Validity and reliability of the reflux symptom score

• Published in: The Laryngoscope Vol. 130; no. 3; p. E98
• Main Authors: Lechien, Jérôme R, Bobin, Francois, Muls, Vinciane, Thill, Marie-Paule, Horoi, Mihaela, Ostermann, Katharina, Huet, Kathy, Harmegnies, Bernard, Dequanter, Didier, Dapri, Giovanni, Maréchal, Marie-Therese, Finck, Camille, Rodriguez Ruiz, Alexandra, Saussez, Sven
• Format: Journal Article
• Language: English
• Published: United States 01.03.2020
• Subjects: Adult; Aged; Aged, 80 and over; Female; Humans; Laryngopharyngeal Reflux - diagnosis; Male; Middle Aged; Patient Reported Outcome Measures; Prospective Studies; Reproducibility of Results; ROC Curve; Severity of Illness Index; Surveys and Questionnaires - standards; Symptom Assessment - standards; Translations; Young Adult; laryngitis; symptom; reflux; Laryngopharyngeal; outcome; tool
• ISSN: 1531-4995
• DOI: 10.1002/lary.28017

To develop and validate the Reflux Symptom Score (RSS), a self-administered patient-reported outcome questionnaire for patients with laryngopharyngeal reflux (LPR). Prospective controlled study. A total of 113 patients with LPR were enrolled and treated with diet and 3 months of pantoprazole, alginate, and/or magaldrate depending on the LPR characteristics (acid, nonacid, or mixed). Eighty asymptomatic individuals completed the study. Patients and controls completed the RSS twice within a 7-day period to assess test-retest reliability. Internal consistency was measured using Cronbach's α for the RSS items in patients and controls. Validity was assessed by comparing the baseline RSS with the Reflux Symptom Index (RSI) and Voice Handicap Index (VHI). Seventy-seven patients completed the RSS at baseline and after 6 and 12 weeks of treatment to assess responsiveness to change. The RSS cutoff for determining the presence and absence of LPR was examined by receiver operating characteristic analysis. Test-retest reliability (r = 0.921) and internal consistency reliability (α = 0.969) were high. RSS exhibited high external validity indicated by a significant correlation with the RSI (r = 0.831). Internal validity was excellent based on the higher RSS in patients compared with controls (P = .001). RSS, RSI, and VHI scores significantly improved from pre- to posttreatment, indicating a high responsiveness to change. RSS >13 can be considered suggestive of LPR-related symptoms. RSS was not influenced by the occurrence of gastroesophageal reflux disease, LPR subtypes, or patient characteristics. RSS is a self-administered patient-reported outcome questionnaire that demonstrates high reliability and excellent criterion-based validity. RSS can be used in diagnosing and monitoring LPR disease. 3b Laryngoscope, 130:E98-E107, 2020.