{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:49:36Z","timestamp":1753876176420,"version":"3.41.2"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,5,3]],"date-time":"2025-05-03T00:00:00Z","timestamp":1746230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,3]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Symptom assessment and proton pump inhibitor (PPI) trial are limited in predicting pathologic gastroesophageal reflux disease (GERD) on pH testing and endoscopy, which has led to PPI overuse. We aimed to develop a novel scoring system using demographic factors, clinical factors, and symptoms to predict pathologic GERD. Adult patients with GERD were prospectively enrolled into a Heartburn Center Registry from April 2019 to September 2021. Demographics, patient responses to validated questionnaires, results of endoscopy and pH testing were collected. We selected variables associated with pathologic GERD (P\u00a0&amp;lt;\u20090.10) in bivariable analyses for inclusion in multivariable models to predict pathologic GERD. A total of 365 patients were included. About 199\/365 (33%) of these patients had pathologic GERD based on abnormal pH testing (49.7%) and\/or abnormal esophagogastroduodenoscopy (EGD) (61.3%). Our clinical prediction model included 10 variables and had a sensitivity of 90%, specificity of 56%, and area under the receiver operator characteristic curve (AUROC) 0.77, and was then validated using a separate cohort. The model was then refitted using the expanded criteria for definition of GERD from the new Lyon Consensus 2.0. Four new variables led to improved model performance including history of chronic lung disease, history of asthma, history of gastroparesis and heartburn after meals. This expanded model including 14 variables had a sensitivity of 84.2%, specificity of 71.7%, and AUROC of 0.80, which was then validated in a separate cohort.<\/jats:p>\n               <jats:p>Our novel 10-variable GERD prediction model performs well for estimating risk for pathologic GERD without invasive testing and is potentially a practical clinical screening tool for pathologic GERD.<\/jats:p>","DOI":"10.1093\/dote\/doaf046","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T19:26:22Z","timestamp":1749669982000},"source":"Crossref","is-referenced-by-count":0,"title":["Predictors of gastroesophageal reflux disease revisited: a novel gastroesophageal reflux disease clinical prediction score"],"prefix":"10.1093","volume":"38","author":[{"given":"Lea","family":"Fayad","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions , Baltimore, MD ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ethan","family":"Gough","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Almario","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions , Baltimore, MD ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Dbouk","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions , Baltimore, MD ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth Abou","family":"Diwan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions , Baltimore, MD ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia Irene","family":"Canto","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions , Baltimore, MD ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"issue":"6","key":"2025061115261601300_ref1","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1136\/gutjnl-2012-304269","article-title":"Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review","volume":"63","author":"El-Serag","year":"2014","journal-title":"Gut."},{"issue":"1","key":"2025061115261601300_ref2","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.gtc.2013.11.007","article-title":"Extraesophageal presentations of GERD: where is the science?","volume":"43","author":"Madanick","year":"2014","journal-title":"Gastroenterol Clin North Am"},{"issue":"7","key":"2025061115261601300_ref3","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1136\/gutjnl-2017-314722","article-title":"Modern diagnosis of GERD: the Lyon consensus","volume":"67","author":"Gyawali","year":"2018","journal-title":"Gut."},{"issue":"7","key":"2025061115261601300_ref4","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1136\/gut.2003.033290","article-title":"Gastro-oesophageal reflux monitoring: review and consensus report on detection and definitions of acid, non-acid, and gas reflux","volume":"53","author":"Sifrim","year":"2004","journal-title":"Gut."},{"issue":"8","key":"2025061115261601300_ref5","doi-asserted-by":"crossref","first-page":"1900-20; quiz","DOI":"10.1111\/j.1572-0241.2006.00630.x","article-title":"The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus","volume":"101","author":"Vakil","year":"2006","journal-title":"Am J Gastroenterol"},{"issue":"2","key":"2025061115261601300_ref6","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/dote.12163","article-title":"Systematic review: questionnaires for assessment of gastroesophageal reflux disease","volume":"28","author":"Bolier","year":"2015","journal-title":"Dis Esophagus"},{"issue":"6","key":"2025061115261601300_ref7","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1136\/gut.2009.200063","article-title":"Accuracy of the diagnosis of GORD by questionnaire, physicians and a trial of proton pump inhibitor treatment: the diamond study","volume":"59","author":"Dent","year":"2010","journal-title":"Gut."},{"issue":"2","key":"2025061115261601300_ref8","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00535-011-0480-0","article-title":"Impedance-pH reflux patterns can differentiate non-erosive reflux disease from functional heartburn patients","volume":"47","author":"Savarino","year":"2012","journal-title":"J Gastroenterol"},{"issue":"3","key":"2025061115261601300_ref9","first-page":"217","article-title":"Quality of life scale for gastroesophageal reflux disease","volume":"183","author":"Velanovich","year":"1996","journal-title":"J Am Coll Surg"},{"issue":"2","key":"2025061115261601300_ref10","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/S0892-1997(02)00097-8","article-title":"Validity and reliability of the reflux symptom index (RSI)","volume":"16","author":"Belafsky","year":"2002","journal-title":"J Voice"},{"issue":"4","key":"2025061115261601300_ref11","first-page":"780-6","article-title":"Value of physiologic assessment of foregut symptoms in a surgical practice","volume":"114","author":"Costantini","year":"1993","journal-title":"Surgery."