Validity of clinical symptoms in benign esophageal disease, assessed by questionnaire

A questionnaire designed to test the value of questions identifying benign esophageal disease was sent to patients representing four well-defined entities: angina pectoris (n = 30), benign esophageal disease (n = 25), gastroduodenal ulcer or former gallstones (n = 27) and normal subjects (n = 38). By means of logistic regression, three key-questions were selected. A combination of an affirmative answer to "difficulty in swallowing solid food" and to "pain in the chest" or "heartburn at night" or both did not occur in the group of normal subjects, while occurring in 68% of the patients with esophageal diseases. The combination occurred in only 10% of the patients with angina pectoris and 15% of those suffering from gastroduodenal ulcer or gallstones. The predictive accuracy of the combination of the three questions is estimated for various hypothetic prevalences of esophageal disease. These questions appear to identify approximately two-thirds of individuals with esophageal disease with acceptable false-positive rates and can therefore be used in epidemiological studies.