Protocol - Gastroesophageal Reflux Disease (GERD) Symptoms
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
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
NoneEquipment Needs
NoneRequirements
| Requirement Category | Required |
|---|---|
| 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
| Standard | Name | ID | Source |
|---|---|---|---|
| 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 ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX191101_Addtional_Medications_Frequency | ||||
| PX191101060000 | For the next 6 questions please think about more | N/A | ||
| PX191101_Difficulty_Sleeping_Frequency | ||||
| PX191101050000 | For the next 6 questions please think about more | N/A | ||
| PX191101_Heartburn_Frequency | ||||
| PX191101010000 | For the next 6 questions please think about more | N/A | ||
| PX191101_Nausea_Frequency | ||||
| PX191101040000 | For the next 6 questions please think about more | N/A | ||
| PX191101_Regurgitation_Frequency | ||||
| PX191101020000 | For the next 6 questions please think about more | N/A | ||
| PX191101_Stomach_Pain_Frequency | ||||
| PX191101030000 | For the next 6 questions please think about more | N/A | ||
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.