Specific HRQL instruments and symptom scores were more responsive than preference-based generic instruments in patients with GERD

J Clin Epidemiol. 2009 Jan;62(1):102-10. doi: 10.1016/j.jclinepi.2008.02.012. Epub 2008 Jul 10.


Objective: To determine relative responsiveness of disease-specific and generic preference-based health-related quality of life instruments in gastroesophageal reflux disease (GERD).

Study design and setting: We compared standardized response means (SRM) of disease-specific and preference-based instruments in 217 outpatients with GERD.

Results: Quality of Life in Reflux and Dyspepsia and symptom scores were responsive across all domains, whereas global rating of change and Work Productivity and Activity Impairment-GERD only in single domains. The most responsive were Quality of Life in Reflux and Dyspepsia food/drink problems (SRM: 1.90, 95% confidence interval [CI]: 1.76-2.03) and vitality (SRM: 1.68, 95% CI 1.55-1.82) domains, Work Productivity and Activity Impairment-GERD workdays with reflux symptoms (SRM: 2.02, 95% CI 1.84-2.19), symptoms of heartburn (SRM: 1.83, 95% CI 1.69-1.96) and acid reflux (SRM: 1.48, 95% CI 1.35-1.62), and global rating of change in stomach problems (SRM: 2.19, 95% CI 2.05-2.32). The least responsive were Work Productivity and Activity Impairment-GERD domains related to hours absent at work (SRM: 0.22, 95% CI 0.05-0.38), reduced productivity at work (SRM: 0.66, 95% CI 0.48-0.83) and during other activities (SRM: 0.78, 95% CI 0.65-0.92), as well as emotional global rating of change (SRM: 0.72, 95% CI 0.58-0.85), and the standard gamble (SRM: 0.35, 95% CI 0.21-0.48), which was less responsive than the feeling thermometer (SRM: 0.92, 95% CI 0.78-1.05).

Conclusions: In patients with GERD, disease-specific health-related quality of life instruments and symptom scores showed greater responsiveness than preference-based generic instruments. The feeling thermometer proved more responsive than the standard gamble.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Anti-Ulcer Agents / therapeutic use
  • Canada
  • Female
  • Gastroesophageal Reflux / drug therapy
  • Gastroesophageal Reflux / psychology*
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Omeprazole / therapeutic use
  • Quality of Life*
  • Reproducibility of Results
  • Severity of Illness Index
  • Sickness Impact Profile
  • Surveys and Questionnaires / standards*
  • Treatment Outcome


  • Anti-Ulcer Agents
  • Omeprazole