The Value Of GERD Q In The Diadnosis Of Gastroesophageal Reflux Disease

OBJECTIVES: To evaluate the value of gastroesophageal reflux disease questionnaire (GerdQ) in the diagnosis of gastroesophageal reflux disease(GERD), explore the clinical simple, reliable diagnosis .METHODS: One hundred and fifty-six patients for first visit with symptoms such as heartburn ,regurgitation,a pain in the centre of the upper stomach and nausea were surveyed with reflux disease questionnaire(RDQ). Gastroesophageal reflux disease questionnaire and gastroscopy were performed in the patients with RDQ≥6. Reflux esophagitis(RE) was that esophageal mucosal damage was easily found durning gastroscopy. If the results of gastroscopy were negative, diagnostic proton pump inhibitors (PPI )treatments were performed after the patients agreement. The patients with improvement of the symptoms were diagnosed for non erosive gastroesophageal reflux disease(NERD). GERD included RE and NERD. Endoscopy and (or) diagnostic PPI treatments were the "gold standard" of GERD . The sensitivity of Gerd Q ,the missed diagnosis rate ,the specificity ,the misdiagnosis rate ,the positive likelihood ratio,the negative likelihood ratio ,the agreement ,Kappa u,P were calculated。Gerd Q score distribution in patients with Gerd and non-Gerd and the relationship between endoscopic grading and Gerd Q score were analysed.RESULTS: There was 124 diagnosed with GERD by endoscopy and (or) diagnostic PPI treatments in 156 patients; 22 patients were not diagnosed with GERD. There was 111 diagnosed with GERD by Gerd Q in 156 patients; 45 patients were not diagnosed with GERD. The sensitivity of Gerd Q was 71.8%,the missed diagnosis rate was 18.2%; the specificity was 68.8%, the misdiagnosis rate was 31.2%; the positive likelihood ratio was 2.30,the negative likelihood ratio was 0.2645;the agreement was 69.9%, Kappa = 0.2, u=2.46 P<0.05。Gerd Q score did not correlate positively with the severity of reflux esophagitis.CONCLUSIONS: GerdQ for screening GERD had certain feasibility. But in the middle-aged and old man, especially the elderly, malignant tumor may be missing with GerdQ alone. Gastroscopy was suggested firstly in the middle-aged and old man, then GerdQ was used to diagnose NERD if gastroscopy was negative.