Korean J Gastroenterol.  2023 Aug;82(2):84-90. 10.4166/kjg.2023.027.

Comparison of RDQ and GERDQ for Predicting Erosive Esophagitis in Patients with Typical GERD Symptoms

Affiliations
  • 1Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
  • 2Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
  • 3Internal Medicine Department, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
  • 4Department of Medical Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
  • 5Department of Gastroenterology, Dhaka Medical College and Hospital, Dhaka, Bangladesh
  • 6Helicobacter pylori and Microbiota Study Group, Institute Tropical Disease, Universitas Airlangga, Surabaya, Indonesia

Abstract

Background/Aims
The management decisions regarding gastroesophageal reflux disease (GERD) may differ according to the presence of erosive esophagitis. On the other hand, the availability of upper endoscopy in Indonesia is relatively limited. This study compared the Reflux Disease Questionnaire (RDQ) and the GERD questionnaire (GERDQ) performance in predicting the presence of clinically significant erosive esophagitis and determined the validity and reliability of the Indonesian-translated version of RDQ.
Methods
Ninety-two adults with GERD suspicion were recruited. All patients completed RDQ and GERDQ. Receiver operating curve analysis was conducted on RDQ and GERDQ to evaluate their performance in discriminating LA GERD B or higher esophagitis from others. The translated RDQ preserved its main structure and was culturally adapted.
Results
The patients were 66.3% female and 73.9% Javanese. Only 22 (23.9%) patients presented with LA grade B or higher erosive esophagitis. The RDQ showed a higher AUC than the GERDQ (0.602 vs. 0.589). A cutoff point of 20 was selected for the RDQ with sensitivity and specificity of 73% and 50%, respectively, whereas the optimal cutoff point of GERDQ was 8, with a sensitivity and specificity of 77% and 43%, respectively. The r-value greater than the critical value table (r>0.205, p<0.01) confirmed the construct validity of our translated RDQ. The questionnaire also demonstrated excellent reliability (α=0.900) and moderate similarity with the Indonesian version of GERDQ (κ=0.459, p<0.01).
Conclusions
The RDQ is slightly superior to GERDQ in predicting the presence of clinically significant erosive esophagitis (LA grade B or higher). The Indonesian-translated RDQ is valid and reliable.

Keyword

RDQ; GERDQ; GERD; Gastroenterology

Figure

  • Fig. 1 ROC curves of the total RDQ and GERDQ to identify LA grade B, C, or D erosive esophagitis. ROC, receiver operating curve; RDQ, Reflux Disease Questionnaire; GERDQ, GERD questionnaire; LA grade A-D, Los Angeles grade A-D.


