Journal
JOURNAL OF ASTHMA
Volume 58, Issue 11, Pages 1502-1511Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/02770903.2020.1805750
Keywords
Subacute; chronic cough; gastroesophageal reflux disease; FSSG questionnaire; blood; sputum eosinophil count
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The FSSG questionnaire is useful for diagnosing GERD-related cough, especially in patients with low blood or sputum eosinophil counts. The sensitivity and specificity of the diagnosis can be increased in these patients, highlighting the utility of the subjective questionnaire in such cases.
Background The frequency scale for the symptoms of GERD (FSSG) questionnaire, which originally consists of acid-reflux and dysmotility symptom domains, is a succinct questionnaire to evaluate gastroesophageal reflux disease (GERD) symptoms. Objectives To evaluate the utility of subjective questionnaire of GERD for the diagnosis of GERD-related cough by using FSSG questionnaire. Methods We recruited 256 patients with subacute/chronic cough between April 2012 and March 2018, who were analyzed using FSSG questionnaire and blood eosinophil counts. GERD-related cough was inferred through the presence of classic reflux symptoms including heartburn and/or typical coughing trigger (e.g. phonation, rising, lying, eating, and intake of certain food). The diagnosis was confirmed by response to specific treatments for GERD. Receiver operating characteristic curve analysis was performed to determine the cutoff score for the diagnosis. Results One-hundred ten patients (43%) were diagnosed as having GERD-related cough. FSSG questionnaire was relevant for diagnosing GERD-related cough, with the area under the curve (AUC) of 0.70 (p < 0.0001, cutoff score 7 points, sensitivity 75%, specificity 62%). When limited to patients with blood eosinophils of <= 150/mu L or those with sputum eosinophils of <= 3%, sensitivity and specificity of the diagnosis was increased, respectively (sensitivity and specificity; 79% and 65% for blood eosinophils and 82% and 68% for sputum eosinophils.p < 0.0001, AUC 0.74 for both). Conclusions The subjective questionnaire of GERD (FSSG) would be helpful in diagnosing GERD-related cough, particularly in patients with low blood or sputum eosinophil counts.
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