{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:55:30Z","timestamp":1792796130132,"version":"4.5.0"},"reference-count":68,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Brief Esophageal Dysphagia Questionnaire (BEDQ) and Eckardt score (ES) are the most used patient\u2010reported outcomes (PROs) for dysphagia. However, their patient\u2010centered cutoffs, minimal important difference (MID), and test\u2013retest reliability have not been established. We aimed to address these gaps and evaluate BEDQ treatment responsiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective multicenter study was conducted in tertiary centers in Spain and Latin America and enrolled adults referred for high\u2010resolution manometry. Three cohorts were derived: the\n                      <jats:italic>cutoff cohort (<\/jats:italic>\n                      subsequently subdivided into a derivation and a validation cohort), the\n                      <jats:italic>test\u2013retest cohort<\/jats:italic>\n                      (consecutive subsample re\u2010administered PROs), and the\n                      <jats:italic>treatment responsiveness cohort<\/jats:italic>\n                      (patients treated for achalasia). Self\u2010perceived severity was evaluated using a 5\u2010point Likert Patient Global Impression of Severity (PGIS) scale and applied as PGIS &lt;\u20092 (No\/Mild symptoms (NMSS)) and \u2265\u20092.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cutoff cohort included 571 patients, subdivided into derivation (397) and validation (174) cohorts. A BEDQ cutoff of &lt;\u20099 and ES &lt;\u20094 optimally predicted NMSS. The validation cohort and bootstrapping confirmed the stability of these cutoffs. MID was 5 points for BEDQ and 1 point for ES, consistent across cohorts. BEDQ showed excellent test\u2013retest reliability (intraclass correlation coefficient\u2009=\u20090.97), significantly higher than ES (0.85). Both PROs showed statistically significant reductions following treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for both), with standardized response means of 2.14 and 1.98 for BEDQ and ES, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BEDQ &lt;\u20099 and ES &lt;\u20094 are clinically meaningful thresholds for identifying patients with NMSS. Changes exceeding 5 points for BEDQ and 1 point for ES represent clinically meaningful differences. BEDQ demonstrates superior psychometric properties compared to ES.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70431","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:11:01Z","timestamp":1789013461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Definition of Clinically Meaningful Thresholds for the Brief Esophageal Dysphagia Questionnaire and Eckardt Score: A Multicenter Psychometric Study"],"prefix":"10.1111","volume":"38","author":[{"given":"Eugenia","family":"Morales","sequence":"first","affiliation":[{"name":"Cl\u00ednica Alemana de Santiago, Facultad de Medicina Cl\u00ednica Alemana Universidad del Desarrollo  Santiago de Chile Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Glasinovic","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Alemana de Santiago, Facultad de Medicina Cl\u00ednica Alemana Universidad del Desarrollo  Santiago de Chile Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Remes\u2010Troche","sequence":"additional","affiliation":[{"name":"Instituto de Investigaciones Medico Biologicas, Universidad Veracruzana  Veracruz Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Garc\u00eda\u2010Zerme\u00f1o","sequence":"additional","affiliation":[{"name":"Instituto de Investigaciones Medico Biologicas, Universidad Veracruzana  Veracruz Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"Garc\u00eda Marmolejo","sequence":"additional","affiliation":[{"name":"Hospital San Ignacio, Pontificia Universidad Javeriana  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albis","family":"Hani","sequence":"additional","affiliation":[{"name":"Hospital San Ignacio, Pontificia Universidad Javeriana  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Ardila\u2010Hani","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Reina Sofia\u2010Keralty  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Ditaranto","sequence":"additional","affiliation":[{"name":"Hospital Universitario, Escuela de Medicina, Fundaci\u00f3n Favaloro  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquin","family":"Agotegaray","sequence":"additional","affiliation":[{"name":"Hospital Universitario, Escuela de Medicina, Fundaci\u00f3n Favaloro  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Bilder","sequence":"additional","affiliation":[{"name":"Hospital Universitario, Escuela de Medicina, Fundaci\u00f3n Favaloro  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Monrroy","sequence":"additional","affiliation":[{"name":"Departamento de Gastroenterolog\u00eda, Facultad de Medicina, Pontificia Universidad Cat\u00f3lica De Chile, Laboratorio de Fisiolog\u00eda Digestiva, UC\u2010Christus Health  Santiago de Chile Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Rey","sequence":"additional","affiliation":[{"name":"Departamento de Gastroenterolog\u00eda, Facultad de Medicina, Pontificia Universidad Cat\u00f3lica De Chile, Laboratorio de Fisiolog\u00eda Digestiva, UC\u2010Christus Health  Santiago de Chile Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Ignacio","family":"Gran","sequence":"additional","affiliation":[{"name":"Departamento de Gastroenterolog\u00eda, Facultad de Medicina, Pontificia Universidad Cat\u00f3lica De Chile, Laboratorio de Fisiolog\u00eda Digestiva, UC\u2010Christus Health  Santiago de Chile Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Serra","sequence":"additional","affiliation":[{"name":"Digestive System Research Unit University Hospital Vall d'Hebron  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis G.","family":"Alcal\u00e1\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Digestive System Research Unit University Hospital Vall d'Hebron  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Barber\u2010Caselles","sequence":"additional","affiliation":[{"name":"Digestive System Research Unit University Hospital Vall d'Hebron  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dustin A.