The diagnostic value of GERDQ questionnaire for GERD: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LI Liqun ¹ ,  XIE Sheng ² , CHEN Mingbing ¹ , LI Jianfeng ¹ , TAN Jinjing ²

1. Guangxi University of Traditional Chinese Medicine, Nanning 530000, P.R.China;
2. Department of Spleen and Stomach, the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning 530000, P.R.China;

Corresponding author：

XIE Sheng, Email: xsh916566@163.com

Keywords：

GerdQ; Gastro-oesophageal reflux disease; Meta-analysis; Diagnostic value

DOI：

10.7507/1672-2531.201804030

Video：

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Objectives To systematically review the diagnostic value of GerdQ questionnaire for diagnosing the gastro-oesophageal reflux disease (GERD).Methods PubMed, Web of Science, EBMR, CNKI, CBM, VIP and WanFang Data databases were searched to collect studies on the diagnostic value the GerdQ questionnaire in diagnosing the GERD from inception to January 1^st 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using Meta-Disc 1.4 software. We used the Stata 12.0 software to assess the publication bias with funnel plots.Results A total of 20 studies were enrolled, including 7 978 patients. Among them, 4 848 patients were confirmed with GERD. The results of meta-analysis showed that: a) The pooled sensitivity, specificity, +LR, −LR, and DOR were 0.79 (95%CI 0.78 to 0.81), 0.66 (95%CI 0.65 to 0.68), 2.28 (95%CI 1.77 to 2.94), 0.37 (95%CI 0.27 to 0.52) and 6.34 (95%CI 3.59, 11.19), SROC(AUC) was 0.789 3, and Q* was 0.726 6. b) When the cut-off was 7, the diagnostic accuracy of GerdQ questionnaire for the GERD was the highest, and that of 9 was the second. c) The diagnostic accuracy of GerdQ questionnaire was higher when it was used in China.Conclusions GerdQ questionnaire has a moderate accuracy for the diagnosis of GERD, which can be a useful complementary tool for diagnosing GERD, and can be popularized in clinical settings. Due to limitation of quantity and quality of included studies, the above conclusions requires verification by more high quality studies.

Citation： LI Liqun, XIE Sheng, CHEN Mingbing, LI Jianfeng, TAN Jinjing. The diagnostic value of GERDQ questionnaire for GERD: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2019, 19(8): 915-923. doi: 10.7507/1672-2531.201804030 Copy

