Tielemans Merel M, Jansen Jan Bmj, van Oijen Martijn Gh
Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, Netherlands.
Interact J Med Res. 2012 Sep 26;1(2):e7. doi: 10.2196/ijmr.2101.
Persons with gastroesophageal reflux disease (GERD) frequently search online for information about causes and treatment options. The GerdQ self-assessment questionnaire can be used for diagnosis of GERD and follow-up of symptoms.
To assess whether it is feasible (1) to study the prevalence and impact of GERD in persons visiting a GERD information website, and (2) to identify partial responsiveness to proton pump inhibitor (PPI) therapy using the GerdQ.
All visitors (aged 18-79 years) to a GERD information website between November 2008 and May 2011 were invited to complete the GerdQ online. The GerdQ questionnaire consists of 6 questions (score per question: 0-3). In respondents who did not use PPIs, we used the questionnaire to identify those with GERD (total score ≥8) and assess the influence of these symptoms on their daily life, divided into low (total score <3 on impact questions) and high impact (total score ≥3 on impact questions). In PPI users, we used the GerdQ to quantify partial responsiveness by any report of heartburn, regurgitation, sleep disturbance, or over-the-counter medication use for more than 1 day in the preceding week. We subsequently asked GerdQ respondents scoring ≥8 to complete the disease-specific Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire.
A total of 131,286 visitors completed the GerdQ, of whom 80.23% (n = 105,329) did not use a PPI. Of these, we identified 67,379 respondents (63.97%) to have GERD (n = 32,935; 48.88% high impact). We invited 14,028 non-PPI users to complete the QOLRAD questionnaire, of whom 1231 (8.78%) completed the questionnaire. Mean total QOLRAD scores were 5.14 (SEM 0.04) for those with high-impact GERD and 5.77 (SEM 0.04) for those with low-impact GERD (P < .001). In PPI users, 22,826 of 25,957 respondents (87.94%) reported partial responsiveness. We invited 6238 PPI users to complete the QOLRAD questionnaire, of whom 599 (9.60%) completed the disease-specific quality-of-life questionnaire. Mean total QOLRAD scores were 4.62 (SEM 0.05) for partial responders and 5.88 (SEM 0.14) for adequate responders (P < .001).
The GerdQ identified GERD in many website respondents and measured partial responsiveness in the majority of PPI users. Both non-PPI users with GERD and PPI users with partial responsiveness were associated with a decreased health-related quality of life. We have shown the feasibility of GERD patient identification online.
胃食管反流病（GERD）患者经常在网上搜索有关病因和治疗方案的信息。GerdQ自我评估问卷可用于GERD的诊断和症状随访。
评估（1）研究访问GERD信息网站的人群中GERD的患病率及其影响，以及（2）使用GerdQ识别质子泵抑制剂（PPI）治疗的部分反应性是否可行。
邀请2008年11月至2011年5月期间访问GERD信息网站的所有访客（年龄在18 - 79岁之间）在线完成GerdQ。GerdQ问卷由6个问题组成（每个问题得分：0 - 3分）。在未使用PPI的受访者中，我们使用该问卷识别出患有GERD的患者（总分≥8分），并评估这些症状对其日常生活的影响，分为低影响（影响问题总分<3分）和高影响（影响问题总分≥3分）。在使用PPI的患者中，我们使用GerdQ通过在前一周内任何关于烧心、反流、睡眠障碍或使用非处方药物超过1天的报告来量化部分反应性。随后，我们要求GerdQ得分≥8分的受访者完成特定疾病的反流和消化不良生活质量（QOLRAD）问卷。
共有131,286名访客完成了GerdQ，其中80.23%（n = 105,329）未使用PPI。在这些未使用PPI的受访者中，我们确定67,379名受访者（63.97%）患有GERD（n = 32,935；48.88%为高影响）。我们邀请14,028名未使用PPI的用户完成QOLRAD问卷，其中1231名（8.78%）完成了问卷。高影响GERD患者的QOLRAD总平均分是5.14（标准误0.04），低影响GERD患者的QOLRAD总平均分是5.77（标准误0.04）（P <.001）。在使用PPI的患者中，25,957名受访者中有22,826名（87.94%）报告有部分反应性。我们邀请6238名使用PPI的用户完成QOLRAD问卷，其中599名（9.60%）完成了特定疾病的生活质量问卷。部分反应者的QOLRAD总平均分是4.62（标准误0.05），充分反应者的QOLRAD总平均分是5.88（标准误0.14）（P <.001）。
GerdQ在许多网站受访者中识别出了GERD，并在大多数使用PPI的患者中测量了部分反应性。患有GERD的未使用PPI患者和有部分反应性的使用PPI患者均与健康相关生活质量下降有关。我们已经证明了在线识别GERD患者的可行性。