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Kenneth C. Griffin Esophageal Center of Northwestern Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Cisternas","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Alemana de Santiago, Facultad de Medicina Cl\u00ednica Alemana Universidad del Desarrollo  Santiago de Chile Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12467"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-017-9844-9"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31829b1d84"},{"key":"e_1_2_9_5_1","first-page":"336","article-title":"Assessing Symptoms, Disease Severity, and Quality of Life in the Clinical Context: A Theoretical Framework","volume":"10","author":"Finlayson T. L.","year":"2004","journal-title":"American Journal of Managed Care"},{"key":"e_1_2_9_6_1","first-page":"221","article-title":"Application of Severity Measurement Systems for Hospital Quality Measurement","volume":"35","author":"Thomas J. W.","year":"1990","journal-title":"Hospital & Health Services Administration"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14058"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp070364"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/dow028"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-021-10283-7"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-4-79"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91428-7"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1010502"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13297"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13221"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.10.011"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13287"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13827"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12889"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14025"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-021-10290-8"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13760-020-01563-4"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000536"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12941"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14321"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2022.12.040"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13725"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm20229"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doaa080"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0698"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm14014"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04142.x"},{"key":"e_1_2_9_33_1","volume-title":"ECDEU Assessment Manual for Psychopharmacology","author":"Guy W.","year":"1976"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-10-80"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1714"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c2921"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002924"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14120"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.184.2.01840364"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E"},{"key":"e_1_2_9_41_1","unstructured":"R Core Team R: A Language and Environment for Statistical Computing(R Foundation for Statistical Computing 2024)."},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1081\/COPD-200050663"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211053869"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-024-03610-6"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.03.012"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.4065\/77.4.371"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1586\/erp.11.12"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"e_1_2_9_49_1","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J.","year":"1988"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2006.03.012"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.11.019"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-016-4373-1"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.10"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-021-00831-4"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-012-2463-2"},{"key":"e_1_2_9_56_1","volume-title":"Attachment to Discussion Document for Patient\u2010Focused Drug Development Public Workshop on Guidance 3: Select, Develop or Modify Fit\u2010for\u2010Purpose Clinical Outcome Assessments\u2014Appendices","author":"Food US","year":"2018"},{"key":"e_1_2_9_57_1","volume-title":"Guidance for Industry: Patient\u2010Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims","author":"Food US","year":"2009"},{"key":"e_1_2_9_58_1","volume-title":"Patient\u2010Focused Drug Development: Selecting, Developing, or Modifying Fit\u2010for\u2010Purpose Clinical Outcome Assessments. Guidance for Industry, Food and Drug Administration Staff, and Other Stakeholders","author":"Food US","year":"2025"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-022-03180-5"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-020-01246-7"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.1997.142318000.x"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1905380"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/0471722146"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e318189a7f9"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16561"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.31887\/DCNS.2014.16.2\/mbullinger"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2007.096032"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14228"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-024-01063-x"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70431","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nmo.70431","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70431","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:23:08Z","timestamp":1790659388000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.70431"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":68,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/nmo.70431"],"URL":"https:\/\/doi.org\/10.1111\/nmo.70431","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-04-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70431"}}