Heading Robert C, Thomas Edward C M, Sandy Phil, Smith Gary, Fass Ronnie, Hungin Pali S
aSchool of Medicine, Pharmacy and Health, Durham University, Durham bCategory Development Organisation, Reckitt Benckiser Plc, Slough, UK cChief Research Officer, Winkle BV, Keizersgracht , Amsterdam, The Netherlands dDepartment of Gastroenterology, Case Western Reserve University, Cleveland, Ohio, USA.
Eur J Gastroenterol Hepatol. 2016 Apr;28(4):455-62. doi: 10.1097/MEG.0000000000000565.
The objective of this study was to develop a self-administered questionnaire for upper gastrointestinal (GI) symptoms using lay vocabulary uninfluenced by established medical terminology or concepts and to conduct a survey of symptom occurrence among sufferers in four countries.
The questionnaire was designed by integrating information gained from the vocabulary used by 38 upper GI symptom sufferers. There was no medical input to its development. The questionnaire was then used, after appropriate translation, in Brazil, Russia, the UK and the USA. Details of 10 659 symptom episodes were obtained from 2665 individuals.
Nine symptoms described in lay vocabulary were identified during questionnaire development. Of these, one corresponded to regurgitation, whereas two that were distinguished by survey participants might both be interpreted as heartburn. One chest symptom for which a corresponding medical term was uncertain occurred in ∼30% of the respondents. Five different 'stomach' or abdominal symptoms were identified. The predominant symptom and the pattern of concurrent symptoms often varied from one symptom episode to another. Use of the terms 'heartburn', 'reflux', 'indigestion' and 'burning stomach' to describe symptoms varied between countries.
Some common upper GI symptoms described by those who suffer them have no clear counterpart in conventional medical terminology. Inadequacy of the conventional terminology in this respect deserves attention, first, to characterize it fully, and thereafter to construct enquiry that delivers more precise symptom identification. Our results suggest that improvement may require the use of vocabulary of individuals suffering the symptoms without imposing conformity with established symptom concepts.
本研究的目的是开发一份针对上消化道（GI）症状的自我管理问卷，使用不受既定医学术语或概念影响的通俗词汇，并在四个国家对患者的症状发生情况进行调查。
通过整合从38名上消化道症状患者使用的词汇中获得的信息来设计问卷。问卷开发过程中没有医学方面的参与。然后，经过适当翻译后，该问卷在巴西、俄罗斯、英国和美国使用。从2665名个体中获得了10659次症状发作的详细信息。
在问卷开发过程中确定了9个用通俗词汇描述的症状。其中，一个对应于反流，而调查参与者区分出的两个症状可能都可解释为烧心。约30%的受访者出现了一个相应医学术语不确定的胸部症状。确定了5种不同的“胃部”或腹部症状。主要症状和并发症状的模式在不同的症状发作之间往往有所不同。各国使用“烧心”“反流”“消化不良”和“胃部灼烧感”等术语来描述症状的情况有所不同。
患者描述的一些常见上消化道症状在传统医学术语中没有明确对应的表述。传统术语在这方面的不足值得关注，首先要对其进行全面描述，然后构建能够更精确识别症状的询问方式。我们的结果表明，改进可能需要使用出现症状的个体的词汇，而不强制符合既定的症状概念。