1.	Iwakiri K, Kinoshita Y, Habu Y, et al. Evidence-based clinical practice guidelines for gastro-oesophageal reflux disease. J Gastroenterol, 2016, 51(8): 751-767.
2.	EL Serag HB, Sweet S, Winchester CC, et al. Update on the epidemiology of gastroesophageal reflux disease: a symtematic review. Gut, 2014, 63(6): 871-880.
3.	Henry MA. Diagnosis and management of gastroesophageal reflux disease. Arq Bras Cir Dig, 2014, 27(3): 210-215.
4.	Dent J, Jones R, Vakil N, et al. A management strategy for GERD base on the gastroesephageal reflux disease questionnaire (GerdQ). Gut, 2007, 56(Suppl III): A75.
5.	沈皓, 康杰, 呼丞娟, 等. 以症状为基础不同诊断量表在胃食管反流病诊断中应用价值的比较. 宁夏医学杂志, 2016, 38(2): 160-161.
6.	Margarita SM, Mario AJ, William OR, et al. Validation of a questionaire regarding gastroesophageal reflux (GERD) in a Colombian population. Rev Col Gastroenterol, 2013, 28(3): 199-206.
7.	Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
8.	张天嵩, 钟文昭. Meta-DiSc 软件在诊断试验 Meta 分析中的应用. 循证医学, 2008, 8(2): 97-100.
9.	柏建岭, 钟文昭, 郑明华, 等. Stata 在 Meta 分析中的应用. 循证医学, 2007, 7(6): 363-368.
10.	GerdQ 研究协作组. 胃食管反流性疾病问卷对胃食管反流性疾病的诊断价值. 中华消化杂, 2009, 29(12): 793-798.
11.	Jones R, Junghard O, Dent J, et al. Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care. Aliment Pharmacol Ther, 2009, 30(10): 1030-1038.
12.	Brian E, La CY, Chehade R, et al. A prospective study to compare a symptom-based reflux disease questionnaire to 48-h Wireless PH Monitoring for the Identification of Gastroesophageal Reflux (revised 2-26-11). Am J Gastroenterol, 2011, 106(9): 1604-1611.
13.	王连芬, 郑长青, 林连捷, 等. GerdQ 量表在胃食管反流性疾病中的诊断价值. 世界华人消化杂志, 2011, 19(18): 1941-1945.
14.	刘慧敏, 蔡迎彬. 应用胃食管反流性疾病问卷临床诊断胃食管反流性疾病. 新疆医学, 2011, 41(12): 39-41.
15.	唐小波, 王亚雷, 许建明. 胃食管反流性疾病问卷在胃食管反流性疾病诊断中的价值. 安徽医科大学学报, 2011, 46(3): 275-278.
16.	胡杰波, 卢海亚, 田进信. GerdQ 量表在门诊胃食管反流性疾病诊断中的价值. 现代实用医学, 2012, 24(06): 629-630.
17.	Jonasson C, Wernersson B, Hoff DA, et al. Validation of the GerdQ questionnaire for the diagnosis of gastro-oesophageal reflux disease. Aliment Pharmacol Ther, 2013, 37(5): 564-572.
18.	翟浩良, 闻瑜. GerdQ 量表在胃食管反流性疾病中的诊断价. 中国临床医学, 2013, 15(05): 697-699.
19.	沈奕, 李兴华, 钟捷, 等. 胃食管反流性疾病调查问卷的诊断价值评价. 中国临床医学, 2013, 20(4): 541-543.
20.	Suzuki H, Matsuzaki J, Okada S, et al. Validation of the GerdQ questionnaire for the management of gastro-oesophageal reflux disease in Japan. United European Gastroenterol J, 2013, 1(3): 175-183.
21.	王志, 张成, 王俭, 等. GerdQ 量表在胃食管反流性疾病诊断中的应用. 中华胃食管反流性疾病电子杂志, 2014, 1(1): 36-38.
22.	Zavala-Gonzales MA, Azamar-Jacome AA, Meixueiro-Daza A, et al. Validation and diagnostic usefulness of gastroesophageal reflux disease questionnaire in a primary care level in Mexico. J Neurogastroenterol Motil, 2014, 20(4): 475-482.
23.	李颖, 李长锋, 闰振坤, 等. 胃食管反流性疾病问卷对胃食管反流性疾病的诊断价值. 中华消化内镜杂志, 2014, 31(6): 336-338.
24.	陈平湖, 叶伟智, 陈娇莲. GerdQ 量表在胃食管反流性疾病中的诊断价值分析. 中外医学研究, 2014, 12(10): 36-38.
