Diagnostic Accuracy of Patient-Reported Outcome Measures and Finding Instruments in Laryngopharyngeal Reflux Disease.

IF 2.5 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2025-07-01 Epub Date: 2025-03-24 DOI:10.1002/ohn.1237

Catherine Muscato, Jerome R Lechien

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引用次数: 0

Abstract

Objective: To investigate the diagnostic accuracy of various combinations of patient-reported outcome measures (PROMs) and upper aerodigestive tract finding instruments dedicated to the clinical diagnosis of laryngopharyngeal reflux disease (LPRD).

Study design: Prospective, multicenter study.

Setting: University hospital.

Methods: Patients with LPRD at the 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring were recruited from three European hospitals. Asymptomatic individuals served as the control group. Participants completed the Reflux Symptom Index (RSI), Reflux Symptom Score (RSS), and Reflux Symptom Score-12 (RSS-12) at baseline and 3-month posttreatment. Clinical signs were evaluated with the Reflux Finding Score (RFS), Reflux Sign Assessment (RSA), and Reflux Sign Assessment-10 (RSA-10). Sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) were calculated for each instrument and their combinations.

Results: A total of 542 LPRD patients and 204 healthy controls were included. The RSS was the PROM with the highest SE (95.4%), whereas RSS-12 reported the highest SP (94.7%). RSA had the highest SE (94.0%), and RSA-10 reported the highest SP (76.3%). The highest SE and SP of combination tools were found for RSS+RSA (90.4%) and RSS+RSA-10 (99.4%), respectively. RSS+RSA-10 achieved the highest PPV value (99.7%) and RSS+RSA had the highest NPV (79.3%). Overall, the RSS demonstrated the greatest diagnostic accuracy with an area under the curve (AUC) of 0.985. The combination RSS+RSA reported an AUC of 0.934.

Conclusion: The combination of RSS and RSA provided the most accurate diagnostic performance, maximizing SE, SP, PPV, and NPV. This combination offers enhanced utility for the preliminary diagnosis of LPRD.

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喉咽反流病患者报告的预后指标和发现工具的诊断准确性。

目的：探讨患者报告预后指标（PROMs）与上气消化道诊断仪联合用于临床诊断喉咽反流病（LPRD）的诊断准确性。研究设计：前瞻性、多中心研究。单位：大学医院。方法：从欧洲三家医院招募24小时下咽-食管多通道腔内阻抗- ph监测的LPRD患者。以无症状者为对照组。参与者在基线和治疗后3个月完成反流症状指数（RSI）、反流症状评分（RSS）和反流症状评分-12 （RSS-12）。临床症状通过反流发现评分（RFS）、反流体征评估（RSA）和反流体征评估-10 （RSA-10）进行评估。计算每种仪器及其组合的敏感性（SE）、特异性（SP）、阳性预测值（PPV）和阴性预测值（NPV）。结果：共纳入LPRD患者542例，健康对照204例。RSS为SE最高的PROM(95.4%)，而RSS-12为SP最高的PROM（94.7%）。RSA的SE最高（94.0%），RSA-10的SP最高（76.3%）。组合工具的SE和SP分别以RSS+RSA（90.4%）和RSS+RSA-10（99.4%）最高。RSS+RSA-10的PPV值最高（99.7%），RSS+RSA的NPV值最高（79.3%）。总体而言，RSS的诊断准确率最高，曲线下面积（AUC）为0.985。RSS+RSA组合的AUC为0.934。结论：RSS和RSA联合应用诊断效果最准确，可使SE、SP、PPV和NPV最大化。这种组合为LPRD的初步诊断提供了增强的效用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.