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The diagnosis of gastro-esophageal reflux disease (GERD) remains a challenge as both invasive methods and symptom-based strategies have limitations. The symptom-based management of gastro-esophageal reflux disease in primary care may be further optimised with the use of a questionnaire. Dr Jonasson and his colleauges assessed the diagnostic validity of the GerdQ questionnaire in patients with symptoms suggestive of gastro-esophageal reflux disease. Patients with symptoms suggestive of gastro-esophageal reflux disease without alarm features, underwent upper endoscopy, and if normal, pH-metry. The research team reported that patients were followed for 4 weeks and gastro-esophageal reflux disease was completed blinded to the investigator at both visits. Reflux esophagitis or pathological acid exposure was used as diagnostic references for gastro-esophageal reflux disease.  | | GERD had a high positive predictive value of 92% | | Alimentary Pharmacology & Therapeutics |
The team of doctors assessed the diagnostic accuracy for gastro-esophageal reflux disease on symptom response to proton pump inhibitor. Among the 169 patients, a gastro-esophageal reflux disease cutoff 9 gave the best balance with regard to sensitivity, 66%, and specificity, for gastro-esophageal reflux disease. The research team reported that the high prevalence of reflux esophagitis resulted in a high proportion of true positives, but at the same time a high proportion of false-negatives. Consequently, gastro-esophageal reflux disease had a high positive predictive value, 92%, but a low negative predictive value, 22%, for gastro-esophageal reflux disease. The team of doctors found that the symptom resolution on proton pump inhibitor therapy had high sensitivity, 76%, but low specificity, 33%, for gastro-esophageal reflux disease. Dr Jonasson's team concluded, "GerdQ is a useful complementary tool for the diagnosis of gastro-esophageal reflux disease in primary care." "The implementation of GerdQ could reduce the need for upper endoscopy, and improve resource utilization." "Symptom resolution on proton pump inhibitor did not predict gastro-esophageal reflux disease."
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