25.	Zhou LY, Wang Y, Lu JJ, et al. Accuracy of diagnosing gastroesophageal reflux disease by GerdQ, esophageal impedance monitoring and histology. J Dig Dis, 2014, 15(5): 230-238.
26.	赵迎盼, 廖宇, 钟家珮, 等. 胃食管反流性疾病问卷 (GerdQ) 与反流性疾病问卷 (RDQ) 的比较研究. 胃肠病学和肝病学杂志, 2015, 24(5): 572-574.
27.	Gontar AS, Sahat H, Ricky RS. Comparison of endoscopic findings with gastroesophageal reflux disease questionaires (GerdQ) and reflux disease quetionaires (RDQ) for gastroesophageal reflux disease in medan. Indones J Gastroenterol Hepatol Digest Endosc, 2015, 16(3): 143-147.
28.	邱锋, 彭如洁. 胃食管反流性疾病问卷对老年人胃食管反流性疾病的诊断价值. 中国医药科学, 2017, 7(18): 185-187.
29.	Wang M, Zhang JZ, Kang XJ, et al. Relevance between GerdQ score and the severity of reflux esophagitis in Uygur and Han Chinese. Oncotarget, 2017, 8(43): 74371-74377.
30.	Wu JC. Gastroesophageal reflux disease: an Asian perspective. J Gastroenterol Hepatol, 2008, 23(12): 1785-1793.
31.	Tack J, Becher A, Mulligan C, et al. Systematic review: the burden of disruptive gastro-oesophageal reflux disease on health-related quality of life. Aliment Pharmacol Ther, 2012, 35(11): 1257-1266.
32.	Lacy BE, Weiser K, Chertoff J, et al. The diagnosis of gastroesophageal reflux disease. Am J Med, 2010, 123(7): 583-592.
33.	El-Serag HB. Epidemiology of non-erosive reflux disease. Digestion, 2008, 78(1): 6-10.
34.	Vakil N, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence based consensus. Am J Gastroenterol, 2006, 101(8): 1900-1920.
35.	Bossuyt, P M. Trial therapy with proton pump inhibitors is not a suitable test for gastroesophageal reflux disease: a meta-analysis of the diagnostic test characteristics. Ned Tijdschr Geneeskd, 2005, 149(6): 321-322.
36.	周丽雅, 郝建宇, 李兆申, 等. 胃食管反流性疾病量表和质子泵抑制剂试验对胃食管反流性疾病的诊断价值的多中心研究. 中华消化杂志, 2016, 36(4): 241-245.
37.	Ponce J, Garrigues V, Agréus L, et al. Structured management strategy based on the Gastro-oesophageal Reflux Disease (GERD) Questionnaire (GerdQ) vs. usual primary care for GERD: pooled analysis of five cluster-randomised European studies. Int J Clin Pract, 2012, 66(9): 897-905.
38.	He S, Liu Y, Chen Y, et al. Value of the Gastroesophageal reflux disease questionnaire (GerdQ) in predicting the proton pump inhibitor response in coronary artery disease patients with gastroesophageal reflux-related chest pain. Dis Esophagus, 2016, 29(4): 367-376.
39.	王琨, 段丽萍, 葛颖, 等. 症状量表、食管 24hpH 及阻抗监测对 Barrett 食管、反流性食管炎和非糜烂性反流病的诊断价值. 中华医学杂志, 2011, 91(18): 1228-1232.
40.	Jonasson C, Moum B, Bang C, et al. Randomised clinical trial: a comparison between a GerdQ-based algorithm and an endoscopy-based approach for the diagnosis and initial treatment of GERD. Aliment Pharmacol Ther, 2012, 35(11): 1290-1300.
41.	Numans ME, Lau J, de Wit NJ, et al. Short-term treatment with proton-pump inhibitors as a test for gastroesophageal reflux disease: a meta-analysis of diagnostic test characteristics. Ann Intern Med, 2004, 140(7): 518-527.

