Sensitivity and specificity of combination of Hull airway reflux questionnaire and gastroesophageal reflux disease questionnaire in identifying patients with gastroesophageal reflux-induced chronic cough

Siwan Wen; Shengyuan Wang; Shanshan Niu; Mengru Zhang; Cuiqin Shi; Zhongmin Qiu; Xianghuai Xu; Li Yu

doi:10.21037/atm-20-3236

Sensitivity and specificity of combination of Hull airway reflux questionnaire and gastroesophageal reflux disease questionnaire in identifying patients with gastroesophageal reflux-induced chronic cough

Ann Transl Med. 2020 Dec;8(23):1564. doi: 10.21037/atm-20-3236.

Authors

Siwan Wen¹, Shengyuan Wang¹, Shanshan Niu¹, Mengru Zhang¹, Cuiqin Shi¹, Zhongmin Qiu¹, Xianghuai Xu¹, Li Yu¹

Affiliation

¹ Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University, School of Medicine, Shanghai, China.

Abstract

Background: There is a need to find a simple, non-invasive and effective diagnostic tool for diagnosing gastroesophageal reflux-induced chronic cough (GERC) in clinic. This study aimed to evaluate the predictive diagnostic value of Hull airway reflux questionnaire (HARQ) and its combination with gastroesophageal reflux disease questionnaire (GerdQ) for GERC.

Methods: Chronic cough patients were enrolled and the diagnosis of GERC was established according to the chronic cough diagnosis and treatment process. The diagnostic value of HARQ and GerdQ alone or the combination of HARQ and GerdQ was analyzed.

Results: A total of 402 patients with chronic cough were eventually enrolled, including 166 GERC patients. When the HARQ score was used to predict the diagnosis of GERC, the area under the ROC curve was 0.796. The sensitivity and specificity were 77.19% and 77.06%, respectively. When the GerdQ was used to predict the diagnosis of GERC, the area under the ROC curve was 0.763. The sensitivity and specificity were 70.18% and 76.15%, respectively. When HARQ combined with GerdQ were used to predict the diagnosis of GERC, the area under the ROC curve was 0.848. The sensitivity and specificity were 77.19% and 79.82%, respectively.

Conclusions: HARQ used to evaluate the cough hypersensitivity has a certain predictive diagnostic value for GERC. The diagnosis of GERC should be considered when the HARQ score is ≥24. The predictive diagnostic value of the combination of HARQ and GerdQ is significantly higher, which makes the diagnosis of GERC simpler, quicker and more effective.

Keywords: Hull airway reflux questionnaire (HARQ); gastroesophageal reflux disease questionnaire (GerdQ); gastroesophageal reflux-induced chronic cough (GERC); predictive diagnosis.