ArticleThe American journal of gastroenterology2025
Validation of Esophageal Global Symptom Severity as a Patient-Reported Outcome for Evaluation of Reflux Symptoms.
Article in The American journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Editorial: Do We Need to Adapt GERD Metrics Based on the Population Being Evaluated?Alimentary pharmacology & therapeutics · 2026Article
- Asian Patients Report Higher Reflux Symptom Burden than US Patients Despite Lower Objective Reflux Burden.Alimentary pharmacology & therapeutics · 2026Article
- Gastroesophageal Reflux Disease and Reflux-like Phenotypes: Using Lyon Consensus 2.0 to Guide Clinical Approach.Journal of neurogastroenterology and motility · 2026Review
- Laryngopharyngeal Symptoms and Laryngopharyngeal Reflux Disease: Presentation, Health Care Burden, and Risk Stratification.Neurogastroenterology and motility · 2026Review
- Genetic evidence links alcohol, coffee, cheese, and anxiety to GERD risk: A Mendelian randomization study.Medicine · 2026Article
- The American Foregut Society endoscopic classification outperforms Hill in phenotyping the esophago-gastric junction to guide gastroesophageal reflux disease management.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Article
- Observational
- Combined Lyon and Milan Scores Predict Gerd Management Outcome Better Than Either Score Alone or Their Individual Components.Alimentary pharmacology & therapeutics · 2025Article
- The Impact of Endoscopic Gastric Remodeling on Gastroesophageal Reflux Disease.Clinical and translational gastroenterology · 2025Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
introductionVisual Analog Scales (VAS) are simple, easy for patients to comprehend, and require limited translation. We evaluated the value of esophageal global symptom severity (GSS) measured using VAS in assessing initial reflux symptom burden as compared with other validated questionnaires, esophageal symptom burden, and outcome after reflux management.
methodsWe analyzed pooled data from published historical cohorts of patients undergoing pH-impedance testing for reflux symptoms from 3 continents (North America, Europe, Asia). Univariate (Spearman correlation), multivariable (general linear regression), and receiver operating characteristic analyses were performed to compare GSS with validated symptom instruments including gastroesophageal reflux disease questionnaire (GERDQ), GERD health-related quality of life (GERD-HRQL), Reflux Symptom Index (RSI), and metrics from pH-impedance monitoring per Lyon Consensus 2.0.
resultsOne thousand two hundred ninety-six patients (mean age 52.0 years, 61.9% female) were included: 937, 197, and 162 from North America, Europe, and Asia, respectively. GSS significantly correlated with GERDQ (R = 0.455), GERD-HRQL (R = 0.440), RSI (R = 0.491), acid exposure time (AET) (R = 0.158), and total reflux episodes (R = 0.161) ( P < 0.0001 for each comparison). The mean GSS was higher with abnormal GERDQ, GERD-HRQL, RSI, pathologic AET, and conclusive GERD per Lyon Consensus ( P < 0.0001 each comparison). On receiver operating characteristic analyses, GSS was noninferior to GERDQ, GERD-HRQL, and RSI in predicting pathologic AET and total reflux episodes, and conclusive GERD. Percentage improvement in GSS after antireflux treatment significantly correlated with change in GERDQ (R = 0.536, P < 0.0001) and treatment satisfaction (R = 0.532 P = 0.0002). On multivariable linear regression analyses, percentage change in GSS remained an independent predictor of both change in GERDQ (β = 0.813, P < 0.0001) and satisfaction with antireflux therapy (β = 1.90, P = 0.0006). DISCUSSION: GSS correlates with other validated reflux questionnaires and discriminates abnormal from normal reflux burden in patients with reflux symptoms. GSS change also reflects reflux treatment outcome and satisfaction. GSS is a useful addition to patient symptom assessment before and after GERD treatment.
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