Comparison of Pediatric Voice Outcome Survey, Reflux Symptom Index, Reflux Finding Score, and Esophageal Biopsy Results

Abstract

To examine correlations between the Pediatric Voice Outcome Survey (PVOS) score, the Reflux Symptom Index (RSI) score, the Reflux Finding Score (RFS), and esophageal biopsy findings in children undergoing upper aerodigestive tract endoscopy. Design: Retrospective review of pediatric voice qualityof-life and laryngopharyngeal reflux surveys. Blinded assessment of endoscopic laryngeal images. Setting: Tertiary care children's hospital. Patients: The study included 36 children with the primary problem of dysphonia (n=28) or cough (n=8) who underwent endoscopy. Interventions: The PVOS and the RSI were adminstered to the patient's parents before surgery. The patients underwent laryngotracheobronchoscopy and esophageal biopsy. Four raters independently assigned an RFS to the laryngeal photographs. Main Outcome Measures: The assessment included (1) PVOS scores, RSI scores, and RFSs; (2) internal consistency of PVOS and RSI scores; (3) RFS intrarater and interrater reliability; and (4) correlations between PVOS score, RSI score, RFS, and esophageal biopsy findings. Results: The mean (SD) age of the patients was 7.5 (2.6) years; the mean (SD) PVOS score, 71.9 (21.4); and the mean (SD) RSI score, 16.2 (9.1). The PVOS and the RSI scores demonstrated good internal consistency (Cronbach ␣=0.79 and 0.78, respectively). The RFS exhibited good intrarater reliability (r=0.66-0.98) and moderate interrater reliability (r=0.32-0.70). The PVOS and RSI instruments displayed significant correlation (r=−0.30; P=.04). There were no other significant correlations between RFSs, esophageal biopsy results, PVOS scores, or RSI scores (PϾ.05). Conclusions: The RSI may be a useful parent-proxy instrument in addition to the PVOS for pediatric voice patients. The RFS is reliable in children, but its validity could not be demonstrated in this patient population.

The importance of combined 24‐hour multichannel intraluminal impedance–pH monitoring in the evaluation of children with suspected laryngopharyngeal reflux

“…Previously, Simons et al . in their study investigating 36 children with primary problem of dysphonia or cough found that in children with LPR, mean RFS was 5.6.…”

Absence of <emph type="ital">Helicobacter pylori</emph> in Pediatric Adenoid Hyperplasia

“…The RSI is a 9-item, self-administered outcomes instrument that documents the severity of LPR in adults 14 and correlates well with the Reflux Finding Score, which is obtained using laryngeal endoscopy. 34 In a study 17 of children with dysphonia and chronic, refractory cough, which are generally accepted symptoms of extraesophageal reflux, the RSI correlated with the Pediatric Voice Outcome Sur-vey, thereby supporting the clinical usefulness of the RSI in a pediatric population.…”

Prevalence of Laryngopharyngeal Reflux Symptoms

“…Therefore, adequate diagnosis and effective treatment are necessary before progression of LPRD. The RSI, a means to assess the symptoms in subjects with LPR proposed by Belafsky et al, 6 has been used to evaluate LPR in certain populations 3,7 ,8, 14 . In the present study, the RSI was used to survey the prevalence of LPR in health checkup examinees and in patients with OME of undetermined etiology, and the results were compared.…”