Comparative Evaluation of RSI, RSS, RFS, and RSA for Screening Laryngopharyngeal Reflux

To evaluate the application value of the reflux symptom index (RSI), reflux symptom score (RSS), reflux finding score (RFS), and reflux sign assessment (RSA) in screening for laryngopharyngeal reflux (LPR).

Fifty patients from the Department of Otolaryngology at the First Affiliated Hospital of Bengbu Medical University (May to August 2025) were enrolled. All participants completed the RSI, RSS, RFS, and RSA questionnaires and underwent saliva pepsin measurements after morning fasting and 2 hours post-dinner. Using the pepsin test strip results as the diagnostic standard for LPR, weighted Cohen's kappa statistics were applied to analyze the consistency between the questionnaire results (RSI, RSS, RFS, RSA) and saliva pepsin testing.

Fifty patients were included (17 males and 33 females). The kappa values between pepsin detection and RSI, RFS, RSS, and RSA were 0.03 (P = 0.694), 0.263 (P = 0.025), 0.504 (P < 0.01), and 0.149 (P = 0.231), respectively. The sensitivity of RSI, RFS, RSS, and RSA was 22%, 63.41%, 92.68%, and 68.85%, respectively, while specificity was 66.67%, 77.78%, 55.56%, and 55.56%, respectively. The RSS scale demonstrated the optimal area under the curve (AUC = 0.741, P = 0.025; 95% CI: 0.532-0.951).

Compared to RSI, RFS, and RSA, the RSS questionnaire shows superior screening value for LPR.