Reliability and validity of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire in dyspepsia: A six-country study

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Psychometric validation of the German translation of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire in patients with reflux disease

BACKGROUND: Symptoms of heartburn has an impact on health-related quality of life (HRQL). When a questionnaire is translated into a new language, a linguistic validation is necessary but not sufficient unless the psychometric characteristics have been verified. The aim is to document the psychometric characteristics of the German translation of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire. METHODS: 142 patients with symptoms of heartburn (Age: M = 47.5, ± 14.6; Males = 44.4%) completed the German translation of GSRS, the QOLRAD, the Short-Form-36 (SF-36) and the Hospital Anxiety and Depression (HAD) scale. RESULTS: The internal consistency reliability of GSRS ranged from 0.53–0.91 and of QOLRAD from 0.90–0.94, respectively. The test-retest reliability of GSRS ranged from 0.49–0.73 and of QOLRAD from 0.70–0.84. The relevant domains of the GSRS and QOLRAD domain scores significantly correlated. GSRS domains of Abdominal Pain and Constipation correlated (negatively) with most of the domains of the SF-36. The relevant QOLRAD domains significantly correlated with all SF-36 domains. CONCLUSIONS: The psychometric characteristics of the German translation of GSRS and QOLRAD were found to be good, with satisfactory reliability and validity. The reliability of the GSRS Abdominal Pain domain was moderate

The impact of illness in patients with moderate to severe gastro-esophageal reflux disease

BACKGROUND: Gastro-esophageal reflux disease (GERD) is a common disease. It impairs health related quality of life (HRQL). However, the impact on utility scores and work productivity in patients with moderate to severe GERD is not well known. METHODS: We analyzed data from 217 patients with moderate to severe GERD (mean age 50, SD 13.7) across 17 Canadian centers. Patients completed three utility instruments – the standard gamble (SG), the feeling thermometer (FT), and the Health Utilities Index 3 (HUI 3) – and several HRQL instruments, including Quality of Life in Reflux and Dyspepsia (QOLRAD) and the Medical Outcomes Short Form-36 (SF-36). All patients received a proton pump inhibitor, esomeprazole 40 mg daily, for four to six weeks. RESULTS: The mean scores on a scale from 0 (dead) to 1 (full health) obtained for the FT, SG, and HUI 3 were 0.67 (95% CI, 0.64 to 0.70), 0.76 (95% CI, 0.75 to 0.80), and 0.80 (95% CI, 0.77 to 0.82) respectively. The mean scores on the SF-36 were lower than the previously reported Canadian and US general population mean scores and work productivity was impaired. CONCLUSION: GERD has significant impact on utility scores, HRQL, and work productivity in patients with moderate to severe disease. Furthermore, the FT and HUI 3 provide more valid measurements of HRQL in GERD than the SG. After treatment with esomeprazole, patients showed improved HRQL

Psychometric validation of the Afrikaans translation of two patient-reported outcomes instruments for reflux disease

Objectives: To verify the validity and reliability of two Afrikaans patient-reported outcomes instruments, a disease-specific and a health-related quality of life instrument in patients with reflux disease. Design: Psychometric validation study. Setting: South African, major referral gastroenterology clinic. Subjects: Consecutive patients with predominant symptoms of heartburn. Outcome measures: Patients completed the Afrikaans versions of the Gastrointestinal Symptom Rating Scale (GSRS), the Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD) and the Short Form Health-36 (SF-36). The frequency and severity of heartburn during the previous 7 days were recorded. Results: 125 patients (aged of 46.0 ±12.3 years, 74.4% female, 87% mixed race) completed the assessments. Most patients (62%) had severe symptoms and half (54%) had symptoms on more than 5 days in the previous week. Patients were most bothered by symptoms of reflux (mean GSRS score of 4.9), indigestion (4.0) and abdominal pain (4.0). These symptoms caused patients problems with food and drink (mean QOLRAD score of 3.5), emotional distress (3.6), impaired vitality (3.7) and sleep disturbance (3.8). The internal consistency of the GSRS symptom clusters was between 0.65 and 0.86 and, for QOLRAD dimensions, it was in the range 0.82 0.94. Test-retest reliability was 0.620.75 (GSRS) and 0.710.82 (QOLRAD). Relevant domains of GSRS and QOLRAD were significantly correlated. GSRS domains of abdominal pain and indigestion, and relevant QOLRAD domains, showed negative correlation with related SF-36 domains. Conclusions: The Afrikaans translations of GSRS and QOLRAD are valid and reliable instruments for use in clinical trials for the assessment of reflux symptoms and their impact on South African patients' healthrelated quality of life. South African Gastroenterology Review Vol. 4(1) 2006: 5-