Validity and reliability of the reflux symptom score

Lechien, Jérôme R.; Bobin, François; Muls, Vinciane; Thill, Marie Paule; Horoi, Mihaéla; Ostermann, Katharina; Huet, Kathy; Harmegnies, Bernard; Dequanter, Didier; Dapri, Giovanni; Maréchal, Marie-Thérèse; Finck, Camille; Ruiz, Alexandra Rodriguez; Saussez, Sven

doi:10.1002/lary.28017

Cited by 117 publications

(152 citation statements)

References 35 publications

(85 reference statements)

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“…Similarly, many digestive complaints associated with LPR are absent, although they predominate in LPR. [30][31][32] Lechien et al also identified RFS weakness in identifying clinical findings associated with LPR. This scale does not consider extra-laryngeal signs such as pharyngeal sticky mucus, pharyngeal wall erythema, and tongue tonsil hypertrophy, although many studies that reported that these signs may be associated with LPR.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Reflux Symptom Index and the Endolaryngeal Findings Scale after Treatment in Individuals with Laryngopharyngeal Reflux

Silva

Duprat

Machado

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Laryngopharyngeal reflux (LPR) is a prevalent condition in outpatients visiting the otorhinolaryngological clinic, with many controversies regarding its diagnosis and follow-up. Therefore, there is a need for clinical instruments that can diagnose individuals and monitor the results of their treatment. Objective To evaluate the applicability of the scores translated and adapted to Brazilian Portuguese: Reflux Symptom Index (RSI) and Endolaryngeal Reflux Findings Scale (ERFS), as instruments for post-treatment follow-up of LPR. Method A total of 35 individuals with atypical symptoms of gastroesophageal reflux disease and with an objective diagnosis of LPR, confirmed by high digestive endoscopy and 24-hour esophageal pH-metry dual probe test were submitted to the RSI and ERFS questionnaires, used in the pre- and post-treatment of 90 days with a Proton Pump Inhibitor. Result The evaluation of RSI and ERFS in the pre- and post-treatment showed a reduction in the results of the two scores, with a higher drop in the RSI (p < 0.001) than in the ERFS (p = 0.014). Although there was an improvement in the values in 23.9% of the individuals in the ERFS, there was no change in the category (p = 0.057), different from the RSI (p < 0.001), where there was a 67.4% improvement in values, as well as change in category (score went from positive to negative). There was a correlation between RSI and ERFS, moderate in the pretreatment and strong in the post-treatment. Conclusion The RSI and ERFS scores, when translated and adapted for Brazilian Portuguese and applied simultaneously, can be considered a good tool for post-treatment LPR follow-up.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Reflux Symptom Index and the Endolaryngeal Findings Scale after Treatment in Individuals with Laryngopharyngeal Reflux

Silva

Duprat

Machado

et al. 2020

Int Arch Otorhinolaryngol

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“…Baseline symptoms of patients have been assessed using the reflux symptom score (RSS) a few days before the MII‐pH. RSS is an easily administered, highly reproducible, reliable, and valid patient‐reported outcome questionnaire including respiratory; gastrointestinal; and ear, nose, and throat symptoms attributed to LPR . The U.S. version of RSS is described in Figure .…”

Section: Methodsmentioning

confidence: 99%

Saliva pepsin level of laryngopharyngeal reflux patients is not correlated with reflux episodes

