ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2024
Validated Clinical Score to Predict Gastroesophageal Reflux in Patients With Chronic Laryngeal Symptoms: COuGH RefluX.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 17 citations in OpenAlex.
- Optimizing Evaluation of Gastroesophageal Reflux With Atypical Symptoms: Cost-Effectiveness and Cost-Minimalization Analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Gastroesophageal Reflux Disease and Reflux-like Phenotypes: Using Lyon Consensus 2.0 to Guide Clinical Approach.Journal of neurogastroenterology and motility · 2026Review
- Clinical predictors of pathological gastroesophageal reflux: a pH-impedance study of 2688 adults with laryngopharyngeal reflux symptoms.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Article
- Laryngopharyngeal Symptoms and Laryngopharyngeal Reflux Disease: Presentation, Health Care Burden, and Risk Stratification.Neurogastroenterology and motility · 2026Review
- Laryngopharyngeal Symptoms and Laryngopharyngeal Reflux Disease: Diagnostic Testing and Clinical Approach Based on the San Diego Consensus.Neurogastroenterology and motility · 2026Review
- The Milan Score is an Effective Manometric Tool to Predict Gastroesophageal Reflux in Patients With Laryngopharyngeal Symptoms.Neurogastroenterology and motility · 2026Article
- Gatherings in Esophagology: Innovations and Future Directions in the Diagnosis and Management of Reflux Disease.Annals of the New York Academy of Sciences · 2026Article
- Laryngopharyngeal reflux current developments and therapeutic strategies.BMC gastroenterology · 2026Review
- Low pillow height is associated with LPR among patients with GERD: a retrospective single-center study.BMC gastroenterology · 2025Article
- Clinical Application of Lyon Consensus 2.0 in Asia: An Overview.Gut and liver · 2025Review
- Accuracy of COuGH RefluX Score as a Predictor of Gastroesophageal Reflux Disease (GERD) in Mexican Patients with Chronic Laryngopharyngeal Symptoms: A Cross-Sectional Study.Diagnostics (Basel, Switzerland) · 2025Article
- Diagnosis and Management of Gastroesophageal Reflux Disease: Current Insights.Clinical and experimental gastroenterology · 2025Review
- Laryngopharyngeal Reflux: Historical Perspectives, Current Diagnostics and Therapies, and Remaining Challenges.Acta gastroenterologica LatinoamericanaReview
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Authors and funding
12 authors at 6 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsDiscerning 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.
methodsThis 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 β coefficients informed a weighted model. The validation phase assessed performance characteristics of the weighted model.
resultsA 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.
conclusionsThe 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.
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