{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:25:25Z","timestamp":1787070325358,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100006282","name":"Koning Boudewijnstichting","doi-asserted-by":"publisher","award":["2021"],"award-info":[{"award-number":["2021"]}],"id":[{"id":"10.13039\/501100006282","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To establish the minimal clinically important difference (MCID) of reflux symptom score (RSS), reflux symptom score\u201012 (RSS\u201012), and Reflux Symptom Index (RSI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>University hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Patients with laryngopharyngeal reflux disease (LPRD) at 24\u2010hour hypopharyngeal\u2010esophageal impedance pH monitoring were prospectively recruited from the European Reflux Clinic. Pretreatment to posttreatment symptoms and findings were assessed with RSS, RSS\u201012, RSI, and reflux sign assessment (RSA). Baseline LPRD severity (mild, moderate, severe) was determined using the RSS\u2010Quality\u2010of\u2010Life (RSS\u2010QoL). Therapeutic response was defined as improvement by at least one severity category regarding the IFOS classification based on post\u2010treatment RSS\u2010QoL. MCID was evaluated using receiver operating characteristic (ROC) curve analysis and Youden\u2010index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Evaluation was completed by 351 consecutive patients (208 females), including 127 responders to treatment (36.2%) and 224 (63.8%) partial or nonresponders. RSS\u2010QoL demonstrated strong correlations with RSS (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.697), RSS\u201012 (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.783), and RSI (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.776; all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), validating its use as anchor. Responders showed significantly greater score improvements than non\u2010responders for all patient\u2010reported outcome measures (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). ROC analysis revealed excellent discriminative ability for RSS (AUC\u2009=\u20090.822; 95% CI: 0.78\u20100.87), RSS\u201012 (AUC\u2009=\u20090.827; 0.78\u20100.87), and RSI (AUC\u2009=\u20090.867; 0.76\u20100.97). MCID values were 35 points for RSS, (sensitivity 81.1%, specificity 69.6%), 20 points for RSS\u201012 (sensitivity 85.3%, specificity 68.2%), and 8 points for RSI (sensitivity 77.3%, specificity 88.6%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The MCID for improvement in RSS, RSS\u201012, and RSI in LPRD patients is a decrease of 35, 20, and 8 points, respectively. This information improves the understanding of therapeutic response, allowing for drug class discontinuation and weaning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70379","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:25:11Z","timestamp":1787066711000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Minimal Clinically Important Difference of Reflux Symptom Score, Reflux Symptom Score\u201012, and Reflux Symptom Index"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-0845","authenticated-orcid":false,"given":"J\u00e9r\u00f4me R.","family":"Lechien","sequence":"first","affiliation":[{"name":"Department of Surgery, UMONS Research Institute for Health Sciences and Technology University of Mons (UMons) Mons Belgium"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Foch Hospital Paris Saclay University Paris 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