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Updated: Jul 25, 2025

Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
A novel pediatric Eosinophilic Esophagitis Symptoms and Adaptive Behavior Scale for different ages: GaziESAS v2.0
Dilek Yapar1,2,3, Hacer Ilbilge Ertoy Karagol3,4, Sinem Polat Terece3,4
1Turkish Ministry of Health, Muratpaşa District Health Directorate, Antalya, Turkey.
Insights
A new scale, GaziESAS v2.0, effectively measures symptoms and adaptive behaviors in children and teens with eosinophilic esophagitis (EoE). This high-quality scale offers separate forms for children, teens, and parents, ensuring age-appropriate assessment.
Area of Science:
- Pediatric Gastroenterology
- Clinical Assessment Tools
- Eosinophilic Gastrointestinal Disorders
Background:
- Eosinophilic esophagitis (EoE) requires validated tools to assess symptoms and adaptive behaviors (AB) across pediatric age groups.
- Current assessment methods may lack the necessary quality, reliability, and age-specific applicability for children with EoE.
Purpose of the Study:
- To develop and validate a high-quality pediatric scale (HQS) for measuring EoE symptoms and AB in children and adolescents.
- To create age-specific forms of the scale suitable for different pediatric age ranges and their parents.
Main Methods:
- Development of the Gazi University Eosinophilic Esophagitis Symptoms and Adaptive Behavior Scale (GaziESAS) version 2.0 (v2.0) involving item generation and domain identification.
- Assessment of content validity (CnV), construct validity (CsV) via field testing, and convergent validity (CgV) by correlating with PEESS v2.0.
- Evaluation of reliability using internal consistency (Cronbach's alpha) and test-retest reliability (intraclass correlation coefficients - ICC).
Main Results:
- The study included 19 children, 42 teens, and 82 parents, with GaziESAS v2.0 comprising 20 items across symptom and AB domains.
- Excellent content validity indexes were achieved for all items.
- Good to excellent convergent validity (r=0.6 to 0.9) and good reliability (Cronbach's α >0.7, ICC >0.6) were demonstrated.
Conclusions:
- GaziESAS v2.0 is the first pediatric HQS designed to quantify EoE symptoms and AB frequency over the past month.
- The scale offers distinct forms tailored for children, teens, and parents, enhancing its clinical utility for diverse pediatric populations with EoE.
Background:
High-quality scales (HQS) suitable that measure symptoms and adaptive behaviors (AB) with proven validity and reliability are needed for different age groups of children with eosinophilic esophagitis (EoE).
Objective:
To develop a high-quality pediatric EoE symptoms and AB scale for different age groups.
Methods:
Children (7-11 years), teens (12-18 years), and parents of 2-18-year-old children with EoE were included. A HQS should have encompassed: the identification of domain and item generation; content validity (CnV) and field test for construct validity (CsV) and reliability. Convergent validity (CgV) was examined for CsV. Correlations between the Pediatric Eosinophilic Esophagitis Symptom Score, version 2.0 (PEESS v2.0) and Gazi University Eosinophilic Esophagitis Symptoms and Adaptive Behavior Scale (GaziESAS) version 2.0 (v2.0) were examined for CgV. Reliability was determined through internal consistency (Cronbach-α) and test-retest reliability (intraclass correlation coefficients: ICC).
Results:
Nineteen children, 42 teens, and 82 parents completed the study. GaziESAS v2.0 was composed of 20 items with two main domains: symptoms (subdomains: dysphagia and nondysphagia) and AB. CnV indexes were excellent for all items. The CgV varied from good to excellent correlation (r = 0.6 to r = 0.9). GaziESAS v2.0 showed good reliability (Cronbach-α >0.7 and ICC >0.6).
Conclusion:
GaziESAS v2.0 is the first pediatric HQS that measures the frequency of symptoms and AB in EoE within the last month with separate forms for children, teens, and parents.
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