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. 2007 May 1;25(9):1087-97. doi: 10.1111/j.1365-2036.2007.03271.x.

Abstract

Background: The reflux disease questionnaire (RDQ) is a short, patient-completed instrument.

Aims: To investigate the psychometric characteristics of the RDQ in patients with heartburn-predominant (HB) and non-heartburn predominant (NHB) dyspepsia.

Methods: HB (n = 388) and NHB (n = 733) patients were randomized to esomeprazole 40 mg daily or twice daily for 1 week, followed by 3 weeks of esomeprazole 40 mg daily.

Results: High factor loadings (0.78-0.86) supported the 'regurgitation' dimension of the RDQ. Overlapping factor loadings in the 'heartburn' and 'dyspepsia' dimensions suggested symptom overlap. All dimensions demonstrated high internal consistency (Cronbach's alpha: 0.79-0.90). Intra-class correlation coefficients over 4 weeks were good (0.66-0.85). The RDQ showed good responsiveness over 4 weeks of treatment, with high effect sizes (> or =0.80). Moderate or large symptom improvements were reported by 90% and 77% of HB and NHB patients, respectively, following treatment. Patients who responded to acid suppression also experienced symptom benefits in all RDQ dimensions.

Conclusions: The RDQ is reliable, valid and responsive to change in HB and NHB patients. The symptom overlap is important but need not play a major role in determining treatment strategy as both patient groups benefited from proton pump inhibitor treatment.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Anti-Ulcer Agents / therapeutic use*
  • Canada
  • Dyspepsia / drug therapy*
  • Esomeprazole / therapeutic use*
  • Gastric Acid / metabolism
  • Gastroesophageal Reflux / drug therapy*
  • Heartburn / drug therapy*
  • Humans
  • Male
  • Psychometrics
  • Surveys and Questionnaires / standards*

Substances

  • Anti-Ulcer Agents
  • Esomeprazole