Physicians and Patients Measure Different Dimension on Assessment for Gatroesophageal Reflux Disease-Related Symptoms

ABSTRACT

BACKGROUND/AIMS: Gastroesophageal reflux disease is a highly prevalent disease. Assessing treatment efficacy is critical in that clinical endpoints are properly evaluated. Clinical tools for symptoms severity assessment should be discriminative, predictive and evaluative. METHODS: In this study we compared a patient-oriented symptoms evaluation (ReQuest(TM)) vs a structured interview assessment initiated by a physician (sickness impact profile [SIP]). Both questionnaires were analyzed in a multidimensional space using latent factors. Five dimensions were found 1 for the short ReQuest(TM) questionnaire and 4 for SIP. RESULTS: We included 1,522 women and 1,296 men; mean age was 36 +/- 7 years, and mean body mass index was 26 +/- 4. The score questionnaire assessment evaluation by physicians and patients did not correlate between them (between r = 0.03 and 0.26) except nausea and sleep disorder (r = 0.45 and 0.51) but both were sensitive enough to detect changes after treatment (P < 0.05). Medical specialty of the physician showed effect on the score of both, ReQuest(TM) and SIP evaluation. Questionnaire variance decomposition due to specialist was only 2% (P < 0.05). CONCLUSIONS: While both evaluations are orthogonal (non-correlated), meaning patients and physicians measured diverse aspects of the same disease, they both were able to measure patient's improvement with treatment.