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ObjectivesTo compare the screening value of the Reflux Symptom Score (RSS) and the Reflux Symptom Index (RSI) for laryngopharyngeal reflux (LPR).MethodsAll included patients attending the Department of Otolaryngology at the Sixth Medical Center of the PLA General Hospital from February 2022 to August 2022, completed the RSS and the RSI and underwent 24‐hour hypopharyngeal‐esophageal multichannel intraluminal impedance‐pH (24 h HEMII‐pH) monitoring. The results of 24 h HEMII‐pH were used as a diagnostic criterion for LPR, consistency between two questionnaires (RSS, RSI) and 24 h HEMII‐pH was compared by the weighted Cohen's kappa statistic and the screening value of RSS and RSI for LPR was compared by receiver operating characteristics analysis.ResultsA total of 77 patients, 58 males, and 19 females, were included. The Kappa values of between RSS, RSI, and 24 h HEMII‐pH were 0.663 (p < 0.001) and 0.213 (p < 0.05), respectively. The sensitivity of RSS and RSI were 92.8% and 48.2%, respectively, the specificity was 71.4% and 80.9%. The negative predictive value and positive predictive value of RSI were 36.9%, 87.1%, and that of RSS were 78.9%, 89.6%. The area under curve of the RSS (0.783; 95% CI = 0.53, 0.75) is significantly higher than RSI (0.633; 95% CI = 0.72, 0.90).ConclusionThe RSS has a higher consistency and better screening value for LPR compared to RSI. In addition, the RSS includes more reflux symptoms, which may reduce the number of missed diagnoses in patients with LPR to some extent.Level of Evidence3 Laryngoscope, 133:2104–2109, 2023

Objective To investigate the optimal time point for diagnosing laryngopharyngeal reflux (LPR) through combining 24‐h hypopharyngeal‐esophageal multichannel intraluminal impedance‐pH (24‐h HEMII‐pH) monitoring and the multi‐time point salivary pepsin test (MTPSPT). Study Design Prospective uncontrolled trial. Method Patients with and without LPR symptoms were included as the test group and the control group, respectively. The patients in the test group underwent 24‐h HEMII‐pH and MTPSPT. The results of 24‐h HEMII‐pH were used as a diagnostic criterion for LPR, and the diagnostic value of salivary pepsin tests performed at different time points was compared by receiver operating characteristic (ROC) analysis. Results A total of 153 patients were included. Based on 24‐h HEMII‐pH, the positive rate of LPR in the test group of patients was 84.00%. In the control group, only one person (3.57%) had a positive salivary pepsin test result. The area under the curve (AUC) of the MTPSPT was 0.827. In addition, we separately calculated the AUC of the combined salivary pepsin test at different time points, and found good diagnostic value (AUC = 0.799) when the test was combined with the waking, 1 and 2 h after breakfast and lunch, and 1 h after dinner tests. However, when the number of tests were further increased, the diagnostic value did not improve significantly. Conclusion Salivary pepsin testing combined with waking, 1 h and 2 h after breakfast and lunch, and 1 h after dinner has almost the same diagnostic value as MTPSPT, and testing at these time points can be an effective method for diagnosing LPR. Level of Evidence 3 Laryngoscope, 133:1706–1711, 2023