Development and validation of a simple and multifaceted instrument, GERD-TEST, for the clinical evaluation of gastroesophageal reflux and dyspeptic symptoms

Table 1 Gastroesophageal reflux and dyspepsia-therapeutic efficacy and satisfaction test

Q1. Have you been bothered by heartburn during the past week? (By heartburn we mean a burning pain or discomfort behind the breastbone in your chest)
Q2. Have you been bothered by acid regurgitation during the past week? (By acid regurgitation we mean regurgitation or flow of sour or bitter fluid into your mouth)
Q3. Have you been bothered by epigastric pain or burning during the past week? (Epigastric pain includes any type of pain of the stomach)
Q4. Have you been bothered by postprandial fullness during the past week? (Postprandial fullness refers to discomfort or a sensation of heaviness caused by the food you consume remaining in the stomach)
Q5. Have you been bothered by early satiation during the past week? (Early satiation refers to the inability to finish a normally sized meal)
Response scale for Q1-5:
1 = no discomfort at all, 2 = slight discomfort, 3 = mild discomfort, 4 = moderate discomfort, 5 = moderately severe discomfort, 6 = severe discomfort, 7 = very severe discomfort.
Q6. During the past week, how often have you felt dissatisfaction because you were unable to eat meals as you intended due to chest and stomach symptoms? (Not being able to eat as you intended refers to the inability to eat the sufficient amount of food you want to eat at an uninhibited, natural pace)
Q7. During the past week, how often have you felt dissatisfaction due to impaired sleep caused by chest and stomach symptoms?
Q8. During the past week, how often have you felt dissatisfaction due to impairment of your work, housework, or other daily activities caused by chest and stomach symptoms?
Q9. During the past week, how often have you felt dissatisfaction because you were in a bad mood due to chest and stomach symptoms?
Response scale for Q.6-9:
1 = not at all, 2 = slightly, 3 = moderately, 4 = quite a lot, 5 = extremely.
Q10. During the past week, how often have you wanted another drug in addition to the drug your doctor prescribed because of intense symptoms of heartburn and acid regurgitation?
1 = not at all, 2 = on 1 d, 3 = on 2 to 3 d, 4 = on 4 to 5 d, 5 = always.
Q11. During the past week, how have you felt about symptoms of heartburn and acid regurgitation as compared with the symptom severity before current treatment?
1 = extremely improved, 2 = improved, 3 = slightly improved, 4 = not changed, 5 = aggravated.
Q12. If 10 corresponds to your symptoms before current treatment and 0 is "symptom-free", what number corresponds to symptoms of heartburn and acid regurgitation during the past week? Please circle the applicable score below:
			0	………….. 1 ………….. 2 ………..... 3 ………..... 4….…….... 5 ………..... 6 ….……... 7 …..……... 8 ….…….... 9 ……….....	10
			|		|
			Symptom-free		Symptoms before current treatment
Q13. What proportion of the proton pump inhibitor prescribed to you did you take as instructed?
1 = took drug as instructed, 2 = generally took drug as instructed (took at least three-quarters of the drug prescribed), 3 = sometimes forgot (took at least half but less than three-quarters of the drug prescribed, 4 = took little (took less than half of the drug prescribed), 5 = did not take any.

Before therapy, questions about treatment efficacy and adherence (Q10–Q13) were excluded. The following scores were defined: Score of GERD symptom subscale (GERD-SS) = (Q1 + Q2)/2; Score of Epigastric pain/burning symptom (EPS-Sx) = Q3; Score of Postprandial distress symptom subscale (PDS-SS) = (Q4 + Q5)/2; Score of FD symptom subscale (FD-SS) = [Q3 + (Q4 + Q5)/2]/2; Score of dissatisfaction with daily life subscale (DS-SS) = (Q6 + Q7 + Q8 + Q9)/4; Residual symptom rate (%) = 100 × (GERD-SS score at 4 wk-1)/(GERD-SS score at 0 wk-1). GERD: Gastroesophageal reflux and dyspepsia-therapeutic efficacy; FD: Functional dyspepsia.