Physicians and patients measure different dimension on assessment for gastroesophageal reflux disease-related...

Gastroesophageal reflux disease is a highly prevalent disease. Assessing treatment efficacy is critical in that clinical endpoints are properly evaluated. Clinical tools for symptoms severity assessment should be discriminative, predictive and evaluative.

In this study we compared a patient-oriented symptoms evaluation (ReQuest™) vs a structured interview assessment initiated by a physician (sickness impact profile [SIP]). Both questionnaires were analyzed in a multidimensional space using latent factors. Five dimensions were found: 1 for the short ReQuest™ questionnaire and 4 for SIP.

We included 1,522 women and 1,296 men; mean age was 36 ± 7 years, and mean body mass index was 26 ± 4. The score questionnaire assessment evaluation by physicians and patients did not correlate between them (between r = 0.03 and 0.26) except nausea and sleep disorder (r = 0.45 and 0.51) but both were sensitive enough to detect changes after treatment (P < 0.05). Medical specialty of the physician showed effect on the score of both, ReQuest™ and SIP evaluation. Questionnaire variance decomposition due to specialist was only 2% (P < 0.05).

While both evaluations are orthogonal (non-correlated), meaning patients and physicians measured diverse aspects of the same disease, they both were able to measure patient's improvement with treatment.