1. Iwakiri K, Kinoshita Y, Habu Y, et al. Evidence-based clinical practice guidelines for gastro-oesophageal reflux disease. J Gastroenterol, 2016, 51(8): 751-767.
2. EL Serag HB, Sweet S, Winchester CC, et al. Update on the epidemiology of gastroesophageal reflux disease: a symtematic review. Gut, 2014, 63(6): 871-880.
3. Henry MA. Diagnosis and management of gastroesophageal reflux disease. Arq Bras Cir Dig, 2014, 27(3): 210-215.
4. Dent J, Jones R, Vakil N, et al. A management strategy for GERD base on the gastroesephageal reflux disease questionnaire (GerdQ). Gut, 2007, 56(Suppl III): A75.
5. 沈皓, 康杰, 呼丞娟, 等. 以症状为基础不同诊断量表在胃食管反流病诊断中应用价值的比较. 宁夏医学杂志, 2016, 38(2): 160-161.
6. Margarita SM, Mario AJ, William OR, et al. Validation of a questionaire regarding gastroesophageal reflux (GERD) in a Colombian population. Rev Col Gastroenterol, 2013, 28(3): 199-206.
7. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
8. 张天嵩, 钟文昭. Meta-DiSc 软件在诊断试验 Meta 分析中的应用. 循证医学, 2008, 8(2): 97-100.
9. 柏建岭, 钟文昭, 郑明华, 等. Stata 在 Meta 分析中的应用. 循证医学, 2007, 7(6): 363-368.
10. GerdQ 研究协作组. 胃食管反流性疾病问卷对胃食管反流性疾病的诊断价值. 中华消化杂, 2009, 29(12): 793-798.
11. Jones R, Junghard O, Dent J, et al. Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care. Aliment Pharmacol Ther, 2009, 30(10): 1030-1038.
12. Brian E, La CY, Chehade R, et al. A prospective study to compare a symptom-based reflux disease questionnaire to 48-h Wireless PH Monitoring for the Identification of Gastroesophageal Reflux (revised 2-26-11). Am J Gastroenterol, 2011, 106(9): 1604-1611.
13. 王连芬, 郑长青, 林连捷, 等. GerdQ 量表在胃食管反流性疾病中的诊断价值. 世界华人消化杂志, 2011, 19(18): 1941-1945.
14. 刘慧敏, 蔡迎彬. 应用胃食管反流性疾病问卷临床诊断胃食管反流性疾病. 新疆医学, 2011, 41(12): 39-41.
15. 唐小波, 王亚雷, 许建明. 胃食管反流性疾病问卷在胃食管反流性疾病诊断中的价值. 安徽医科大学学报, 2011, 46(3): 275-278.
16. 胡杰波, 卢海亚, 田进信. GerdQ 量表在门诊胃食管反流性疾病诊断中的价值. 现代实用医学, 2012, 24(06): 629-630.
17. Jonasson C, Wernersson B, Hoff DA, et al. Validation of the GerdQ questionnaire for the diagnosis of gastro-oesophageal reflux disease. Aliment Pharmacol Ther, 2013, 37(5): 564-572.
18. 翟浩良, 闻瑜. GerdQ 量表在胃食管反流性疾病中的诊断价. 中国临床医学, 2013, 15(05): 697-699.
19. 沈奕, 李兴华, 钟捷, 等. 胃食管反流性疾病调查问卷的诊断价值评价. 中国临床医学, 2013, 20(4): 541-543.
20. Suzuki H, Matsuzaki J, Okada S, et al. Validation of the GerdQ questionnaire for the management of gastro-oesophageal reflux disease in Japan. United European Gastroenterol J, 2013, 1(3): 175-183.
21. 王志, 张成, 王俭, 等. GerdQ 量表在胃食管反流性疾病诊断中的应用. 中华胃食管反流性疾病电子杂志, 2014, 1(1): 36-38.
22. Zavala-Gonzales MA, Azamar-Jacome AA, Meixueiro-Daza A, et al. Validation and diagnostic usefulness of gastroesophageal reflux disease questionnaire in a primary care level in Mexico. J Neurogastroenterol Motil, 2014, 20(4): 475-482.
23. 李颖, 李长锋, 闰振坤, 等. 胃食管反流性疾病问卷对胃食管反流性疾病的诊断价值. 中华消化内镜杂志, 2014, 31(6): 336-338.
24. 陈平湖, 叶伟智, 陈娇莲. GerdQ 量表在胃食管反流性疾病中的诊断价值分析. 中外医学研究, 2014, 12(10): 36-38.
25. Zhou LY, Wang Y, Lu JJ, et al. Accuracy of diagnosing gastroesophageal reflux disease by GerdQ, esophageal impedance monitoring and histology. J Dig Dis, 2014, 15(5): 230-238.
