prevalence and clinical spectrum of gastroesophageal reflux in Olmsted County, Minnesota. A reliable and valid self-report questionnaire was mailed to an age- and sex-stratified random sample of 2200 Olmsted County residents aged 25-74 years. The prevalence per 100 of heartburn and/or acid regurgitation experienced at least weekly was 19.8 (95% confidence interval [95% CI], 17.7-21.9). Heartburn and acid regurgitation were associated with noncardiac chest pain (odds ratio [OR], 4.2; 95% CI, 2.9-6.0), dysphagia (OR, 4.7; 95% CI, 2.9-7.4), dyspepsia (OR, 3.1; 95% CI, 1.9-5.0), and globus sensation (OR, 1.9; 95% CI, 1.0-3.6) but not with asthma, hoarseness, bronchitis, or a history of pneumonia. Among subjects with reflux symptoms, 1.0% reported an episode of hematemesis and 1.3% had a past esophageal dilatation. Symptoms of reflux are common among white men and women who are 25-74 years of age. Heartburn and acid regurgitation are significantly associated with chest pain, dysphagia, dyspepsia, and globus sensation. The percentage of patients reporting complications is low, but the absolute number is probably considerable given the high prevalence of the condition in the community.Gastroenterology 05/1997; 112(5):1448-56. · 12.82 Impact Factor
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ABSTRACT: Locally validated symptom questionnaires are essential instruments in dyspepsia research. A symptom score for Chinese dyspeptics was developed. Multiple aspects of validity and reliability were assessed. Sixty-five patients with endoscopy-negative dyspepsia and 65 healthy controls were presented with a list of 24 previously determined common abdominal symptoms and asked to rate the severity in a five point Likert scale. Comprehensibility and relevance of symptoms were assessed. The questionnaire was administered 3 h later to assess for reproducibility. A locally validated Short Form-36 quality-of-life questionnaire was also administered. Cisapride 5 mg thrice daily was prescribed to dyspeptic patients but not to the controls. The dyspepsia symptom and SF-36 questionnaires were repeated after 3 weeks for patients under treatment. Global change in symptoms and the need for further medical care were assessed. Concept, content, construct and criterion validity, consistency and reproducibility of the dyspepsia symptom questionnaire were assessed. All items were considered comprehensible by more than 90% of subjects. Relevance of individual symptoms to dyspeptic patients ranged from 10.8-76.9%. Twelve items were selected by logistic regression to account for most of the differences between control and dyspeptic patients. Test-retest reproducibility and internal consistency were good with the intraclass correlation coefficient of 0.89 and Cronbach's alpha coefficient of 0.90. A cut-off score of equal to or greater than 16 was determined to discriminate between controls and dyspeptic patients. The dyspepsia score correlated negatively with all domains of the SF-36 quality of life scale except physical functioning. The dyspepsia questionnaire also discriminated between patients who reported a subjective improvement in symptoms and those who reported no change or worsening. The dyspepsia symptom index was easy to understand, internally consistent and reproducible. It predicted global symptom change, and the symptom severity scores correlated negatively with quality of life.Journal of Gastroenterology and Hepatology 06/2002; 17(5):545-51. · 3.33 Impact Factor