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Protocol - Gastroesophageal Reflux Disease (GERD) Symptoms

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Description

The Gastroesophageal Reflux Disease Questionnaire (GerdQ) is a 6-item questionnaire that helps identify patients with gastroesophageal reflux disease (GERD). Patients are asked to report frequency of symptoms over the past 7 days.

Specific Instructions

If the administration of the GerdQ produces a positive score for GERD, the Gastrointestinal Working Group (WG) recommends performing a pH impedence test to confirm the results and determine disease severity. Please see the Gastrointestinal WG Supplemental Information for a pH impedence test protocol.

The Gastroesophageal Reflux Disease Questionnaire (GerdQ) is a proprietary instrument that is available for use with permission from AstraZeneca.

To use the Gastroesophageal Reflux Disease Questionnaire (GerdQ), permission must be obtained from AstraZeneca. To obtain permission, contact AstraZeneca at PROinformation@astrazeneca.com and complete a License Agreement.

Availability

Limited Availability

Protocol

For the next 6 questions please think about your symptoms over the past 7 days . . .

1. How often did you have a burning feeling behind your breastbone (heartburn)?

0 [ ] 0 days

1 [ ] 1 day

2 [ ] 2–3 days

3 [ ] 4–7 days

2. How often did you have stomach contents (liquid or food) moving upwards to your throat or mouth (regurgitation)?

0 [ ] 0 days

1 [ ] 1 day

2 [ ] 2–3 days

3 [ ] 4–7 days

3. How often did you have pain in the center of the upper stomach?

3 [ ] 0 days

2 [ ] 1 day

1 [ ] 2–3 days

0 [ ] 4–7 days

4. How often did you have nausea?

3 [ ] 0 days

2 [ ] 1 day

1 [ ] 2–3 days

0 [ ] 4–7 days

5. How often did you have difficulty getting a good nights sleep because of your heartburn and/or regurgitation?

0 [ ] 0 days

1 [ ] 1 day

2 [ ] 2–3 days

3 [ ] 4–7 days

6. How often did you take additional medications for your heartburn and/or regurgitation other than what your physician told you to take (such as Tums, Rolaids, Maalox)?

0 [ ] 0 days

1 [ ] 1 day

2 [ ] 2–3 days

3 [ ] 4–7 days

Scoring Information

Scores ranging from 0 to 3 were applied for the positive predictors and from 3 to 0 (reversed order, where 3 = none) for negative predictors. The Gastroesophageal Reflux Disease Questionnaire (GerdQ) score was calculated as the sum of these scores, giving a total score ranging from 0 to 18. Those with a score of 8 or more have a high likelihood of having Gastroesophageal Reflux Disease (GERD), and those with less than 8 have low or no likelihood. For more detailed scoring information, see the reference in the Source section.

Personnel and Training Required
None
Equipment Needs
None
Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Lifestage

Adult

Participants

Adults, aged 18 years and older

Selection Rationale

The Gastroesophageal Reflux Disease Questionnaire (GerdQ) was selected because it is readily available, easy to use, and fairly accurate at diagnosing gastroesophageal reflux disease (GERD).

Language

Chinese, English

Standards
StandardNameIDSource
Logical Observation Identifiers Names and Codes (LOINC) GERD symptoms proto 62973-3 LOINC
Human Phenotype Ontology Gastroesophogeal reflux HP:0002020 HPO
caDSR Form PhenX PX191101 - Gastroesophageal Reflux Disease Gerd Symptoms 6195150 caDSR Form
Derived Variables

None

Process and Review

Not applicable.

Protocol Name from Source

Gastroesophageal Reflux Disease Questionnaire (GerdQ)

Source

Jones, R., Junghard, O., Dent, J., Vakil, N., Halling, K., Wernersson, B., & Lind, T. (2009). Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care. Alimentary Pharmacology and Therapeutics, 30(10), 1030–1038.

General References

Chehade, R. J., Lacy, B. E., & Crowell, M. D. (2010, May). Gastroesophageal reflux disease: A prospective study comparing a symptom-based reflux disease questionnaire to BRAVO pH capsule monitoring. Poster presented at the Digestive Disease Week conference, New Orleans, LA.

Vakil, N., van Zanten, S. V., Kahrilas, P., Dent, J., & Jones, R. (2007). The Montreal definition and classification of gastroesophageal reflux disease: A global evidence-based consensus. American Journal of Gastroenterology, 101(8), 1900–1920.

Protocol ID

191101

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX191101_Addtional_Medications_Frequency
PX191101060000 For the next 6 questions please think about more
your symptoms over the past 7 days... How often did you take additional medications for your heartburn and/or regurgitation other than what your physician told you to take (such as Tums, Rolaids, Maalox)? show less
N/A
PX191101_Difficulty_Sleeping_Frequency
PX191101050000 For the next 6 questions please think about more
your symptoms over the past 7 days... How often did you have difficulty getting a good night's sleep because of your heartburn and/or regurgitation? show less
N/A
PX191101_Heartburn_Frequency
PX191101010000 For the next 6 questions please think about more
your symptoms over the past 7 days... How often did you have a burning feeling behind your breastbone (heartburn)? show less
N/A
PX191101_Nausea_Frequency
PX191101040000 For the next 6 questions please think about more
your symptoms over the past 7 days... How often did you have nausea? show less
N/A
PX191101_Regurgitation_Frequency
PX191101020000 For the next 6 questions please think about more
your symptoms over the past 7 days... How often did you have stomach contents (liquid or food) moving upwards to your throat or mouth (regurgitation)? show less
N/A
PX191101_Stomach_Pain_Frequency
PX191101030000 For the next 6 questions please think about more
your symptoms over the past 7 days... How often did you have pain in the center of the upper stomach? show less
N/A
Gastrointestinal
Measure Name

Gastroesophageal Reflux Disease (GERD) Symptoms

Release Date

December 13, 2010

Definition

This questionnaire asks about symptoms of heartburn, pain, and regurgitation in the past 7 days to determine the presence of gastroesophageal reflux disease (GERD).

Purpose

This measure is used to assist health care professionals in the diagnosis and effective management of patients with gastroesophageal reflux disease (GERD).

Keywords

esophagus, gastroesophageal reflux disease, GERD, pH monitoring, heartburn, reflux, regurgitation, Gastrointestinal, proprietary

Measure Protocols
Protocol ID Protocol Name
191101 Gastroesophageal Reflux Disease (GERD) Symptoms
Publications

There are no publications listed for this protocol.