Reference

1. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R. Global Consensus Group. 2006; The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 101:1900–1920. quiz 1943DOI: 10.1111/j.1572-0241.2006.00630.x. PMID: 16928254.
Article
2. Nirwan JS, Hasan SS, Babar ZU, Conway BR, Ghori MU. 2020; Global prevalence and risk factors of gastro-oesophageal reflux disease (GORD): Systematic review with meta-analysis. Sci Rep. 10:5814. DOI: 10.1038/s41598-020-62795-1. PMID: 32242117. PMCID: PMC7118109.
Article
3. Spechler SJ, Jain SK, Tendler DA, Parker RA. 2002; Racial differences in the frequency of symptoms and complications of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 16:1795–1800. DOI: 10.1046/j.1365-2036.2002.01351.x. PMID: 12269973.
Article
4. Syam AF, Sobur CS, Hapsari FC, Abdullah M, Makmun D. 2017; Prevalence and risk factors of GERD in Indonesian population-an internet-based study. Adv Sci Lett. 23:6734–6738. DOI: 10.1166/asl.2017.9384.
Article
5. Miftahussurur M, Doohan D, Nusi IA, et al. 2018; Gastroesophageal reflux disease in an area with low Helicobacter pylori infection prevalence. PLoS One. 13:e0205644. DOI: 10.1371/journal.pone.0205644. PMID: 30427843. PMCID: PMC6241118.
Article
6. Yamasaki T, Hemond C, Eisa M, Ganocy S, Fass R. 2018; The changing epidemiology of gastroesophageal reflux disease: Are patients getting younger? J Neurogastroenterol Motil. 24:559–569. DOI: 10.5056/jnm18140. PMID: 30347935. PMCID: PMC6175565.
Article
7. Katz PO, Dunbar KB, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ. 2022; ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 117:27–56. DOI: 10.14309/ajg.0000000000001538. PMID: 34807007. PMCID: PMC8754510.
Article
8. Savarino E, Marabotto E, Bodini G, et al. 2017; Epidemiology and natural history of gastroesophageal reflux disease. Minerva Gastroenterol Dietol. 63:175–183. DOI: 10.23736/S1121-421X.17.02383-2. PMID: 28215067.
Article
9. Savarino E, Zentilin P, Savarino V. 2013; NERD: an umbrella term including heterogeneous subpopulations. Nat Rev Gastroenterol Hepatol. 10:371–380. DOI: 10.1038/nrgastro.2013.50. PMID: 23528345.
Article
10. Makmun D. 2014; Present status of endoscopy, therapeutic endoscopy and the endoscopy training system in Indonesia. Dig Endosc. 26 Suppl 2:2–9. DOI: 10.1111/den.12245. PMID: 24750141.
Article
11. Gyawali CP, Fass R. 2018; Management of gastroesophageal reflux disease. Gastroenterology. 154:302–318. DOI: 10.1053/j.gastro.2017.07.049. PMID: 28827081.
Article
12. Gyawali CP, Kahrilas PJ, Savarino E, et al. 2018; Modern diagnosis of GERD: the Lyon Consensus. Gut. 67:1351–1362. DOI: 10.1136/gutjnl-2017-314722. PMID: 29437910. PMCID: PMC6031267.
Article
13. Syam AF, Aulia C, Renaldi K, Simadibrata M, Abdullah M, Tedjasaputra TR. 2013; [Revision of the national consensus on the management of gastroesophageal reflux disease (GERD) in Indonesia]. Indonesian Gastroenterology Association. 263–270. Indonesian.
14. Simadibrata M, Rani A, Adi P, Djumhana A, Abdullah M. 2011; The gastro-esophageal reflux disease questionnaire using Indonesian language: a language validation survey. Med J Indones. 20:125–130. DOI: 10.13181/mji.v20i2.442.
15. Siregar GA, Halim S, Sitepu RR. 2015; Comparison of endoscopic findings with gastroesophageal reflux disease questionnaires (GerdQ) and reflux disease questionnaire (RDQ) for gastroesophageal reflux disease in Medan. Indones J Gastroenterol Hepatol Dig Endosc. 16:143–147. DOI: 10.24871/1632015143-147.
Article
16. Shaw MJ, Talley NJ, Beebe TJ, et al. 2001; Initial validation of a diagnostic questionnaire for gastroesophageal reflux disease. Am J Gastroenterol. 96:52–57. DOI: 10.1111/j.1572-0241.2001.03451.x. PMID: 11197287.
Article
17. van Zanten SV, Armstrong D, Barkun A, Junghard O, White RJ, Wiklund IK. 2007; Symptom overlap in patients with upper gastrointestinal complaints in the Canadian confirmatory acid suppression test (CAST) study: further psychometric validation of the reflux disease questionnaire. Aliment Pharmacol Ther. 25:1087–1097. DOI: 10.1111/j.1365-2036.2007.03271.x. PMID: 17439510.
Article
18. Ho KY, Gwee KA, Khor JL, Selamat DS, Yeoh KG. 2008; Validation of a graded response questionnaire for the diagnosis of gastroesophageal reflux disease in an Asian primary care population. J Clin Gastroenterol. 42:680–686. DOI: 10.1097/MCG.0b013e3180653613. PMID: 18347510.