Bobin¹,

Journé

Lechien

2019

The Laryngoscope

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Objective: To investigate the relationship between the laryngopharyngeal reflux (LPR) episodes at the multichannel intraluminal impedance-pH monitoring (MII-pH) and the concentration of pepsin in the saliva of LPR patients.Methods: Patients with LPR were enrolled from the polyclinic of Poitiers, France. Patients benefited from 24-hour MII-pH that allowed a correlation study between reflux episodes and symptoms. Patients reported the occurrence of the critical symptoms during the testing period through a recording device. Simultaneously, they collected a first saliva sample 30 minutes after the symptoms and a second saliva collection a few hours after the first collection. The patient symptoms were assessed with reflux symptom score (RSS). The relationship between pepsin concentration in the saliva, symptoms, and the reflux episode characteristics at the MII-pH was investigated through multiple linear regression.Results: A total of 65 patients with LPR were recruited. The mean concentrations of the first and the second pepsin samples were 92.0 AE 108.1 and 101.8 AE 131.0, respectively. Peptest (RD Biomed, Milan, Italy) was positive in 51 LPR patients (78.5%). Concentrations of both pepsin samples were significantly correlated (P = 0.019). There was no significant association between pepsin concentrations in saliva samples, RSS, key symptoms during the test period, and MII-pH findings.Conclusion: The level of pepsin saliva concentration is not associated with the reflux episodes at the MII-pH. Future studies are needed to better understand the relationship between the extracellular pepsin concentration, mucosal inflammation, and related laryngopharyngeal symptoms.

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“…In initial evaluation, non-laryngologists more frequently perform or refer for esophagoscopy, although less than 40% of LPR patients have GI findings such as hiatal hernia or esophagitis. 31,32 The majority of otolaryngologists believe that GI endoscopy is indicated for patients requiring long-term PPI therapy or those with refractory LPR. Only 14.2% of otolaryngologists recommend performing GI endoscopy in elderly LPR patients, while these patients are known to have a lower perception of esophageal irritation and a related higher risk of "silent" erosive esophageal lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Irrespective of specialty, the majority of otolaryngologists use once The selection of the symptoms including in the survey was based on the Reflux Symptom Score. 31 The numbers in the table consist of the percent of physicians who rate the symptom association: physicians had to choose from 1 (high-associated LPR symptom) to 5 (not associated with LPR). LPR = laryngopharyngeal reflux.…”

Section: Treatment Of Lpr Patientsmentioning

confidence: 99%

Do Laryngologists and General Otolaryngologists Manage Laryngopharyngeal Reflux Differently?

et al. 2020

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Objective To investigate current practices of laryngologists and non‐laryngologists in management of Laryngopharyngeal Reflux (LPR). Methods An online survey was sent to members of otolaryngology societies about LPR, and subgroup analysis was performed between laryngologists and non‐laryngologists. This survey was conducted by the LPR Study Group of Young Otolaryngologists of the International Federation of Otolaryngological Societies. Results A total of 535 otolaryngologists completed the survey. Among them, 127 were laryngologists and 408 were non‐laryngologists. Collectively, symptoms most commonly attributed to LPR are cough after lying down/meal, throat clearing, and acid brash; most common findings are thought to be arytenoid erythema and posterior commissure hypertrophy. Respectively, 12.5% and 5% of non‐laryngologists and laryngologists believe that ≥50% of LPR patients suffer from heartburn (P = .010). Non‐laryngologists are more aware about some extra‐laryngeal findings associated with LPR (eg, pharyngeal erythema) than laryngologists. Neither laryngologists nor non‐laryngologists associated development of benign lesions of the vocal folds with reflux. The management of LPR substantially differs between groups, with laryngologists indicating increased awareness of (impedance)‐pH monitoring as well as the prevalence and treatment of nonacid/mixed LPR. Conversely, non‐laryngologists are much more likely to include gastroenterology referral in their management of presumed LPR. Respectively, 44.8% and 27.6% of non‐laryngologists and laryngologists believe themselves not sufficiently knowledgeable about LPR. Conclusions Significant differences exist between laryngologists and non‐laryngologists in diagnosis and treatment of LPR. Overall only one‐third of responders believe themselves to be sufficiently educated about LPR. Level of Evidence 4 Laryngoscope, 130:E539–E547, 2020

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Validity and reliability of the reflux symptom score

Cited by 117 publications

References 35 publications

Evaluation of the Reflux Symptom Index and the Endolaryngeal Findings Scale after Treatment in Individuals with Laryngopharyngeal Reflux

Evaluation of the Reflux Symptom Index and the Endolaryngeal Findings Scale after Treatment in Individuals with Laryngopharyngeal Reflux

Saliva pepsin level of laryngopharyngeal reflux patients is not correlated with reflux episodes

Do Laryngologists and General Otolaryngologists Manage Laryngopharyngeal Reflux Differently?

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