Look--but also listen! ReQuest: A new dimension-oriented GERD symptom scale

The symptom spectrum of gastroesophageal reflux disease (GERD) is much wider than is commonly believed, and in about half the patients endoscopic examination is negative. The role of endoscopy to assess response to treatment is therefore much reduced in GERD. Assessment of symptoms is becoming increasingly important, so different outcome measures are required. The Reflux Questionnaire ReQuest was thus designed as a brief, effective and robust method of tracking and quantifying GERD symptoms during treatment. It comprises seven dimensions: general well-being, acid complaints, upper abdominal/stomach complaints, lower abdominal/digestive complaints, nausea, sleep disturbances and other complaints. In the short version of ReQuest the symptom burden of each dimension is measured by its frequency and intensity (except general well-being, for which only the intensity was determined). The long version also includes 67 symptom descriptions that constitute the dimensions (except general well-being). The rigorous validation process included clinical trial evaluation and statistical assessment of the findings. Important measures of the instrument, such as internal consistency, test/ retest reliability, construct validity and the responsiveness to changes during treatment, among others, all fulfilled or exceeded requirements, thereby demonstrating the accuracy of the instrument. ReQuest meets the criteria set by regulatory authorities and serves as the primary outcome measure for symptom assessment in future clinical trials of current and new treatments.