Article
19. Dent J, Vakil N, Jones R, et al. 2010; Accuracy of the diagnosis of GORD by questionnaire, physicians and a trial of proton pump inhibitor treatment: the Diamond Study. Gut. 59:714–721. DOI: 10.1136/gut.2009.200063. PMID: 20551454.
Article
20. Shaw M, Dent J, Beebe T, et al. 2008; The reflux disease questionnaire: a measure for assessment of treatment response in clinical trials. Health Qual Life Outcomes. 6:31. DOI: 10.1186/1477-7525-6-31. PMID: 18447946. PMCID: PMC2390523.
Article
21. Cao Y, Yan X, Ma XQ, et al. 2008; Validation of a survey methodology for gastroesophageal reflux disease in China. BMC Gastroenterol. 8:37. DOI: 10.1186/1471-230X-8-37. PMID: 18717991. PMCID: PMC2533006.
Article
22. Nocon M, Kulig M, Leodolter A, Malfertheiner P, Willich SN. 2005; Validation of the reflux disease questionnaire for a German population. Eur J Gastroenterol Hepatol. 17:229–233. DOI: 10.1097/00042737-200502000-00015. PMID: 15674102.
Article
23. Nuevo J, Tafalla M, Zapardiel J. [Validation of the reflux disease questionnaire (RDQ) and gastrointestinal impact scale (GIS) in patients with gastroesophageal reflux disease in the Spanish population]. Gastroenterol Hepatol. 2009; 32:264–273. Spanish.
Article
24. Pace F, Scarlata P, Casini V, Sarzi-Puttini P, Porro GB. 2008; Validation of the reflux disease questionnaire for an Italian population of patients with gastroesophageal reflux disease. Eur J Gastroenterol Hepatol. 20:187–190. DOI: 10.1097/MEG.0b013e3282f246b2. PMID: 18301298.
Article
25. Pan WH, Yeh WT. 2008; How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations. Asia Pac J Clin Nutr. 17:370–374.
26. Acquadro C, Conway K, Giroudet C, Mear I. Linguistic validation manual for health outcome assessments. Mapi Institute;2012.
27. Siegle D. Critical values of the Pearson product-moment correlation coefficient. [Internet]. Neag Center for Gifted Education and Talent Development University of Connecticut;2010. cited 2023 Feb 15. Available from: https://researchbasics.education.uconn.edu/.
28. George D, Mallery M. 2003. Using SPSS for Windows step by step: a simple guide and reference. 11.0 update. Allyn & Bacon;Boston:
29. Yamasaki T, Fass R. 2017; Reflux hypersensitivity: A new functional esophageal disorder. J Neurogastroenterol Motil. 23:495–503. DOI: 10.5056/jnm17097. PMID: 28992673. PMCID: PMC5628981.
Article
30. Kim YS, Kim N, Kim GH. 2016; Sex and gender differences in gastroesophageal reflux disease. J Neurogastroenterol Motil. 22:575–588. DOI: 10.5056/jnm16138. PMID: 27703114. PMCID: PMC5056567.
Article
31. Eusebi LH, Ratnakumaran R, Yuan Y, Solaymani-Dodaran M, Bazzoli F, Ford AC. 2018; Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis. Gut. 67:430–440. DOI: 10.1136/gutjnl-2016-313589. PMID: 28232473.
Article
32. Cai N, Ji GZ, Fan ZN, et al. 2012; Association between body mass index and erosive esophagitis: a meta-analysis. World J Gastroenterol. 18:2545–2553. DOI: 10.3748/wjg.v18.i20.2545. PMID: 22654453. PMCID: PMC3360454.
Article
33. Zhu W, Zeng N, Wang N. 2010; Sensitivity, specificity, accuracy, associated confidence interval and ROC analysis with practical SAS implementations. NESUG proceedings: health care and life sciences, Baltimore, Maryland. 19:67.
34. Rabin R, Gudex C, Selai C, Herdman M. 2014; From translation to version management: a history and review of methods for the cultural adaptation of the EuroQol five-dimensional questionnaire. Value Health. 17:70–76. DOI: 10.1016/j.jval.2013.10.006. PMID: 24438719.
Article
35. Na'im A, Syaputra H. [Results of the 2010 population census: Citizenship, ethnicity, religion, and common language of the Indonesian population]. The Jakarta Central Bureau of Statistics;2010. cited 2023 Feb 15. Indonesian: Available from: https://www.bps.go.id/publication/2012/05/23/55eca38b7fe0830834605b35/kewarganegaraan-suku-bangsa-agama-dan-bahasa-sehari-hari-penduduk-indonesia.html.
36. Carlsson R, Dent J, Bolling-Sternevald E, et al. 1998; The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol. 33:1023–1029. DOI: 10.1080/003655298750026697. PMID: 9829354.
Article
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