Validated COuGH RefleX score can predict likelihood of GERD

The validated Cough, Overweight/Obesity, Globus, Hiatal Hernia, Regurgitation, and Male Sex (COuGH RefluX) score can predict the likelihood of proven gastroesophageal reflux disease (GERD) in patients with chronic laryngeal symptoms, according to a study published online Feb. 1 in Clinical Gastroenterology and Hepatology.

Amanda J. Krause, M.D., from the University of California San Diego in La Jolla, and colleagues conducted a multicenter international study involving adults with chronic laryngeal symptoms who underwent objective testing (upper gastrointestinal endoscopy and/or ambulatory reflux monitoring) between March 2018 and May 2023. A model with optimal receiver operating characteristic curves was identified in the training phase, and β coefficients informed a weighted model. Performance characteristics of the weighted model were assessed in the validation phase. Overall, 304 adults were included in the training cohort and 552 in the validation cohort.

The researchers found that the optimal predictive model was the COuGH RefluX score (area under the curve, 0.68), with a lower and upper threshold of 2.5 and 5.0, respectively, for predicting proven GERD. The COuGH RefluX score had an area under the curve of 0.67 in the validation phase, with sensitivity and specificity of 79 and 81 percent, respectively, for proven GERD.

"The score can be used, in conjunction with other noninvasive testing, to help guide diagnostic strategies to reduce inappropriate protein pump inhibitor use and testing for patients referred for laryngopharyngeal reflex evaluation," the authors write.

Several authors disclosed ties to the pharmaceutical and medical device industries.