},{"issue":"3","key":"2025061115261601300_ref12","doi-asserted-by":"crossref","first-page":"311","DOI":"10.5056\/jnm20046","article-title":"The Lyon consensus: does it differ from the previous ones?","volume":"26","author":"Ghisa","year":"2020","journal-title":"J Neurogastroenterol Motil"},{"issue":"19","key":"2025061115261601300_ref13","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1002\/(SICI)1097-0258(19971015)16:19<2143::AID-SIM655>3.0.CO;2-3","article-title":"Smooth non-parametric receiver operating characteristic (ROC) curves for continuous diagnostic tests","volume":"16","author":"Zou","year":"1997","journal-title":"Stat Med"},{"key":"2025061115261601300_ref14","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1136\/gutjnl-2023-330616","article-title":"Updates to the modern diagnosis of GERD: Lyon consensus 2.0","volume":"73","author":"Gyawali","year":"2023","journal-title":"Gut."},{"issue":"10","key":"2025061115261601300_ref15","doi-asserted-by":"crossref","first-page":"211","DOI":"10.21037\/atm.2017.04.01","article-title":"Drawing nomograms with R: applications to categorical outcome and survival data","volume":"5","author":"Zhang","year":"2017","journal-title":"Ann Transl Med"},{"issue":"14","key":"2025061115261601300_ref16","doi-asserted-by":"crossref","first-page":"4017","DOI":"10.3748\/wjg.v20.i14.4017","article-title":"Positive predictors for gastroesophageal reflux disease and the therapeutic response to proton-pump inhibitors","volume":"20","author":"Becker","year":"2014","journal-title":"World J Gastroenterol"},{"issue":"12","key":"2025061115261601300_ref17","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/j.cgh.2012.06.030","article-title":"Limited ability of the proton-pump inhibitor test to identify patients with gastroesophageal reflux disease","volume":"10","author":"Bytzer","year":"2012","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"7","key":"2025061115261601300_ref18","doi-asserted-by":"crossref","first-page":"518","DOI":"10.7326\/0003-4819-140-7-200404060-00011","article-title":"Short-term treatment with proton-pump inhibitors as a test for gastroesophageal reflux disease: a meta-analysis of diagnostic test characteristics","volume":"140","author":"Numans","year":"2004","journal-title":"Ann Intern Med"},{"issue":"5","key":"2025061115261601300_ref19","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1185\/030079908X280680","article-title":"Timely confirmation of gastro-esophageal reflux disease via pH monitoring: estimating budget impact on managed care organizations","volume":"24","author":"Lee","year":"2008","journal-title":"Curr Med Res Opin"},{"issue":"12","key":"2025061115261601300_ref20","first-page":"725","article-title":"Update on functional heartburn","volume":"13","author":"Yamasaki","year":"2017","journal-title":"Gastroenterol Hepatol (N Y)"},{"issue":"3","key":"2025061115261601300_ref21","doi-asserted-by":"crossref","first-page":"199","DOI":"10.7326\/0003-4819-143-3-200508020-00006","article-title":"Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications","volume":"143","author":"Hampel","year":"2005","journal-title":"Ann Intern Med"},{"issue":"22","key":"2025061115261601300_ref22","doi-asserted-by":"crossref","first-page":"3332","DOI":"10.3748\/wjg.v10.i22.3332","article-title":"Composite score of reflux symptoms in diagnosis of gastroesophageal reflux disease","volume":"10","author":"Wang","year":"2004","journal-title":"World J Gastroenterol"},{"issue":"10","key":"2025061115261601300_ref23","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1111\/j.1365-2036.2009.04142.x","article-title":"Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care","volume":"30","author":"Jones","year":"2009","journal-title":"Aliment Pharmacol Ther"},{"issue":"5","key":"2025061115261601300_ref24","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1007\/s10278-019-00218-y","article-title":"MDCalc medical calculator app review","volume":"32","author":"Elovic","year":"2019","journal-title":"J Digit Imaging"},{"issue":"1","key":"2025061115261601300_ref25","doi-asserted-by":"crossref","first-page":"27","DOI":"10.14309\/ajg.0000000000001538","article-title":"ACG clinical guideline for the diagnosis and Management of Gastroesophageal Reflux Disease","volume":"117","author":"Katz","year":"2022","journal-title":"Am J Gastroenterol"},{"issue":"4","key":"2025061115261601300_ref26","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1053\/j.gastro.2017.01.031","article-title":"The risks and benefits of long-term use of proton pump inhibitors: expert review and best practice advice from the American Gastroenterological Association","volume":"152","author":"Freedberg","year":"2017","journal-title":"Gastroenterology."},{"issue":"9","key":"2025061115261601300_ref27","doi-asserted-by":"crossref","first-page":"2128","DOI":"10.1111\/j.1572-0241.2006.00723.x","article-title":"The burden of gastrointestinal and liver diseases, 2006","volume":"101","author":"Shaheen","year":"2006","journal-title":"Am J Gastroenterol"}],"container-title":["Diseases of the Esophagus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/38\/3\/doaf046\/63472831\/doaf046.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/38\/3\/doaf046\/63472831\/doaf046.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T19:26:26Z","timestamp":1749669986000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/dote\/article\/doi\/10.1093\/dote\/doaf046\/8160604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,3]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,5,3]]}},"URL":"https:\/\/doi.org\/10.1093\/dote\/doaf046","relation":{},"ISSN":["1120-8694","1442-2050"],"issn-type":[{"type":"print","value":"1120-8694"},{"type":"electronic","value":"1442-2050"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2025,5,3]]},"article-number":"doaf046"}}