Your browser doesn't support javascript.
loading
Validated Clinical Score to Predict Gastroesophageal Reflux in Patients With Chronic Laryngeal Symptoms: COuGH RefluX.
Krause, Amanda J; Kaizer, Alexander M; Carlson, Dustin A; Chan, Walter W; Chen, Chien-Lin; Gyawali, C Prakash; Jenkins, Andrew; Pandolfino, John E; Polamraju, Vinathi; Wong, Ming-Wun; Greytak, Madeline; Yadlapati, Rena.
Afiliación
  • Krause AJ; Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California.
  • Kaizer AM; Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado.
  • Carlson DA; Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
  • Chan WW; Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
  • Chen CL; Division of Gastroenterology and Hepatology, Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
  • Gyawali CP; Division of Gastroenterology, Department of Medicine, Washington University, St. Louis, Missouri.
  • Jenkins A; Division of Gastroenterology, Hepatology and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
  • Pandolfino JE; Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
  • Polamraju V; Division of Gastroenterology, Department of Medicine, Washington University, St. Louis, Missouri.
  • Wong MW; Division of Gastroenterology and Hepatology, Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.
  • Greytak M; Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California.
  • Yadlapati R; Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California. Electronic address: ryadlapati@ucsd.edu.
Clin Gastroenterol Hepatol ; 22(6): 1200-1209.e1, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38309491
ABSTRACT
BACKGROUND &

AIMS:

Discerning whether laryngeal symptoms result from gastroesophageal reflux is clinically challenging and a reliable tool to stratify patients is needed. We aimed to develop and validate a model to predict the likelihood of gastroesophageal reflux disease (GERD) among patients with chronic laryngeal symptoms.

METHODS:

This multicenter international study collected data from adults with chronic laryngeal symptoms who underwent objective testing (upper gastrointestinal endoscopy and/or ambulatory reflux monitoring) between March 2018 and May 2023. The training phase identified a model with optimal receiver operating characteristic curves, and ß coefficients informed a weighted model. The validation phase assessed performance characteristics of the weighted model.

RESULTS:

A total of 856 adults, 304 in the training cohort and 552 in the validation cohort, were included. In the training phase, the optimal predictive model (area under the curve, 0.68; 95% CI, 0.62-0.74), was the Cough, Overweight/obesity, Globus, Hiatal Hernia, Regurgitation, and male seX (COuGH RefluX) score, with a lower threshold of 2.5 and an upper threshold of 5.0 to predict proven GERD. In the validation phase, the COuGH RefluX score had an area under the curve of 0.67 (95% CI, 0.62-0.71), with 79% sensitivity and 81% specificity for proven GERD.

CONCLUSIONS:

The externally validated COuGH RefluX score is a clinically practical model to predict the likelihood of proven GERD. The score classifies most patients with chronic laryngeal symptoms as low/high likelihood of proven GERD, with only 38% remaining as indeterminate. Thus, the COuGH RefluX score can guide diagnostic strategies and reduce inappropriate proton pump inhibitor use or testing for patients referred for evaluation of chronic laryngeal symptoms.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reflujo Gastroesofágico / Tos Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Gastroenterol Hepatol Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reflujo Gastroesofágico / Tos Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Gastroenterol Hepatol Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos