COSMIN database

Symptom-based outcome measures for dyspepsia and GERD trials: a systematic review

Fraser, A., Delaney, B., and Moayyedi, P.
BACKGROUND: Symptom assessment using questionnaires has been recommended as the primary outcome measure in clinical gastroesophageal reflux and dyspepsia trials. Questionnaires should have proven reliability, validity, and responsiveness, and may assess the frequency and/or severity of dyspepsia symptoms. Although a number of measures have been developed, it remains unclear which of these should be used in new trials.

OBJECTIVE: To describe existing questionnaire outcome measures that assess symptoms of gastroesophageal reflux dyspepsia for use in clinical trials.

METHODS: Studies were identified from Medline, Embase, the Cochrane library, and reference lists. The inclusion criterion was that the study assessed a questionnaire, which measured the frequency or severity of dyspepsia or gastroesophageal reflux symptoms, in a sample of patients.

RESULTS: No direct comparison between questionnaires was possible due to methodological heterogeneity. Thirty-seven studies describing 26 questionnaires met the inclusion criteria. Twelve were unidimensional (assessed symptoms only) and 14 were multidimensional (also assessed quality of life). Eleven questionnaires assessed both frequency and severity of dyspepsia, and 10 had proven reliability, validity, and responsiveness. No studies compared different questionnaires.

CONCLUSIONS: Future gastroesophageal reflux and dyspepsia clinical trials should use unidimensional or multidimensional outcome measures that assess both the frequency and severity of symptoms, and have proven reliability, validity, and responsiveness. Further research is necessary to compare existing outcome measures to determine which are the most reliable, valid, and responsive instruments.
Am J Gastroenterol
0002-9270 (Print)
Publication year:
Symptom status:
Physical state
Overall quality of life:
Overall quality of life
Adults (18-65)
Children (0-18)
Seniors (65+)
Diseases of and symptoms related to the digestive system
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
6 - Clinical rating scales
Adjectival Scale Dyspepsia Questionnaire
Adjectival Scale Symptom Questionnaire
DHSI - Digestive Health Status Instrument
DSSI - Dyspepsia Symptom Severity Index
Dyspepsia Symptom Score
Esophagal Symptom Questionnaire
GSRS - Gastrointestinal Symptom Rating Scale
Hong Kong index of dyspepsia
LDQ - Leeds Dyspepsia Questionnaire (AND LDQ-sv - Short-form Leeds Dyspepsia Questionnaire)
Postal Health Status Questionnaire
Questionnaire for the diagnosis of dyspepsia
RDQ - Reflux Disease Diagnostic Questionnaire
UESS - Ulcer Oesophagitis Subjective Symptoms Scale