Reliability and Validity of the German Version of the Reflux Symptom Score-12 for Laryngopharyngeal Reflux Assessment

Diagnosing laryngopharyngeal reflux (LPR) is challenging due to the overlap of its symptoms with those of other conditions. The Reflux Symptom Score-12 (RSS-12) is a condensed version of the RSS questionnaire to facilitate LPR assessment in clinical practice. This study aimed to validate the German version of the RSS-12 (G-RSS-12) and evaluate its reliability, clinical validity, and responsiveness.

A prospective, controlled, cross-sectional study.

This single-center study included 73 patients with LPR symptoms and 50 healthy controls. The participants underwent clinical examination, neck sonography, and 24-hour pH monitoring to confirm LPR. Participants completed the G-RSS-12 and the German version of the Reflux Symptom Index (G-RSI). Thirty-seven patients with confirmed LPR underwent 12-week treatment with pantoprazole 20 mg twice a day. Responsiveness to treatment and the G-RSS-12 cutoff for determining the presence or absence of LPR were examined.

The G-RSS-12 demonstrated high internal consistency (Cronbach's α = 0.809, N = 123) and excellent test-retest reliability (ICC = 0.98, N = 37). Construct validity was supported by significant differences in scores between patients and controls (P < 0.001). G-RSS-12 showed high criterion validity, correlating strongly with the G-RSI (rho = 0.895, P < 0.001, N = 123). Responsiveness was evident, with significant improvements in scores after treatment (P < 0.001, N = 37). A G-RSS-12 cutoff value of 12 indicated LPR with high sensitivity (97.30%) and specificity (91.70%).

G-RSS-12 demonstrated superior discriminative properties compared with G-RSI. G-RSS-12 proved to be a highly reliable, valid, and responsive tool for assessing LPR symptoms and monitoring treatment outcomes in German-speaking populations.