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Updated: Jan 26, 2026

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Published on: August 25, 2015
Validity and reliability of the reflux symptom score
Jérôme R Lechien1,2,3,4, Francois Bobin1,5, Vinciane Muls6
1Research Committee of the Young Otolaryngologists of the International Federation of Oto-Rhino-Laryngological Societies (YO-IFOS), Marseille, France.
The Reflux Symptom Score (RSS) is a reliable and valid self-administered questionnaire for diagnosing and monitoring laryngopharyngeal reflux (LPR). This tool aids in assessing LPR symptoms effectively.
Area of Science:
- Gastroenterology and Otolaryngology
- Patient-Reported Outcome Measures
- Diagnostic Tool Development
Background:
- Laryngopharyngeal reflux (LPR) presents diagnostic challenges.
- Validated patient-reported outcome measures are crucial for assessing LPR.
- Existing tools may not fully capture the symptom burden of LPR.
Purpose of the Study:
- To develop and validate the Reflux Symptom Score (RSS), a self-administered questionnaire for LPR.
- To establish the reliability and validity of the RSS in patients with LPR.
- To determine the responsiveness of the RSS to treatment.
Main Methods:
- Prospective controlled study involving 113 LPR patients and 80 controls.
- Assessed test-retest reliability and internal consistency (Cronbach's α) of the RSS.
- Evaluated validity against Reflux Symptom Index (RSI) and Voice Handicap Index (VHI), and responsiveness to treatment.
Main Results:
- The RSS demonstrated high test-retest reliability (rs = 0.921) and internal consistency (α = 0.969).
- RSS showed high external validity (rs = 0.831 with RSI) and internal validity (higher scores in patients vs. controls).
- RSS scores significantly improved with treatment, indicating responsiveness; RSS >13 suggests LPR symptoms.
Conclusions:
- The Reflux Symptom Score (RSS) is a reliable and valid self-administered tool for LPR.
- RSS demonstrates excellent criterion-based validity and responsiveness to treatment.
- The RSS can be effectively utilized for diagnosing and monitoring LPR disease.
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