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The Revised Reflux Symptom Index (R-RSI): Development, Internal and External Validation Study.

Andrea Nacci¹, Nicola de Bortoli², Silvia Capobianco¹

¹ENT, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy.

Folia Phoniatrica Et Logopaedica : Official Organ of the International Association of Logopedics and Phoniatrics (IALP)

|July 9, 2024

Summary

The revised Reflux Symptom Index (R-RSI) effectively screens for laryngopharyngeal reflux disease (LPRD). This reliable, self-administered questionnaire with a cutoff of 18 aids in LPRD diagnosis and monitoring.

Keywords:

Gastroesophageal reflux disease Laryngopharyngeal reflux disease Reflux Symptom Index Revised Reflux Symptom Index Twenty-four-hour MII-pH

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Area of Science:

Otolaryngology
Gastroenterology
Diagnostic Tools

Background:

Laryngopharyngeal reflux disease (LPRD) diagnosis can be challenging.
The Reflux Symptom Index (RSI) is a common diagnostic tool.
A revised version, the R-RSI, was developed to improve LPRD suspicion.

Purpose of the Study:

To revise and validate the Reflux Symptom Index (RSI) into the R-RSI.
To assess the reliability and internal consistency of the R-RSI.
To determine the screening properties and optimal cutoff for the R-RSI in diagnosing LPRD.

Main Methods:

Internal validation included 213 participants (160 without LPRD, 53 with self-reported LPRD/GERD).
Test-retest reliability and internal consistency (Cronbach's alpha) were calculated.
External validation in 56 patients used 24-h MII-pH as the gold standard to determine R-RSI cutoff.

Main Results:

The R-RSI demonstrated high test-retest reliability (ICC: 0.970) and excellent internal consistency (Cronbach's alpha: 0.910).
Participants with prior LPRD/GERD diagnoses scored significantly higher than those without.
An R-RSI cutoff of ≥18 showed 84.5% sensitivity and 81.8% specificity for LPRD detection.

Conclusions:

The R-RSI is a reliable and valid self-administered questionnaire for suspecting LPRD.
The R-RSI exhibits high screening properties for LPRD, with or without co-existing GERD.
A cutoff score of ≥18 on the R-RSI can aid in the diagnosis and monitoring of LPRD.