26. 赵迎盼, 廖宇, 钟家珮, 等. 胃食管反流性疾病问卷 (GerdQ) 与反流性疾病问卷 (RDQ) 的比较研究. 胃肠病学和肝病学杂志, 2015, 24(5): 572-574.
27. Gontar AS, Sahat H, Ricky RS. Comparison of endoscopic findings with gastroesophageal reflux disease questionaires (GerdQ) and reflux disease quetionaires (RDQ) for gastroesophageal reflux disease in medan. Indones J Gastroenterol Hepatol Digest Endosc, 2015, 16(3): 143-147.
28. 邱锋, 彭如洁. 胃食管反流性疾病问卷对老年人胃食管反流性疾病的诊断价值. 中国医药科学, 2017, 7(18): 185-187.
29. Wang M, Zhang JZ, Kang XJ, et al. Relevance between GerdQ score and the severity of reflux esophagitis in Uygur and Han Chinese. Oncotarget, 2017, 8(43): 74371-74377.
30. Wu JC. Gastroesophageal reflux disease: an Asian perspective. J Gastroenterol Hepatol, 2008, 23(12): 1785-1793.
31. Tack J, Becher A, Mulligan C, et al. Systematic review: the burden of disruptive gastro-oesophageal reflux disease on health-related quality of life. Aliment Pharmacol Ther, 2012, 35(11): 1257-1266.
32. Lacy BE, Weiser K, Chertoff J, et al. The diagnosis of gastroesophageal reflux disease. Am J Med, 2010, 123(7): 583-592.
33. El-Serag HB. Epidemiology of non-erosive reflux disease. Digestion, 2008, 78(1): 6-10.
34. Vakil N, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence based consensus. Am J Gastroenterol, 2006, 101(8): 1900-1920.
35. Bossuyt, P M. Trial therapy with proton pump inhibitors is not a suitable test for gastroesophageal reflux disease: a meta-analysis of the diagnostic test characteristics. Ned Tijdschr Geneeskd, 2005, 149(6): 321-322.
36. 周丽雅, 郝建宇, 李兆申, 等. 胃食管反流性疾病量表和质子泵抑制剂试验对胃食管反流性疾病的诊断价值的多中心研究. 中华消化杂志, 2016, 36(4): 241-245.
37. Ponce J, Garrigues V, Agréus L, et al. Structured management strategy based on the Gastro-oesophageal Reflux Disease (GERD) Questionnaire (GerdQ) vs. usual primary care for GERD: pooled analysis of five cluster-randomised European studies. Int J Clin Pract, 2012, 66(9): 897-905.
38. He S, Liu Y, Chen Y, et al. Value of the Gastroesophageal reflux disease questionnaire (GerdQ) in predicting the proton pump inhibitor response in coronary artery disease patients with gastroesophageal reflux-related chest pain. Dis Esophagus, 2016, 29(4): 367-376.
39. 王琨, 段丽萍, 葛颖, 等. 症状量表、食管 24hpH 及阻抗监测对 Barrett 食管、反流性食管炎和非糜烂性反流病的诊断价值. 中华医学杂志, 2011, 91(18): 1228-1232.
40. Jonasson C, Moum B, Bang C, et al. Randomised clinical trial: a comparison between a GerdQ-based algorithm and an endoscopy-based approach for the diagnosis and initial treatment of GERD. Aliment Pharmacol Ther, 2012, 35(11): 1290-1300.
41. Numans ME, Lau J, de Wit NJ, et al. Short-term treatment with proton-pump inhibitors as a test for gastroesophageal reflux disease: a meta-analysis of diagnostic test characteristics. Ann Intern Med, 2004, 140(7): 518-527.

Chinese Journal of Evidence-Based Medicine

The diagnostic value of GERDQ questionnaire for GERD: a meta-analysis

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